Why does one dentist tell me I have 8 cavities, while another says I have none?

incipient caries (4)

Before we begin, I’ll say that by using an electric toothbrush, the likelihood of both dentists telling you that you have 0 cavities will probably increase. I prefer either Sonicare or Oral B!

I’ve heard several frustrated people tell me that they didn’t trust a dentist because after being told they had several cavities, they’d visit another dentist who would tell them they didn’t have a single one. I wanted to write a short article explaining this situation.

The first thing you need to know is that neither dentist is necessarily wrong. The reason they give you 2 different diagnoses is often due to a form of caries called incipient decay. Incipient decay is a form of decay where the minerals in your tooth have been weakened by acidic bacterial residues, however the weakened minerals have not yet cavitated or extended past your enamel into the second layer of your tooth, the dentin. (See image on the left).

The differing diagnoses between dentists come because there is a window of progression where, with proper care, the tooth may remineralize. However, visual examination and x-rays are often not enough to give a definite answer as to whether or not the decay is still within the window of remineralization. One dentist may decide that it is within the window, while another could look at the x-ray and believe that the decay has penetrated the dentin.

After determining that the decay has not yet passed through the enamel into the dentin, a dentist may simply treat the decay with fluoride and sealant, and note the incipient decay on his charts for monitoring. The tooth will often remineralize in this situation. The advantage to this approach is that you may avoid having to have a tooth drilled and filled. The disadvantage is that if the tooth doesn’t remineralize, the decay will spread and the dentist will have to drill away more tooth structure than he would have originally, had he drilled out instead of hoping for remineralization. This one disadvantage, however, may take years to come to fruition.

If a dentist determines that the decay has passed into your dentin, he will elect to drill it out and fill it in order to avoid the risk of the caries spreading deeper into your tooth.

Without drilling into the tooth, it can be extremely difficult to determine whether or not the decay has reached the dentin. This further explains why you may get slightly differing diagnoses from one dentist to another. Any time a dentist recommends remineralization, it is crucial that he monitors the incipient decay very closely. This means that you are going to the dentist every 6 months so he can make sure that your tooth is not being destroyed.

Whether or not your tooth decay needs to be drilled, your dentist should be communicating with you and explaining his diagnosis as well as your treatment options. If you ever have a question or are confused about your diagnosis, don’t be afraid to ask your dentist what’s going on. If you are informed on your treatment it will be much easier to trust your dentist and maintain a positive relationship with your dentist and his office.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How Baking Soda Works to Whiten Teeth

bakingsodadrawI’m sure you’ve heard it before. “Baking Soda could whiten your teeth up to 10 shades!” But just how effective is baking soda at whitening your teeth? That depends largely on how stained your teeth are.

Baking Soda works as an effective tooth whitener due to it’s abrasive qualities. It is most effective in fighting stains caused by substances such as coffee, tee, soda, and tobacco. If overused, it’s abrasive qualities can cause damage to the outer layer (enamel) of your teeth. Because of this risk, you should not brush with baking soda more than twice in a week.

There are several effective ways to brush with baking soda, but one should always use toothpaste afterwards because baking soda alone will not kill any bacteria in your mouth. The easiest way to brush with baking soda is to wet all the bristles of your toothbrush and then just dip it in some baking soda. Brush for 2 minutes, then rinse and brush with toothpaste like normal. Alternatively, you can mix baking soda into your regular toothpaste and kill 2 birds with one stone. Some people prefer a mixture of hydrogen peroxide with baking soda. Hydrogen peroxide is a very effective mouthwash and also helps with tooth whitening, but heads up, it tastes pretty gnarly.

Baking Soda can definitely be effective in whitening your teeth, but use it with caution to avoid irreversible damage.

One other method that can sometimes be quiteful in whitening teeth is simply switching to an electric toothbrush. Check out Sonicare Vs Oral B to see a comparison of some of my favorites!

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How Local Anesthesia Works at the Dentist

7c3f6db8a1b5cba94fd67ca900e0dd6e.jpgYour mouth has tons of nerves running all through it. Based on what your dentist needs to do, he will target specific nerves in your mouth with a local anesthetic. Novocain used to be the standard, but it hasn’t been used for many years. The most common anesthetic today is called lidocaine.

Local anesthetic is used to block sensation in the area of the mouth where the dentist is working so that he can drill out your cavities without causing much pain. Many targeted nerves where local anesthetic is used will also cause temporary muscle paralysis, which is why you may have a crooked smile after getting a cavity filled.

In order to feel pain, your body sends sodium into your nerves, which then send a message to your brain, telling it there is damage to those nerves. Local anesthetics act by blocking the channels that sodium typically travels through, thus temporarily inhibiting your ability to feel pain in those nerves.

After injection, the anesthetic is slowly absorbed and eventually cleared out of your system after just a couple hours, when your feeling and muscles return to normal function.

Many years ago, cocaine was one of the most commonly used local anesthetics. This practice was stopped as soon as we learned about the addictive qualities of cocaine. The local anesthetics that are used today have similar qualities to cocaine, minus the addictiveness. That is why they typically end in “-caine”, as is the case with lidocaine.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

Same Day Crowns! – How They Work

ADG-Aurora-Dentist-Cerec-UnitThe machine you see in this picture is called a CEREC machine. It is a very, very expensive machine that allows dentists to do a permanent crown restoration right in their office, so that you don’t have to wait 2 weeks for your crown to be created in the lab. The machine uses extremely advanced imaging technology. Your dentist will use a versatile camera inside your mouth to take many pictures of your tooth after he has drilled away the decayed structure.

Using computer software and his knowledge of dental anatomy, your dentist will digitally recreate your original tooth. Once finished, he simple clicks the “print” button. This sends a message to the mill portion of the machine, which takes two dental burs, or drill bits, and literally carves a brand new tooth for you right in front of your eyes. It’s an amazing machine, creating an absolute masterpiece every time. If you’ve never witnessed this, ask your dentist if you can watch it next time you find yourself in his office. It’s an impressive spectacle!

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

Dental Impressions

4536402876_50d1e5ae1c_zDental impressions are used for many different procedures, including crowns, inlays, onlays, and braces. A dental impressions can give a nearly identical replica of your teeth in a variety of forms. Depending on what the impression will be used for, your dentist has a variety of options to use to create the impression.

For example, if you are getting a crown, your dentist will use the impression material for your temporary crown, and then send another impression to the lab for your permanent crown to be developed, except in the case that your dentist has a CEREC or similar machine to do your permanent crown in office. You can learn more about these machines by clicking here.

Dental impressions are a valuable tool which enables your dentist to create a more accurate representation of your original tooth structure when preparing any number of restorations inside your mouth.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

What is Scaling and Root Planing?

root-scaling-and-planing-njScaling and root planing are known as periodontal treatment. Periodontal literally means around the teeth. So your periodontia includes all of the structures surrounding your teeth, especially your gingiva, or gums, and your bone. Poor periodontal health is actually strongly linked to heart disease, so the benefits of periodontal health go far beyond aesthetics and hygiene.

Plaque tends to build up below your gum line, around the roots and the basest portion of your crowns. If left untreated, this sub gingival plaque could spread to the bone, destroying both your tooth and the bone holding it in place. Scaling and root planing are a technique used to clean below that gum line. A trained dental hygienist will run a special tool along the root and base of your crown, scraping away the plaque and calculus buildup, keeping your tooth structure clean and healthy.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How a Cavity Filling Works

cavityWhen you eat sugar, the bacteria in your mouth turn that sugar into acid, which then eats away at your tooth structure. This weakens the integrity of your tooth structure, causing pain and impaired function. In order to rectify this problem, you need to replace the acid-eaten tooth structure with an artificial replacement material.

The replacement takes place in a two-step process. The first step is called the preparation. In this step your dentist will take his drill to remove all compromised tooth structure and shape the remaining structure in a way which will help it to hold on to the artificial material that will be added in the second step.

The second step is called the restoration. There are 2 types of restorations. The first, a direct restoration, is done directly on your tooth surface while you sit in the dental chair. He’ll add a malleable composite material and use various tools to shape it and make it nearly identical to the original tooth structure. This restoration is typically used when only a small portion of your tooth structure has been eaten away by the acid in your mouth.

The second type is called an indirect restoration, most often used when there is more extensive damage to the tooth structure. The dentist takes an impression or a mold of your teeth before drilling. The mold is then used to create an identical replacement structure after the decayed tooth material has been drilled away. This type of restoration is most commonly used with dental crowns.

Remember, by using an electric toothbrush (Sonicare, or Oral B, for example) you may avoid having to get any cavity fillings!

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How A Veneer Works

prep_empress_vVeneers are most often used as a cosmetic form of dentistry, used to make your tooth look more aesthetically pleasing. It may also be used to protect your tooth surface from damage. When doing a veneer, your dentist will look at your teeth and find the material and shade that will best match and provide the most appealing outcome.

Your dentist will shave about .75mm from the facial, or outer surface of your tooth. Once that is shaved off he will then add a composite material as described above. While the new material does a great job protecting the underlying structure as well as possibly making your tooth more aesthetically pleasing, original tooth structure is usually the best option as long as it hasn’t been eaten away by tooth decay.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How a Dental Inlay/Onlay Works

onlay1This type of restoration is similar to a crown. The main difference is that an inlay or onlay is used to preserve as much of your original tooth structure as possible.

These inlays or onlays are typically a very strong, aesthetically pleasing restoration. When tooth decay has taken excessive tooth structure, including at least one cusp, your dentist may consider an inlay or onlay instead of a traditional filling. The main difference between these two options is that a traditional filling is done in the office by adding a composite material to be used as artificial tooth structure, while an inlay or only is usually done in a lab outside the dental office. Typically, you will be given a temporary restoration while the lab completes your final inlay/onlay.

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com

How Cavities Progress

the-dentist-fort-lauderdaleTooth decay usually starts out on the outer layer of enamel in your teeth. The longer you let it sit there, the more it progresses through the tooth. After eating it’s way through your tooth enamel, the decay reaches your dentin, which is softer than enamel. If the decay continues, it will eventually reach your pulp, where nerves and blood vessels are found.

Once it reaches the pulp, you have to get a root canal. If you don’t, the decay could spread to your bone and other teeth in your mouth. This is why it is so important that you visit the dentist at least twice a year. Many times you have tooth decay that is difficult to detect without the proper tools and knowledge found in your local dentist office. Visiting your dentist twice a year helps ensure that you will not need extensive dental work.

Remember, by using an electric toothbrush (Sonicare, or Oral B, for example) you may avoid having to get any cavity fillings!

Got a dentistry related question? Email us with your question and we’ll build a post just for you, giving a simple, easy to understand explanation. Click here to see basic explanations for many other dental procedures and practices.

Jake the Dentist: brushflossandmouthwash@gmail.com