What I never understood is why in these days we are not able to have a product that would be spread on the teeth (let's say a yearly application) to protect them from most of the major aggressions.
Each time I had a tooth "cured" (i.e. drilled), this "cure" weakened the structure of the tooth so much that it broke with a period of 6 to 24 months. And once the inside was removed with drilling and the outside has broken, what's left? Nothing: goodbye tooth, hello hole.
I am pretty sure that they would have lasted longer if they had not been cured (supposing I could stand the occasional pain, but in half of the cases, pain was not even about to start, a tiny decay was just detected by visual inspection). But now, I have to plan to start eating more soup soon.
> Each time I had a tooth "cured" (i.e. drilled), this "cure" weakened the structure of the tooth so much that it broke with a period of 6 to 24 months.
The article's points aside, there is something seriously wrong here. For contrast, my newest filling is over fifteen years old and all are still going strong. Drilling is still highly problematic, but shouldn't be directly responsible for your teeth crumbling in such a short time frame. Various other conditions can weaken teeth and make them more susceptible to damage.
> What I never understood is why in these days we are not able to have a product that would be spread on the teeth (let's say a yearly application) to protect them from most of the major aggressions.
If I understand what you're talking about, this is already a thing, and not particularly new either. Lasts much longer than a year too.
I have dental sealants but my insurance doesn't cover them because they're considered unnecessary, so I pay out of pocket to get them renewed every once in awhile. Maybe patients are reluctant to do that.
In Germany you can get sealant applied once a year or so as part of standard health care until 18 years of age. IIRC each application takes about 15 minutes at the dentist and one hour of no eating or drinking afterwards.
I had this done during youth, never had it reapplied since, and so far, now heading towards my mid-thirties, never had an issue with my teeth. And, of course, I regularly brush my teeth about once or twice a day.
My dentist checks once a year to see how far the sealant has worn off. I could get it reapplied if necessary but not for free this time. I'll strongly consider paying up though when faced with the choice since this treatment worked out very well for me.
Really? I'm in the USA hear and I have sealants, but have never noticed any difference in feel compared to before (I had them applied in my teens). It sounds like yours were put on REALLY thick. Mine were only put into the indents of my back teeth, so maybe that is the difference?
Typically sealants are applied to the permanent molars of children, and remain in place at least through young adulthood. Apparently there are some risks involved with old sealants. My dentist blamed a partially-eroded sealant for a cavity I got in my thirties.
The crown may last forever, but the underlying tooth may not. I've had several crowns replaced over the last few years as the tooth underneath gets slightly exposed and a cavity forms. The only thing that seems durable is implants, and those are pricey.
Sealants are generally applied on adult molars and premolars as a child. If you've not had cavities before there generally is no point in having sealants.
For the shadier dentists (and they exist), sealants don't bring in as much money as a root canal.
For everyone else, it doesn't help with cavities between the teeth where a lot of people get cavities. The sealants just sit on the upper side of the tooth.
It's not just about pain, a cavity that hits the root can wind up killing you. Significant amounts of bacteria can make their way directly into your bloodstream and to your heart or brain, and you're done.
It's not quite that simple. Bacteria invades the body all the time via poor gum health. It rarely leads to sudden blood poisoning that is fatal. Most often, bacteria form mass of blood vessel bound "goop" that cause scarring of the blood vessel that can lead to anything from blood clots to aneurysm. It's true the finding about how bad gum health can lead to these diseases is only about 5 years old. It was expected before but now there is good proof related to it.
> Each time I had a tooth "cured" (i.e. drilled), this "cure" weakened the structure of the tooth so much that it broke with a period of 6 to 24 months. And once the inside was removed with drilling and the outside has broken, what's left? Nothing: goodbye tooth, hello hole.
I went to a few different dentists a few years ago, and they all said I needed a crown. This was not in my budget, so I went to my grandparent's long-term dentist, who they'd been going to since the 1960's. He was 80+ years old, and was happy to use his tools to sand down my old prosthetic tooth.
He was a cheery old fellow, who still practiced dentistry to take care of his long-term patients who didn't want to go anywhere else. And he gave me the best advice for picking a dentist that I've ever heard:
1. Make sure your dentist's drill is water-cooled - that it sprays water on the tooth that's being drilled. Tooth nerves that get heated die, and then you need more dental work...
2. Never go to a dentist who hasn't been out of school at least 10 years, because young dentists tend to have loans to pay off, and they have an incentive to sell you dental work that you might not really need.
My brother told me about how he got hit with a dental up-sell once. His new dentist told him that he had "micro-cavities" that needed to be filled. My brother was like, "huh? They don't bother me..." But he went along with what the professional recommended. Did he really need that extra work? He doesn't know... But now he has micro-fillings that will probably fall out some day.
I broke my tooth at the lake when I was 12, and have had a prosthetic tooth ever since. I broke the prosthetic tooth off one evening, had it glued back on by a dentist. With the layer of glue, it was just slightly too long, and it started to hit on my other teeth.
The nerves in your teeth shrink as you age. The difference between the nerve size of my root canal'd tooth and its neighbor is incredible. (Did I really need that root canal? My parents could afford it, it was what the professionals recommended, so it's what I got. A friend of mine had a very similar break in the same tooth, but her parents couldn't afford a root canal, she never got it, and still has a nerve on her capped' tooth.)
Your advice is odd. There are high speed and slow speed handpieces. Slow speed handpieces are not water cooled and the RPMs do not get high enough to do damage to the nerve. High speed handpieces can damage the nerve and are always water cooled (at least if you buy them these days in America).
You're opinion on not going to a dentist who has graduated in the last few years is amusing. In America, most dentist get paid on either production or collection. Payment based on production is getting paid a percentage based on the treatments you bill the patient for, while collection is getting paid a percentage on what you actually collect (which is generally lower because of insurance, etc). Also, If a dentist just bought into a practice or bought an existing practice, that dentist has anywhere from 200K-1MM in loans. This likely outweighs whatever they might have paid for dental school. Because of this, almost all dentists are incentivized to "sell you dental work you might not really need." However, there are good dentists and bad dentists as there are in all professions. As with your primary care physician, it's best to build a relationship over many years with somebody you know and trust.
I'd also like to point out that dentistry, like computers, changes. New materials and techniques are invented all the time. In the dental profession, continuing education is required, but there is a lot of flexibility and most of it is just showing up to the class. This means recent graduates have less experience, but they might have improved technique and more recent technical knowledge.
I can't speak to your personal anecdotes, but I've met a lot of bad dentists too. I don't yet have a good filter for determining a good dentist or a bad dentist.
(Disclosure: Take this for what it is worth. My wife graduated from a top dental school and I know a huge number of dentists. )
Do you have any pointers at all on picking a dentist? I'm currently trying to find one, and aside from Yelp (not very helpful) I have no way to make heads or tails of anyone...
In general, I would talk to family and friends and get a recommendation on a personable dentist that will actually take time with you. Word of mouth is really your best bet.
I would try and stay away from larger practices where a dentist owns multiple offices. Not that there is anything wrong with multiple practices, but it's a broad filter for getting rid of dentists who are overly profit focused.
I would only go to a dentist that thinks amalgam is perfectly safe to use. Largely because there is no science to support otherwise and removing amalgam fillings actually releases more mercury. I like medical providers to believe strongly in science.
In many states you can look a dentist up with the state dental board and see if any action has been taken against the dentist by the board. For example, North Carolina's can be found here: http://www.ncdentalboard.org/license_verification.htm and you can also find out if they've ever had their license suspended.
Here's a slight hack that involves a little effort: call up the dental offices in your area and ask them who covers the dentist's emergencies when they are out of town.
This should give you an idea of who is respected among the dentists themselves.
>What I never understood is why in these days we are not able to have a product that would be spread on the teeth (let's say a yearly application) to protect them from most of the major aggressions.
That's a sealant, which is something we do have. I've had a few of my biting surfaces sealed, and it seems to have cut down on the number of cavities. Just once, though, not every year.
It can depend, though of course genetics are probably a factor. I had sealant applied when I was a teenager, but never since. I'm now 38; still - at least, as of my last dentist visit a couple of months ago - no fillings.
Each time I had a tooth "cured" (i.e. drilled), this "cure" weakened the structure of the tooth so much that it broke with a period of 6 to 24 months. And once the inside was removed with drilling and the outside has broken, what's left? Nothing: goodbye tooth, hello hole.
I am pretty sure that they would have lasted longer if they had not been cured (supposing I could stand the occasional pain, but in half of the cases, pain was not even about to start, a tiny decay was just detected by visual inspection). But now, I have to plan to start eating more soup soon.