Chew on This...important, interesting and odd tidbits you need to know for good oral health

Hello Everyone,

“But Doc, my tooth didn’t hurt before you worked on it.  What’s up with that?”

Teeth are strange.  Unlike most medical conditions, problems with the structural integrity of teeth often present without pain.  If you break your finger, there is pain.  Hit your head, there is pain.  Heartburn, back spasms, hangnails...pain, pain, and more pain.  But teeth are pretty amazing.  They withstand the tremendous forces of chewing, swallowing, acid erosion, grinding, clenching, and often blunt trauma without making us run to the hills in agony.  Enamel, the hardest substance in your body, acts like the outer wall to Fort Knox.  It buffers a tremendous amount of force and bacterial challenges continually, without reprieve, and successfully insulates the underlying softer layer of the tooth called dentin.  Dentin is like the mediator between the protector (enamel) and the protected (nerve and blood supply).  Unlike enamel, dentin is alive in the sense that it is cellular, and acts as a secondary insulator for the nerve.  In fact, when there is an insult to the tooth (like a crack or decay/caries), the cells inside the dentin produce a substance that further protects the nerve, keeping it from sensing the problem.  Thank goodness for this, for we would all be walking around in pain most of the time if it were not for these protective features.  

However, when there is a problem even without pain, the problem can’t be ignored.  Eventually it will catch up to you.  The tooth can only withstand biting forces and decay causing bacteria for so long, and before you know it serious problems occur.  Parts of teeth fracture off, teeth fracture in half, decay and fractures reach the nerve, and the nerve dies.  Pain ensues or infection festers, and then root canals and extractions happen.  

We dentists have a duty to protect you, and that means protect your vulnerable teeth.  Fillings are placed in teeth when small amounts of decay are removed and voids need to be filled.  Onlays and crowns cover teeth when the natural tooth can’t fully support itself with its own enamel.  Ultimately, we protect the core of the tooth so you can keep it for a lifetime.  At least that is our duty, within reason.  

Now, here’s the kicker.  Nerves are connected to the brain.  Those nerves in teeth have a sensitive temperament, and any trauma to a tooth, including drilling at very high speeds, can cause irreversible inflammation and sensory overload.  As I stated before, the tooth problem needs to be eradicated before it causes serious pain, infection, or both.  This is a given.  Another given is that the nerve might respond unfavorably after the treatment has been completed. However, the chances are very good that all will be well.  

When it comes down to it, treating any part of the body is an exercise of percentages.  As a patient to whom I have an obligation to do no harm and a duty to keep safe, you must understand that I make these determinations with much thought and educated discernment.  Pain might arise after any procedure and need to be addressed with further treatment, which is always annoying and inconvenient for you.  However, even this event is preferable to what can happen to the untreated tooth.  

Paul Huddleston, DDS

Dear Friends,

Hello Everyone,

I thought I would post a wonderful case we completed for a patient recently so you could see the intricacies of how crowns are made, from start to finish.  One of the benefits of having your crowns made by our team is that I am directly involved with quality assurance during the entire process.  Kymata Dental Arts is closely affiliated with and physically adjacent to my office, which allows us to have constant communication throughout the entire fabrication of crowns.  As you will see, Mike and Rey (Kymata’s master technicians) provide documentation of each case that is second to none.  

So here we go.  

My patient, Steve, presented to me with failing porcelain     veneers on six of his upper front teeth.  Caries (aka dental decay) was infiltrating underneath these veneers, and spreading inward toward the nerves and heightening the possibility of needing root canal therapy.  This is a picture of his preoperative condition.  

Hello Everyone,

I am pleased to introduce to you Gena, a longstanding team member in my office who presents an interesting perspective about patient perceptions and dental insurance.  Her guest blog post is meant to enlighten you about dental insurance and our ongoing determination to make sure our patients are well informed.  Your comments and questions are most welcome.

Paul Huddleston, DDS

Dear Patients,

At the end of last summer, I took it upon myself to evaluate the preparedness of our home in the case of a disaster.  I have always been somewhat prepared, knowing we had most of the items needed to support a family of six and few neighbors along the way.  However, the truth is that they were not organized in the appropriate manner:  food and water here, flashlights somewhere, camp stove and fuel maybe used up...better make a trip to REI.  I knew I had to do better, and within a few hours I was able to consolidate all of my essentials and achieve a level of preparedness adequate for most disasters.  Hopefully, I will never have to resort to using them.  

Today, it happened, for the first time in 2012.  I usually see it about once per year, and I'm not talking about the rate at which my father shoots a hole in one (last year he had two!).  One of my patients brought in a mangled nightguard, thoroughly enjoyed by his dear canine companion.  I have never heard of a more expensive chew toy!  I love my dog, Buster, but if he got hold of my sleep apnea appliance, he would be, well, in the doghouse.  So beware, fellow dog lovers, and keep those nightguards and sleep apnea appliances secure in their cases and placed high on a shelf.  Does anyone out there have a similar pet story?  Or a hole in one?  Please share...

Dear Dental Bloggers,