MyEggsAreCooked: FREE DENTAL ADVISE

Tuesday, August 31, 2004

FREE DENTAL ADVISE

I have worked as a dental hygienist for 18 years in po dunk South Carolina, glitsy Beverly Hills, celebrity filled Malibu and now for a periodontist (gum surgeon). I am an Extended Functions Dental Hygienist which means I give injections, nitrous oxide (laughing gas) and anesthesia.

These are 50 things you should know about gum disease:

:: 85% of all of you reading this have, or will have, gum disease - 85%!

:: Plaque looks like tons of BUGS under the microscope

:: Your gums do not get inflamed around nothing

:: Your gums bleed or are puffy because of plaque

:: Plaque calcifies after 2 weeks and turns into little bits of cement called tartar (calculus)

:: It takes a professional cleaning (sharp tools) to get calculus off of your teeth and away from your gums

:: Plaque is NOT food

:: Plaque is bacteria in your saliva that clumps together

:: Plaque is anaerobic bacteria - meaning it likes to be away from oxygen

:: Plaque loves to go deep under the gums

:: Especially under the papilla (pointed tissue between teeth)

:: Your gums get puffy and bleed within 2-3 days of plaque not being removed

:: Bone holds your teeth in your mouth and jaw

:: After 3 months of inflammation, your bone begins to break down around your teeth

:: Most people should get their teeth cleaned every 3 months

:: Your dental insurance company could give a shit about the 3 month scientific fact

:: A toothpaste company in 1903 came up with the saying "see your dentist twice a year"

:: Most people have millimeters of bone loss every 6 months after 30 years of age

:: Years of this break down lead to loose teeth and tooth loss

:: Inflammation in your mouth drags on your entire immune system

:: Hormonal changes (pregnancy, puberty, menopause, hormone treatments) can cause your gums to react more violently against the bacteria in plaque

:: The more you massage your gums, the healthier they will be

:: When you floss, floss deep - up each side of the pointed tissue between your teeth

:: Most people don't floss

:: Most people who do floss, floss incorrectly

:: Most dental hygienists are nags

:: Most dental hygienists are lazy

:: It takes a good hygienist an hour to clean MY teeth

:: If you are getting your teeth cleaned in 30 minutes, you are getting a sucky job !

:: Most dentists do sucky work

:: Pregnancy gingivitis is very common

:: Gingivitis is related to heart disease

:: Bleeding is the first sign of gum disease

:: Most people ignore the bleeding and think it is normal

:: Most people don't brush the necks of their teeth at the gumline

:: Only use a soft bristle toothbrush

:: A medium or hard bristle toothbrush is too hard for your gumline and roots

:: Sonicare toothbrushes are awesome

:: Sonicare toothbrushes penetrate 4-5 mm beyond a regular toothbrush

:: Most people don't use a Sonicare correctly

:: Hold the Sonicare at the gumline with light pressure and do NOT brush back and forth

:: Hold the Sonicare still for a few seconds and then move it, hold it, move it etc...

:: Most people brush their teeth WAY too fast

:: Dentures are uncomfortable

:: People who wear dentures are uncomfortable every day of their lives

:: Dentures make it difficult to eat most foods and affect digestion and thus health

:: Molars have three roots, anterior teeth have one root

:: Molars generally have deeper pockets (bone loss)

:: People lose their back teeth first

:: The canines (eye teeth) are usually the last to go - they have one root and long roots

:: Tartar forms fastest on the bottom front teeth because of a duct under the tongue

:: Bacteria is rampant in your bloodstream after a teeth cleaning appointment (prophy)

:: If you have a heart murmur, you need to take antibiotics one HOUR before you get your teeth cleaned - you could DIE

:: I (hygienists) do not care more about your teeth than you do

:: It is amazing how many patients have an attitude

:: Tooth whitening (Bleach) is awesome

:: Dental tooth whitening bleach - NOT CLOROX

:: Active ingredient is hydrogen peroxide and is strongest strength in dental offices

:: Crest white strips suck

:: Dental office bleach trays and bleach are much more cost effective than over-the-counter whitening

:: Most people bleach their teeth incorrectly

:: Do not bleach back teeth or at gumline (can cause severe sensitivity)

:: I touch up my teeth with my whitening trays (that are 4 years old) every 3 months

:: My teeth look awesome

:: A good teeth cleaning is like a good facial

:: A good hygienist should be thorough and gentle

:: Most hygienists are hacks (did I say that already?)

:: Most dentists do sucky work (did I say that already?)

:: I am NOT a dental assistant..........I SUCK as a dental assistant

:: Dental Hygienists have their own rooms with their own scheduled patients

:: HEALTHY GUMS ............DO NOT BLEED!

:: IF YOUR GUMS BLEED, CLEAN THEM BETTER THAN EVER

:: BLEEDING TELLS YOU WHERE THE BACTERIA IS

:: I have seen miracle healing when patients clean their teeth properly

:: You could save thousands of dollars by taking care of your gums and teeth

I don't know if this is 50 things everyone should know. I don't have the patience to count. If anyone has questions, I will answer brutally, and honestly.

posted by Julianna · 8/31/2004

32 Comments:

At 9:40 PM,

Anonymous said...
my gums are tender when I brush and have been bleeding a little bit BUT I have a huge pimple looking thing high on my gum. Should I pop it?

At 10:36 PM,

Julianna said...
are you kidding me? Okay.

You have an abscess.

Most likely a root abscess. You need to see your dentist ASAP. You may need a root canal.

At 11:41 AM,

Stacy said...
Does dipping the floss in H2O2 help kill the bacteria? How about rinising with it?

Thanks for the info. You got me motivated!

At 5:59 PM,

Julianna said...
Hi Ladies!

Amanda - I don't blame you for being aggravated with your dentist. You ask a tough question. Most people love their dentist so asking for word of mouth is not accurate. Unfortunately, most dentists SUCK. Restorations should be invisible. My crowns, fillings and veneers look exactly like my other teeth. Most fillings and crowns are noticable. Poor margins on fillings and crowns lead to decay and gum disease and are actually the CAUSE of tooth loss. Sorry I am rambling but it just kills me! If I were looking for a new dentist and had an insurance list I would ask:
1. How long do they allow for cleaning appointments (I have never seen a good dentist who allows less than an hour)
2. I would like to know the age of the dentist. Dentists recently out of school tend to do better work. They could not have passed their boards with sucky crowns or fillings so hopefully they are still in perfection mode.
3. Be leery of an office that expects you to get x-rays, cleaning and an exam in one prophy appointment - I've seen dentists expect a hygienist to do all of that in 45 minutes. The full hour should be for the cleaning. The dentist should have you in HIS chair and take his time with you. Too many times the dentist charges out $50.00 or more for an "exam" when they only spent two minutes with you in the hygiene room.
4. I would ask if they take a panorex or FMX (individual full mouth x-rays) A panorex whips around your head and takes a few seconds and is terrible for diagnosing cavities. They get paid the same and most dentists who take a panorex instead of the more time involved FMX usually are $ motivated. An oral surgeon or orthodontist needs the panorex. A general dentist should take an FMX.
5. I would not do anything until you are done with your hormone ordeal. It is amazing how much bacteria is in the mouth after a prophy. A lot of physicians do not want women in the first trimester to get a prophy.
6. If your gums bleed or get puffy, just brush them well and that will help toughen them up until you can get the tartar removed.

Good luck to you!!

Stacy - I do not like hydrogen peroxide rinses. It kills bad bacteria but also kills the good bacteria. It messes up the bacterial balance in the mouth. If you have inflammation and use hydrogen peroxide for a few days it won't hurt you but listerine is just as good or better. Listerine is also good to use every day and will not mess with the bacterial balance in the mouth. Your mouth is the beginning of digestion so there are so many enzymes and bacteria that are necessary and important for general health.

Just removing the plaque with floss kills it. Plaque does not go somewhere else and reattach so you don't need an 'extra killer'. You can have a toothpick and get plaque from under the gums between the teeth. If you angle a toothpick towards the roots, it will go 3+ mm and deeper as you go to the back teeth. If you don't massage there regularly, you will see tons of bleeding. You can take that same toothpick with the blood and gunk and go around your entire mouth. You will have done amazing things for dirsupting all of that hidden bacteria. So using a toothpick or rubber tip or proxabrush as deep as it will go between your teeth is better than your brush, floss, hydrogen peroxide or listerine.

Orodemniades: That is great you are getting a root canal! If you arn't in pain, it sounds like you have a great dentist who caught your infection before YOU did (swollen and in pain - usually on a weekend). I'm sure you will be fine. Since you've already had a root canal on that tooth, you may not even need to get an injection. It is not so uncommon that an old root canal needs more work years later. Sorry, I digress!
I love it that you want a SOFT brush. Most people want hard and harder. Unfortunately, electric toothbrush bristles are firmer by the nature of the beast. Try to hold it much more gently than you would your regular brush. Good luck with the root canal!

At 7:17 PM,

Anonymous said...
Hi. Great Post.

1. How do I choose a competent orthodontist(I need to get braces)? I am new in a city(Baltimore) and don't know anyone. I tried 1800-dentists, but they are pigs.

2. Do childeren with baby teeth need braces?

3. Sometimes I use my fingernail to scrape some tartar off my teeth. Is this harmful?

At 7:49 PM,

Julianna said...
Hi Anonymous!

You are fucking funny! Excuse my language. It is not very professional.

Okay.....um hum. ...clearing my throat......um hum huummm....

1. Being in a new city and choosing any kind of professional is difficult. With orthodontics, you are looking at a commitment of years. If it were me, I would go for the younger orthodontist. They seem to still have some ethics. Also, ask if they have "invisilign"....that would make me think they are on top of things. I have an "invisilign" and love it! I am not sure of the spelling however.

2. I auditioned for a commercial for 1-800-DENTIST (I used to do some acting in LA) and you are right! They are ridiculous. Desperate dentists pay to get patients because they can't get patients any other way. Be very leary.. Very very leary of 1-800-DENTIST people. It was down to me and the brunette bitch who had that gig for many years. I hate them.

2. Another "2" because the first "2" was all about me...me .......me. You asked about children with baby teeth....12 year olds still have baby teeth so then the answer would be yes. I assume you were being cute and meant a younger child with full deciduous (baby) teeth
-............just in case you missed it........I was trying to impress you with "deciduous"....it's a good scrabble word.......ANYWAY.........um.....hum...a child with only deciduous teeth can get orthodonic appliances such as one that stretches the hard palate or makes room for spaces for permanent teeth.

3. Scrape away my friend! Tartar forms fastest on the lingual of the bottom front teeth (tongue side), it is like cement and if you hook your fingernail under the chunk you can pop it off. Just like I do with sharp instruments. Better yet, get a toothpick or tweezers. Don't tell anyone I told you that though!!

Good luck to you!

At 8:20 AM,

Anonymous said...
My gums weren't bleeding before but NOW they are bleeding like a mother fucker. I angled a tooth pick like you said and my gums were bleeding like crazy. What to do now?

At 10:40 AM,

Julianna said...
Hi Anonymous!

Your gums are bleeding like a mother fucker?

I'd love to really say that to a patient: "Do you have any changes in your medical history and have you noticed your gums bleeding like a mother fucker lately? sorry.......I digress.

Your gums are bleeding like a mother fucker because you don't clean there and that bacteria that you finally disrupted has been festering for God only knows how long.

Your toothbrush, not even floss, can get into the pockets like you were doing. If you could look at what you were disrupting under a microscope you'd wonder how you even have teeth. It is amazing how your body tries to resist all of the bacteria. It puts a toll on you though because of sending white blood cells trying to fight the bacteria.

Congratulations, you were actually doing the toothpick thing correctly and you haven't been able to get that bacteria until now. Most people don't angle a toothpick, rubber tip, or proxabrush 45 degrees to go deep.

Ideally, a good cleaning would get all of the tartar and plaque out of the pockets but you would still need to massage there to get it healthy. It takes a good 10 days for your gums to get healthy (pale, pink, tight gums).

Imagine if you had an inflammed place on your arm. You could get it cleaned but it would still be puffy. Same in your mouth.

Now, you have to trust me here. Do your toothpick again tomorrow and then the next day. In 3 days you will notice a huge difference in the amount of bleeding and tenderness. Even if you have tartar there (tartar is like cement so you won't be able to remove the tartar under the gums in your pockets) BUT you can massage them.

Your gums have been like mush in your pockets where you couldn't see or brush. Now you are in the little caves between the teeth.

I only mentioned a toothpick earlier because that is something most people have in their homes. You may want to go buy a rubber tip or proxabrush. They are softer and also have handles that allow you to clean the tongue side of the pockets also. You can't get a toothpick on the inside of your molars in the pockets.

Good luck!

At 8:05 PM,

Anonymous said...
Thank you Julianna! I trust you and will let you know if they get better.

At 8:09 PM,

Anonymous said...
Hi, it's me again (the baby teeth poster). Thanks for the advice, I will definitely go for the younger ortho. I now have a non-dental problem, however. After realizing how disgusting the human mouth is, I cannot bear to rub my tongue in another person's mouth. This is bad, because kissing usually leads to sex.

Any advice?

At 8:42 PM,

Julianna said...
Hi baby tooth anonymous!

Okay. You can live your life like Howard Hughes - the more he learned about germs, the more of a recluse he became or you can just throw your legs in the air and say "fuck it".

At 2:31 PM,

Mare said...
Oh sweet Jesus gay- I started scraping away while I was reading this- and I started bleeding like a motherfucker too. Which makes my beer taste nasty. Clearly, we have some work to do.

I love the fact that you are the person in charge of the laughing gas. If I had to have laughing gas, I would definitely want you to be dealing with it.

At 6:43 PM,

Anonymous said...
juliana, i have a question. i hope you can help. i am in need of some braces but i am only in a city for the next nine months-- but i'm told it will take a year to fix. if i move away in the middle of the braces, can i still get them adjusted by another dentist in another city?

At 8:12 PM,

Julianna said...
Hi Anonymous!

All these anonymous' are getting confusing. Can you just make up a name at the end of your post? Thank you.

I get posts via email so I can see when someone posts a question. As long as it doesn't get too ridiculous I will do all I can for sake of teeth and gums!

I am the plaque avenger!!

Okay. I need to calm down. Been a bit down today so just bare with me.

Now to your ortho question.

Moving in 8 months and ortho will take a year. Hmmmmm....that is a tough one. In my experience, ortho almost ALWAYS takes longer than the predicted time so don't be disappointed if it is more than a year.

Orthodontists don't have dental hygienists so I have never worked in an ortho office. I know that most ortho offices want payment in full or monthly payments so where does that leave you when you move? I don't really know.

I think you should discuss this with your orthodontist and see what he/she suggests.

I have known of many patients with braces who changed orthodontists due to a move or disappointment.

I know that an orthodontist in your new city will be happy to see you, it is just the logistics of the money. How much would they charge to finish a case? Don't be surprised when you see a new orthodontist if they change your protocol either.

Sorry I couldn't be of more help.

Good luck to you!

At 10:03 AM,

Anonymous said...
Great post. I have learned alot and have two questions about flouride.

I have a two year old child who has been given flouride tablets. I have read many contradictory things about flouride.

Also, I am going through IVF (can't seem to have a second child) and wonder if I should up my flouride?

Thank you for your generosity.

At 11:58 AM,

Julianna said...
Hi Anonymous FLUORIDE question:

Fluoride is very controversial for some people. You can talk to 10 different people and they will tell you 10 different things.

Fluoride is a naturally occuring substance in some water. It was found that certain communities did not have as much dental decay (thus fillings, thus root canals, thus tooth loss later) and it was found to be because of fluoride.

You would have to drink a tub full of water in one sitting to get sick from fluoride or eat three tubes of toothpaste.

Your teeth have tubules. If you look under a microscope, you will see millions of tubes (enamel tubules or dentin tubules or cementum tubules). Dentin is the layer under the enamel and the cementum is what your roots are made of.

Enamel is very hard but the tubules can still be open allowing for cavities. Fluoride seals off tubules. It covers them up.

If a cavity gets to the dentin layer, it goes fast! The nerve is in the middle of a tooth and if the bacteria gets there, you need a root canal. So imagine a nerve being covered by cementum (on the root) and dentin and then enamel (on the crown). You have two layers of protection on the crown part of your tooth.

Now, bare with me. Your son needs fluoride systemically (in his system) while his teeth are forming. It will make the entire tooth stronger and more resistant to decay and sensitivity.

His pediatrician probably prescribed the fluoride in his vitamins? That is usually the case. So, your son has little tooth buds that are forming into future teeth and this will go on for many years. Him taking the fluoride will help tremendously.

After say age 8 or so, the systemic fluoride is not necessary anymore. YOU do not need to take a fluoride tablet. It will not do any good.

Topical fluoride is what you need. Toothpaste or prescription fluoride rinse. If you have tooth sensitivity it is really the root (cementum). Usually at the gumline is where sensitivity is. So use good fluoride and make sure you get it at the gumline.

This is also the reason tooth whitening causes extreme sensitivity. People use too much and get it at the gumline where the cementum is. Don't use tooth whitening gel or toothpaste at the gumline.

Fluoride is also one of the most commonly misspelled words. It is not Flour it is Fluor.

Good luck with your IVF!

At 7:11 PM,

Anonymous said...
Wanted to say that my gums are not bleeding like a mother fucker anymore. They are MUCH better.

I can't believe it!

Thank you so much for your info!

At 8:46 AM,

Anonymous said...
wow!great post! I have learned more reading this than a lifetime of going to the dentist. I have a question.

I have always had great teeth. I have never had a filling. Now my new dental hygienist tells me I need to get my teeth cleaned every 3 months. My insurance only covers every 6 months. Why is she saying this other than wanting twice as much revenue.

At 7:54 PM,

Julianna said...
Hi Anonymous.

Something about just finding out I am not going to have an IVF#2 that has taken the spunk out of me. So forgive me for being so professional.

Sounds to me like you have a good RDH. Most people who don't have cavities, get gum disease. It has to do with the ph of the saliva. The more basic the ph, the more tartar forms. The more acidic ph, the more cavities.

So because you have always had great teeth and no cavities means you are probably more predisposed to periodontal disease. It usually shows itself when a patient is in their 30's.

So bacteria builds up, tartar forms, gums get inflammed and bone begins to deteriorate after about 3 months.

So.........when you get your teeth cleaned every 3 months, you are breaking up that window of time.

Do you want to go to a dentist who only diagnoses depending on what your insurance covers? It doesn't matter if you have insurance or not. If you are under good care, you need what you need.

Most insurance companies pay for half of one crown a year but that doesn't mean you should get a crown every year.

Dental insurance is a scam. If most people figure what they pay in premiums and what is actually being paid for, they would be better off not having dental insurance. Just my opinion of course.

I said I would be honest!

I think everyone should get their teeth cleaned every 3 months knowing what we know now about gum disease.

Good luck.

At 11:02 AM,

Anonymous said...
I love this post :)

Emily
scrambledeggs

At 9:13 AM,

Julianna said...
Hi grrl!

The hummingbird is cute. That's about it. My husband uses his everyday, although he does not push the little button to make it vibrate. My problem with any floss holder product is that it does not allow the floss to hug the tooth enough and therefore it does not go as high under the gums as it should. If you put a regular piece of floss between your canine (eye tooth) and the tooth in front of it and slide the floss up, now, make sure the floss is hugging (c-shape - tongue side too!) and NOW slide it up. Usually it will look like you have almost cut the tooth in half way up there at the gumline. That is where so much bacteria loves to hide (away from oxygen, as deep as it can get) and a floss holder product keeps the floss too straight so it can't hug the tooth and will never be able to go that deep. The reason I had you do that on a canine is because those teeth have long, narrow roots compared to their crown and thus the floss usually goes deeper there than the other teeth. The top front teeth generally allow you to see how deep the floss can actually go - each side of the pointed tissue.

Now, if you haven't been flossing that high, your gums are going to bleed like crazy when you go that deep. Don't let that scare you. After a few days, you will notice a big decrease in the bleeding and after about 10 days, there should be none.

The silly vibrating with the hummingbird is useless.

Now, for your sensitivity. The tissue on the fronts of teeth is very, very thin and fragile. As we get older, the tissue usually gradually recedes. A lot of dentists used to tell patients they got sensitivity because they were brushing back and forth too much, brushing too hard, using too hard of a toothbrush..etc.... They usually blamed the patient. It is normal to get gradual recession and when it first happens, the teeth can be very sensitive.

Now, that being said, I have had it happen in my mouth after I used whitening toothpaste for a while (about 2 weeks) and I started noticing how sensitive a few teeth got, REALLY sensitive, if I touched the tooth with my fingernail at the gumline it was like a shock. I know that was because of the toothpaste. Whitening toothpaste is way too abrasive - not for the enamel but for the root. I don't think it actually caused any recession but any part of the root that was microscopically exposed got cleaned WAY too much.

Fluoride seals off millions of tubules and abrasive toothbrushes or toothpastes open them right up and those tubules lead right down the middle of the tooth where the nerve is. That is why it hurts so much but also why topical fluoride is the best way to cure sensitivity. Fluoride seals off tubules, closes them up.

I did cause some recession once with a new brush (soft bristle!) and yet it still nicked my tissue, it was one of those brushes where the end bristles are longer than the rest. Such bullshit those brushes! In order for the other bristles to adapt to a tooth, the front longer ones must smash harder into the gums and it is not good. I only recommend toothbrushes with even bristles. You don't need longer and shorter ones. The longer ones will only jab in more than they need to.

Your teeth are not steel pellets that are not going to move. There is always shifting and adjusting. This is normal. If you touch a tooth and then bite down, you can feel it give slightly. This "giving" over years causes the fine tissue on the lip side of the teeth to recede. If you have recession more on one tooth than others, THAT can be bite related. Just don't be surprised as you go through life, that you have the sensitivity every now and then.

Was that too verbose!

Geez! I need pictures to help me explain sometimes.

Take care and I hope all is well with you!

At 9:25 AM,

Julianna said...
Oh geez! I forgot about your listerine question.

STUDY SCHMUDY!

There is an awesome prescription rinse for people with gum disease, PRESCRIPTION and it kills bacteria in plaque a lot more than listerine does and they don't even make that kind of claim.

You would need a syringe and irrigate under the gums where most of the bacteria loves to hide, if you are going to help where the floss gets.

Listerine is good and helps kill bacteria in plaque but the MANUAL things you do, brush, floss, tools, toothpick, generally disrupt HUGE amounts of bacteria compared to surface amounts that a rinse may do.

At 9:05 PM,

Anonymous said...
Julianna, I just read your blog and came back here to make a comment.

You should start a separate blog on gum and teeth help.

The public needs it; I think you should think about it.

Kathy

At 8:24 PM,

Anonymous said...
I agree with Kathy, you should start a separate blog on gum disease. Your knowledge would be helpful.

I do have a question for you when you have the time.

I just moved to Omaha and got a new dentist. He says that my mercury fillings need to be replaced with onlays or tooth colored fillings. My insurance only covers so much and the rest is out of pocket for me. My old dentist never said a thing about my older fillings. Should I get a second opinion?

At 9:00 PM,

Julianna said...
Hi Kathy, Hi anonymous!

Kathy, I'm sorry I didn't get back to you earlier. For some reason, blogspot did not forward your post via email to me. That is how I get these requests and I come back to answer them. I am sorry I left you hangin'. Thank you so much for thinking this is worthwhile but I could get in big trouble if I started my own professional dental hygiene blog. This is such a letigious society that I could lose my license. I am not good at biting my tongue or covering asses and I will only be honest and that could get some people pissed off.

Also, you can talk to 10 different people and they will give you 10 different opinions, my way is not the only way. I treat everyone as if they are a family member and I answer as if you were my relative. It doesn't mean that I am right all the time.

Anonymous, thank you for your question. I hate to tell you this. I am extremely leary of any dentist who tries to scare a patient into replacing ALL of their fillings. The chances of you having decay on ALL of your old fillings is astronomically ridiculous. There are some dentists who make a TON of money by scaring people that way. If you replace all of your molar fillings, that is thousands of dollars. Nice revenue eh?

As far as the mercury scare, you can eat 2 fish a week and get more mercury than if you had a mouth full of old silver fillings. It is bullshit.

I would get a second opinion and this time go to an older dentist. They tend to not scare as much as eager, hungry dentists. I don't think you need to replace all of your fillings unless something significant has changed in your lifestyle such as:

acid reflux
eating tons of sugar products
brushing with all natural toothpaste for the past 6 months - usually doesn't have the fluoride you need
chewing bubble gum, tic tacs or tums (for some reason)

Don't give this new dentist a blank check. Get a second opinion and good luck to you!

At 1:09 AM,

Anonymous said...
Hiya,

I've been reading your blog for a while now, I don't think I've commented before (but know that I wish you all the best, and if I could give you any fertility I might have I would do it in a heartbeat--for all I know that might be none...anyway). Geez, that parenthesis was longer than the main part of the sentence.

So, I have a teeth/dentist question. I suspect my dentist sucks. I clench and/or grind my teeth, which I told him. He noticed that I'm wearing away the enamel at the bases of my bottom teeth, mostly on the sides (and omg did it hurt when he started poking around with metal things, though I did get fillings applied without anasthesia, because I'm macho like that). Now, I've read that the former may cause the latter. He seems to be unaware of any possible connection, which in part leads me to believe in his suckitude. Though my fillings are beautiful. He's older, quite old actually, and so is his x-ray equipment. But is this enough to conclude he sucks?

If so, what's a good way to find a Southern California (but not the fancy part, the Inland Empire) dentist? I'm probably about to get fabulous state employee benefits, so I'm thinking of looking for a new one. Any warning signs? Anti-warning (i.e. positive) signs?

I miss my Hawaii dentist, who recognized and attempted to treat my grinding (though I foiled his attempts--couldn't stand my mouthguard, gave me super-morning-breath nastiness). Ooh, any advice in general for us grinder/clenchers? I often have pain along my upper back teeth on one side, and I think it's because I clench, since it's almost all my molards. But then again I have a wisdom tooth coming in up there, though potentially sucky dentist didn't think it should be a problem, and my other two came in nicely--born without the possibility of a fourth.

Comment is now officially too long, but much love to you, and gratitude, and good wishes and hope and internet hugs. No one deserves good things more than you.

Oh, and I dispense grammar and computer advice, when called upon :)

At 6:17 PM,

Julianna said...
Hi Anonymous.

I assume you are 18 - 24 if you are still thinking of wisdom teeth. If you are older than that, I doubt the pain you feel will be your unerupted molar because after, say, 24, there is little chance that it will erupt.

You are absolutely right in that there is a huge correlation between clinching/grinding and recession/notched/sensitive teeth at the gumline, usually on the buccal side (buccal is lip side, lingual is tongue side of teeth). I can't remember the exact number but your molars exert over 400 psi when chewing or grinding your teeth. If you put that kind of force on,,,,,,,let's say.......a piece of wood, at the top, that piece of wood will not stay firm and will begin to "give". The weakest part of the tooth is where the enamel meets the root (cementum) and the gums can also recede there as well. If I see a patient with notched CEJ's (cemento enamel junctions), I immediately assume they grind.

I wear a nightguard. I clinch at night and also when I am busy doing crafts. It takes about 2 weeks to get used to it. It is kind of like a seatbelt, in that they are uncomfortable in the beginning but then you start to feel naked without it. It can be very smelly, I soak mine in listerine during the day (there is a new whitening listerine that is keeping it clean).

Unfortunately, there is nothing other than a mouthguard for you. It takes the hits and not your teeth. It is amazing when you start to see the wear on it and realize that would have been your teeth.

About the dentist, so many of them suck. To be honest, I have found that Beverly Hills dentists and Malibu dentists charge about the same as other dentists so don't worry about the location as much. Certain insurances (like Delta that you will have with the state) demand that prices are fixed.

I don't like the sound of your dentist. I would never go to a dentist who accepts Medi Cal or Smile Saver or 800DENTIST recipients. I find them to be more like clinics. I truly believe that the younger, the better. Also, USC dentists are much better than UCLA dentists.

See why I don't have a dental blog? I'd get my ass sued. I could also get sued by "patients" for advice that didn't work.

Did your dentist put tooth colored fillings on your roots? at the gumline? were they notched? If so, don't be surprised if they pop out. That is normal when you begin clinching again.

Good luck with everything.

I may take you up on the grammar one day! I bet you could have kicked yourself when you mis-typed "molar". I hate it when that happens.

At 12:58 PM,

Anonymous said...
Hi Julianna,

Gee, i think this post was eons ago. Sorry but may i know if it is absolutely necessary to floss every day? coz i'm kinda sucky at it and it takes me an hour or two to thoroughly floss all my teeth.

Thank you.

Kelvin

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