Six fillings. I was surprised too, considering that I've had only one filling previously, and most of my dentists' comments on my every-two-years checkups have been along the lines of "I wish I had teeth like yours". The X-ray the week before had even showed that at 25 I have no wisdom teeth whatsoever, which is a money-saving genetic polymorphism last seen in one of my great grandparents.
At my checkup the week before the oral hygienist noted "some minor cavitation", and in the mirror I saw 2-3 dark patches on the molars. She called in the dentist and read out a long list of alphabet soup while he poked the corresponding locations with the dental explorer. Nonetheless, I was surprised on Monday to discover that there were six fillings to be done, on tooth numbers 26 OP, 27 OP, 17 OP, 16 OP, 47 O and 46 B (O=occlusal or biting surface, B=buccal or cheeck side, P=palatal or towards the palate), and the oral hygienest confirmed these were the ones. The fillings themselves were mostly-painless, and used a modern light-cured dental composite, where a bright blue light drives a polymerisation reaction, turning the filling putty into a hard tooth-coloured substance. Acid-etching beforehand gives the composite a micromechanical bond to the enamel and dentine, so the filling is pretty much one with the tooth.
After I left I wondered - how many of the fillings were really necessary? Some could have been reversible demineralised regions or incipient decay being filled preventively, rather than real cavities. Preventive dentistry isn't necessarily the best route, since fillings don't last forever (although 10+ years is usual on modern composites, even on molars), and they can go wrong rapidly if a leak occurs that allows bacteria inside. Fillings really do need the 6-month checkups they always tell you to have, because if a leak goes undetected you could find yourself needing a root canal. Seems I'm in for a lot of checkups over the rest of my life.
I read up and found that unnecessary treatment is common, but after the filling all evidence of what was there before is gone. What you are supposed to do is ask the dentist, at the checkup, to show you each site of proposed filling one at a time. If there is no visible cavity, there should be a good explanation (e.g. interproximal cavities may show only on X-rays).
If the dentist says "it is likely to be come a cavity", then you are better off taking it as a warning to modify your oral hygeine and diet rather than getting a filling. I think my problem was that October through February I got into a habit of eating chocolate on campus, at a rate of about 1 square per hour or two. Because my tooth-brushing and flossing habits were fine and I'd never had problems before, it never occured to me that adding a few squares of chocolate to my diet would cause cavities. As it turns out, prolonged sugar levels in the mouth feed acid-producing bacteria, which demineralise the tooth enamel, eventually forming cavities. Rather than brushing during the day, you're supposed to rinse your mouth with water to remove sugars and particles before they feed the bacteria: but that doesn't work with chocolate, toffee or other things which stick to your teeth.
So, don't snack on sticky sweet things between meals (fruit may be ok because fibres remove bacteria and aren't sticky), drink water after eating things, wait 10-20 minutes before brushing to soften particles stuck in your molars, brush carefully morning and evening after meals with a non-frayed toothbrush, and floss daily before brushing. That's the comprehensive diet-and-hygiene way to avoid getting (more) cavities.
At my checkup the week before the oral hygienist noted "some minor cavitation", and in the mirror I saw 2-3 dark patches on the molars. She called in the dentist and read out a long list of alphabet soup while he poked the corresponding locations with the dental explorer. Nonetheless, I was surprised on Monday to discover that there were six fillings to be done, on tooth numbers 26 OP, 27 OP, 17 OP, 16 OP, 47 O and 46 B (O=occlusal or biting surface, B=buccal or cheeck side, P=palatal or towards the palate), and the oral hygienest confirmed these were the ones. The fillings themselves were mostly-painless, and used a modern light-cured dental composite, where a bright blue light drives a polymerisation reaction, turning the filling putty into a hard tooth-coloured substance. Acid-etching beforehand gives the composite a micromechanical bond to the enamel and dentine, so the filling is pretty much one with the tooth.
After I left I wondered - how many of the fillings were really necessary? Some could have been reversible demineralised regions or incipient decay being filled preventively, rather than real cavities. Preventive dentistry isn't necessarily the best route, since fillings don't last forever (although 10+ years is usual on modern composites, even on molars), and they can go wrong rapidly if a leak occurs that allows bacteria inside. Fillings really do need the 6-month checkups they always tell you to have, because if a leak goes undetected you could find yourself needing a root canal. Seems I'm in for a lot of checkups over the rest of my life.
I read up and found that unnecessary treatment is common, but after the filling all evidence of what was there before is gone. What you are supposed to do is ask the dentist, at the checkup, to show you each site of proposed filling one at a time. If there is no visible cavity, there should be a good explanation (e.g. interproximal cavities may show only on X-rays).
If the dentist says "it is likely to be come a cavity", then you are better off taking it as a warning to modify your oral hygeine and diet rather than getting a filling. I think my problem was that October through February I got into a habit of eating chocolate on campus, at a rate of about 1 square per hour or two. Because my tooth-brushing and flossing habits were fine and I'd never had problems before, it never occured to me that adding a few squares of chocolate to my diet would cause cavities. As it turns out, prolonged sugar levels in the mouth feed acid-producing bacteria, which demineralise the tooth enamel, eventually forming cavities. Rather than brushing during the day, you're supposed to rinse your mouth with water to remove sugars and particles before they feed the bacteria: but that doesn't work with chocolate, toffee or other things which stick to your teeth.
So, don't snack on sticky sweet things between meals (fruit may be ok because fibres remove bacteria and aren't sticky), drink water after eating things, wait 10-20 minutes before brushing to soften particles stuck in your molars, brush carefully morning and evening after meals with a non-frayed toothbrush, and floss daily before brushing. That's the comprehensive diet-and-hygiene way to avoid getting (more) cavities.
4 comments:
Many scientists have come to believe in recent years that the human body is supposed to only eat twice or maximally three times a day. It's also got to do with the chemical breakdown process of sugars in the body. Glucose is essentially an acid in the blood stream and your body needs to remove the glucose or neutralise it. It might also use your body's calcium reserves in order to help neutralise the acid. So the problem might be in part internal and in part external.
Possibly we're only supposed to eat 3 times a day (if only because of tooth decay), but glucose as an acid, "neutralising" it with calcium? Sure, speculation, but failing to make sense. Dr GP prescribes some light surfing on biochemistry!
OTOH, you might be thinking of the link to diabetes, and insulin control of blood-sugar levels.
There is a huge amount written on this subject - instead of some "light surfing" I would recommend some in-depth research. Particularly search for "acidosis" and its link to refined sugars. If you then research "alkalosis" you'll also find out why brown sugar and molasses are much better than white sugar. I must actually blog about this myself, it's rather interesting.
Sugar has only marginal association with acidosis. In Type I diabetes, low insulin levels tell the liver to break down fats for energy, producing various acids, causing ketoacidosis. When antibiotics alter intestinal bacterial populations, the bacteria metabolise glucose into acids, causing D-Lactic acidosis.
Glucose itself though is a carbohydrate. It's breakdown products are CO2 (only slightly acidic) and water. If the glucose is used to build fats, those fats could later be broken into acids.
Refined sugar is harmful in large quantities (such as a 2-litre coke), because of metabolic syndrome (controversial status) and Type II diabetes. White bread and baked potatoes however have higher glycemic indeces than sucrose.
BTW, I've found confirmation about eating sticky sugars between meals:
..“The most significant human study was done in Sweden, reported in 1954, and known as the Vipeholm Dental Caries Study. More than 400 adult mental patients were placed on controlled diets and observed for five years. The subjects were divided into various groups. Some ate complex and simple carbohydrates at mealtimes only, while other supplemented mealtime food with between-meal-snacks, sweetened with sucrose, chocolate, caramel, or toffee.
Among the conclusions drawn from the study, was that sucrose consumption could increase caries activity. The risk increased if the sucrose was consumed in a sticky form that adhered to the tooth’s surfaces. The greatest damage was inflicted by foods with high concentrations of sucrose, in sticky form, eaten between meals, even if contact with the tooth’s surfaces was brief. Caries, due to the intake of foods with high sucrose levels, could be decreased when such offending foods were eliminated from the diet."
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