My Teeth Are Sensitive!

If you watch much TV it would appear that two things about dentists are true:

1. Dentists spend much of their time in a white lab coat talking to patients about which toothpaste is the best.
2. Many patients have sensitive teeth.

Of the two, the second statement is absolutely true, the first much less so.  In light of that, addressing the sensitive tooth problem is a real priority.  The intent of this article is to help you save some time and money because if you call your dentist and tell the receptionist you “have a sensitive tooth or teeth” she is going to schedule you for an appointment that will involve at least a limited exam and x-ray fee.  The dentist will ask a series of questions and perhaps perform some tests to help determine if your tooth is merely “sensitive” caused by things in your diet or if you have a cavity, a cracked tooth, or an abscess coming on. Few things are more frustrating for patient and dentist than finding out that you need to cut out some sour things in your diet and just use a sensitivity toothpaste twice a day when you thought you really had a problem! 

That is not to say that sensitive teeth aren’t painful; they are! Much sensitivity is caused by either gum recession, sour foods or beverages, or both, and it is almost always treatable.

Here’s how you can figure out for yourself if you need to make that appointment or can put it off:

If you see a dentist every six months and normally do not have cavities but suddenly your tooth or teeth are sensitive to cold or sweet and the “pain” when stimulated by the cold lasts less than 10 seconds, do not call for an appointment yet. Do use a sensitivity toothpaste 2x/day as directed on the box.  Sensitivity toothpastes have an active ingredient of either potassium nitrate or stannous fluoride.  Both can work; for most patients relief is noted at the two week mark and improves for up to a month. 

If your tooth hurts when biting and you can tell which tooth it is, you definitely need to call the dentist, your tooth is either cracked or abscessed.  If you cannot identify which tooth but it seems several teeth on one side are involved, you may be clenching or grinding your teeth, which can make several hurt at the same time, or you may have a tooth whose pulp is slowly dying and the pain can refer to other teeth, making it difficult to identify exactly which tooth it is.  Call your dentist for definitive diagnosis and treatment.

If you have recently begun using any of the following and have “sensitive teeth”, stop using these items immediately, use a sensitivity paste for a month, and if your sensitivity goes away, that’s all you need to do for now:
1. Whitening mouth rinse.
2. Charcoal toothpaste
3. Whitening toothpaste or tartar control toothpaste that does NOT have stannous fluoride or potassium nitrate as one of the ingredients.
4. Baking soda as homemade toothpaste (or any other homemade paste)
5. Lemons or lemon juice in your drinking water or tea or diet Coke.
6. Crystal light or other sour drink mix
7. Apple Cider Vinegar
8. Pickles or pickle juice
9. Sour candies of any type
10. Any candy or beverage that contains malic acid on the list of ingredients. Some sugar free candies and gum include this to make it taste sour or deepen the flavor profile, such as sugar free Lifesavers.
11. ANY tooth whitening strips or gel. These almost universally cause severe tooth sensitivity.
12. Soda pop.

You may not even realize you are consuming something that has causes your sensitivity at first.  A thoughtful consideration of your dietary habits, and possibly a diet journal you keep for two weeks will shed some light on what is causing your sensitive teeth.  Almost all tooth sensitivity to cold that is not caused by a cavity or crack can be traced back to a dietary cause or the use of a tooth whitening product of some type in our experience. 

What can the dentist do for sensitive teeth if your use of a sensitivity toothpaste and elimination of the suspected dietary villain has not worked after a month? The answer to that will depend on the cause. If you have receded gums,  then the roots surface can be sealed or filled, or you may need some root coverage performed,  usually by a periodontist. You may need to wear a night guard to relieve some of the pressure caused by nighttime clenching, which in some cases can cause sensitivity.  The point is, if your efforts at home have not worked after a month, then please, get in to see the dentist for a definitive diagnosis and treatment.

Hopefully, this information will help you avoid unnecessary dental visits.  And if you do need a visit, you’ll be able to specifically tell your dentist what you’ve tried already that has not worked, which will make his job in diagnosing the cause of your tooth pain or sensitivity that much easier.

Published May 5, 2020

Considering Dental Work Outside the USA? Think Again!

Have you ever heard of dental vacations, or having your dental work done in Mexico or other countries outside the United States? Chances are you have, or know someone who has at least talked about going outside the U.S. for dental work to save money. It is true, you may be able to save some money, at least, initially, by having dental work done south of the border, but let’s examine this practice logically.
“I can save money on my dental work by going to Mexico! Remember, you must factor in the actual cost of travel, lodging, and food, along with any return trips and 6 month exam/hygiene visits. Return trips? Why, yes. Many dental procedures are not one visit or one day procedures, especially those involving dental implants. Most dentists placing and restoring dental implants know and understand that one must heal for at least 3 months before restoring (placing the crown or other prosthesis) on a dental implant. That means at least two trips, assuming all goes well… What? It doesn’t always go well? 
That brings us our next point. What if your body doesn’t heal and that implant falls out?  What if you need bone grafting? Where did the dentist in Mexico procure the graft he put in your socket after he extracted your tooth? Was it an FDA approved material?  For that matter, what about the dental implants and other materials used there? What if the mouthful of crowns you had done there for $200/tooth messed up your bite so badly you cannot shut your mouth like you were able to before?  What if you needed four root canals done before the crowns were put on but the dentist missed them?  What recourse do you have? Who is going to fix you up? The money you thought you were saving was flushed, along with the additional expense you’ll pay to have it redone in the U.S.
These are true stories from patients we’ve seen who have been to Mexico for dental work: Crowns so poorly done that they need to be replaced, missed abscesses that cause terrible pain and potentially life-threatening infection, dental implants that are corroding, and dentures made in a back-alley shop. It is safe to say that 90% of the dental work we’ve seen done at clinics in Mexico has been sub-standard at best
Another true story from a patient who had work done there: While in one operatory having his work done, his wife was herded out of the building through a back door, escorted into a van, and driven across town, and didn’t return for several hours. Nobody explained to her or him what was going on. She reasonably thought she was being kidnapped!  Luckily, she was being driven to another dental office where a different dentist performed her work.
One other issue: Is the dentist in fact one who graduated from an accredited dental school in the United States or Canada, does he/she currently have a license to practice anywhere in the U.S., and if so, why isn’t he/she? States each have licensure programs beyond merely a degree from a dental school. All states in the U.S., with the exception of perhaps New York, require a live patient regional board exam.  A dental student in New York can spend a fifth year in a residency in lieu of the live patient exam.  As an additional point, dentists who have earned their degree in any country other than Canada cannot practice inside the U.S. without going to dental school again at an accredited U.S. dental college. There is significant comfort in knowing, up front, that your dentist has been trained to the highest standards.
Final thought: dental work can be expensive! it is worth the effort to take good care of your teeth, thus reducing the cost over a lifetime. Most dental work is largely preventable with good brushing and flossing habits, but you already knew that!  An exam every 6 months is a great plan for most patients and can save you money by staying out of the “I have a dental emergency!” mode. That always costs more in the long run.  
Smiles Restored exists to make the most expensive dental procedures affordable for the average person.  Check out our fees, compare to true cost of going anywhere outside the U.S. and you’ll find it makes sense to have your dentistry done here in Southern Utah, by accredited dentists, using only FDA approved materials. 

Published February 3, 2020

Why Back Teeth Matter!

One question we frequently hear from patients when we talk about replacing missing teeth is: “Why should I replace that tooth? I don’t miss it. It’s been gone for years!” We NEVER hear this when talking about the front teeth, the ones visible when you smile or talk. Those teeth are the ones of cosmetic concern for everyone and because of that, to most of us, they are the ones we worry about the most.  We want to have a nice smile, right? Nobody wants to look like they don’t care about their teeth, of course. The truth is, front teeth are NOT the most important teeth from a functional and biological standpoint; the back teeth (molars) are. Our teeth are designed to destroy food so we can swallow it and get the energy we need for life. The cosmetic concerns are nice but are merely secondary. 

So, why do molars matter? Why do back teeth matter?  The answer is: They are the teeth that do the majority of the chewing! They are the ones that take the vast forces produced by our jaw muscles and use it to mash food into something we can swallow without gagging or choking.  When they are gone, people, by default, chew with the front teeth instead, transferring those massive chewing forces to the remaining long teeth, or they resort to a bland soft food diet. Over time, those front teeth, which were designed to slice and tear food rather than grind it to a pulp, get ground down themselves.  Or, they just break off at the gumline.  We see this every day in our practice. The more missing back teeth, the faster the remaining teeth get destroyed. So, saving (rather than extracting) or replacing molars and other back teeth helps you keep your front teeth looking nice, which means maintaining your smile! 

What are the options for tooth replacement, assuming all of your teeth aren’t already missing? Dental implants, bridges, and partial dentures are the usual options. Of those, a partial denture is the least expensive but also the least satisfactory.  In fact, roughly half of those who have one do not wear it, and even if they do, they usually cannot replace back teeth in a manner that prevents chewing with the front teeth. Most people struggle with their partial for various reasons, but primarily because a partial is the equivalent of a peg leg for missing body part. It will never function like the real thing. Ever. A bridge is a much more satisfactory tooth replacement option. Chewing function is like having your own tooth back; the downside is keeping the bridge part clean underneath. As a result, over time many bridges are being replaced by dental implants when the teeth under the bridge decay away.

Dental implants are the replacement option that is most likely to function like your own missing tooth. They cost about the same as a bridge in our practice and are easier to clean underneath and around using dental floss and a toothbrush. A patient seen recently, who has had both bridges and a single dental implant, told us she absolutely loves the implant and if she could go back in time, would’ve had the other teeth replaced with implants rather than bridges. So, when the dentist recommends replacing a missing tooth, or saving it with a crown or root canal, it is because he/she understands the consequences of what can happen to your smile down the road if you don’t replace it.

And now you do, too.

Published December 18, 2019