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  • Bryan J. MIck, DDS

Dentists, auto-mechanics and how knowing your mouth (and car) can make for a happier you.

I have to be honest, I've been resistant to the idea of writing a blog. It has seemed to me that practice blogs are quite often just a work of self promotion that no one ever reads. Recently, however, I was reading an article about helping your patients to become more literate in oral health and I thought that this might help. So this raises the question of what is oral literacy, keep reading and I will explain.

How a Dentist is like a Auto Mechanic:

There is a connection between seeing a dentist and an auto mechanic. As a patient, a trip to a mechanic involves a lot of trust. You don't (or at least I don't) understand the workings of your car beyond the general principles, you are trusting that the person fixing your car is (a). knowledgeable and (b). honest. You don't want to go to a mechanic for squeaky brakes and receive a bill for new shocks, tires and a windshield. In other words, you are hoping that the mechanic can identify what is wrong and relay the honest answer on how to fix it and the most reasonable price. A dentist is in a similar position, As a patient you aren't able to diagnose what is going on in your mouth and rely upon your dentist to relay any problems and solution(s) to you. Much like a mechanic you are hoping that your dentist is knowledgeable and honest and you really don't have any way to verify either. This is where oral literacy comes in, oral literacy is just a fancy term used in dentist circles (imagine really boring social gatherings) to describe that you have a knowledge of the basics of oral health. This is important on several levels. Firstly, oral literacy helps you to make decisions that limit damage to your teeth and supporting tissues (your gums). Secondly, when something does need to be done you are better able to evaluate the information I am sharing and therefore more qualified to take part in the decision making process. I try to always offer evidence for any sort of recommendations I make and most of the time you should be able to see the problem. An example of this is an x-ray we take called a bitewing, a bitewing shows the tooth structure in-between your teeth which cannot usually be seen by just looking. In the picture to right, note the red circle, it is highlighting decay. In this case the decay progresses through the outer layer of the tooth (called enamel) into the inner portion (called dentin). Once decay passes through the outer layer we have to remove it and repair. However, in the tooth behind this tooth (to the right) decay is also noted, however, it has not passed beyond the enamel and can be restrengthened without removing any part of the tooth.

So What is Important to Know?

So the next logical question as a patient would be what is important to know? Furthermore, what are they trying to teach me?

There are two major categories of information that we want you, as a patient to know. The first would be what causes tooth decay (cavities) and periodontal disease what can be done to prevent both. The second would be the basics of what we as dentists do to fix common problems so you can feel part of the decision making process and confident in your care.

How to Prevent Tooth Decay

We have been pushing brushing and flossing for years. You probably get it. The why behind it is important, and so, some basics. There are numerous types of bacteria present in your mouth. When you eat, so do the bacteria. As they increase in number they colonize or attach to your teeth and create what is called a biofilm. You may have noticed a biofilm on your shower before you scrub it, same principle. When I explain this to children, I always tell them, "When you eat, the bacteria on your teeth eat, then they poop, and what they poop is acid". This is essentially true, bacteria attached to your teeth produce acid, and it is this acid that "eats" through your enamel and causes a cavity (hole). This is why brushing and flossing is important, it removes the colony of bacteria from your tooth before they poop acid.

What you eat, and how you eat is also important. Bacteria in your mouth is active for approximately 45 minutes after you eat, so if you sip or munch all day the damage is much worse. Also, if what you eat contains acid, it compounds the problem--hello, soda.

How and When We Fix Things

When I do and exam there are certain things I look for, I mentioned previously how I use x-rays to diagnose decay. Also, I am looking for other things. Specifically, the effects of acid. Is your tooth structure rough or missing? Do I see signs of acid activity (it bleaches your tooth) in your biting surface? Do I see stain around a filling? A gap between your crown and tooth? I use an instrument called an explorer to feel, and I use my mirror to see.

How I fix things (and therefore how much they cost) depends on the extent of the damage. A minor amount of damage equals a filling. When a cusp (the pointy part of a tooth) is lost I need to place an onlay or crown at greater cost. Sometimes, to be quite honest, the line between the two can be fuzzy, and I rely upon my experience to dictate whether a filling, crown or onlay is needed.

No matter what is indicated, I should be able to show you and explain why it is I need to do what I need to do. Again, I should offer a full explanation, if you need more information feel free to ask.

The Mechanic Comparison, Again...

I want you to be happy with your experience, and the more you know about your mouth the more we can help you. Please, please, if you ever feel like your car is in the lift and you don't know why, ask. The biggest (and most important) part of my job is explaining.

Moving Forward

It is my plan to post a blog every couple of weeks to a month with the goal of giving you information that would be beneficial. If you ever have a question give me a call!

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