Helping those in need is my job!
Jul. 10th, 2003 10:42 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
thebratqueenOkay, as some of you know I work at a dentist's office. I'm an office manager, which means I have no medical degree whatsoever, but I do learn a bit on the job and this makes people apt to ask me questions. Just in case anyone out there was interested, I thought I'd answer some here.
(The names have been ommitted to protect the guilty ;) )
Manual vs electric toothbrush?
Electric toothbrushes have been proven to only make a difference if they have a circular motion of some kind. Brushes that go back and forth really fast, no matter how expensive they are, haven't shown themselves to be any better than what you can do all on your own with a $2 manual brush from the local Rite Aid. Only brushes that have some kind of circular motion (like Oral-B) make any kind of difference health-wise. So if you're going to invest, invest in one of those. You can get them as cheap as twenty bucks, poss cheaper if you go to CostCo or the like.
What's the big deal with flossing?
Flossing is the only way you can clean between your teeth. So not flossing is more or less the equivilant of not brushing a whole chunk of your mouth. If you don't do it you'll be prone to having bad breath and cavities.
Do you floss?
Now yeah.
When I floss my gums bleed! Do I have to keep doing it?
Yes. The bleeding is actually an indication of how much crud you had between your teeth. Keep doing it.
What brand of mouthwash is best?
Health-wise the only one that does anything is Listerine.
If Listerine "kills germs on contact" why do I have to swish it around in my mouth for a thousand years?
Two reasons. 1. your mouth has lots of nooks and crannies for gunk to hide in, so you swish it around a lot to try to hit all those spaces and 2. many people don't brush and floss properly, so even though Listerine does kill the germs it hits on contact, there are often layers under those germs, and layers under those and layers under those and so on. So the swishing helps deal with that as well.
Do I have to use Listerine?
If you brush and floss properly, not really.
What about tooth whitening stuff?
The over the counter stuff is all good in its own way, though most are really stain-removers more than proper whiteners. An actual bleaching system will run you hundreds of dollars though and your insurance won't cover it so really no harm in forking over the twenty bucks for Crest/Colgate/whatever and finding out if it does what you need it to.
If I have caps/veneers/crowns can I whiten my teeth?
You can, but be aware that the cap/veneer/crown will not change color. If it's in the back of your mouth that's no big whoop, but if it's one of your front teeth you might want to rethink the bleaching - or get a new cap/veneer/crown as needed (if you feel like spending that kind of cash).
What does your doc think of silver vs white fillings?
He does both and says he's found no research to suggest that silver's dangerous enough for him to stop using. If patients prefer white fillings he'll do those, and he certainly does those for any fillings that would show. The only other thing to note is that white fillings tend to cost more and don't last as long as silver.
How do fillings work anyway? (Aka "I had a teeny little cavity but the dentist kept using the drill so much I thought he was looking for oil!")
To understand fillings you need to understand cavities. Basically cavities are caused when the crap on your teeth manages to eat through the hard enamal shell that covers your tooth. Once there's a hole in the tooth bacteria has the opening it needs to get inside and start eating away at the comparatively softer material that's there. So it's possible that even though the outside of the tooth only has a tiny hole, the inside could be eaten away, much like a house with termites. (This is one of the reasons why they take Xrays).
So part of doing a filling is drilling into the tooth so that the dentist can literally scoop out the mushy crud that the bacteria has now turned your tooth into (yum!).
The second part is the filling itself. Basically no matter what kind of material the dentist uses, the filling works by acting as a plug. In order for it to stay in place the dentist needs to drill a hole slightly bigger than the cavity, and drill it with an angle like this: / \ The dentist then puts in the filling material, it hardens, and because the bottom of the filling is thicker than the top, it stays in your tooth.
My teeth are sensitive to hot/cold - should I be worried?
Depends. How long does the pain linger? If it's only for a few seconds or even a minute, you should probably try brushing with a toothpaste for sensitive teeth and see if that helps you. If, on the other hand, the pain lingers for much longer than a minute or two then you may have a nerve that's dying (aka a root canal in your future). See your dentist to find out.
My company doesn't give me dental insurance. Should I get some on my own?
If you're not getting it through work don't bother. It's far too expensive and you don't get enough benefits from it. You're better off trying to price-shop on your own, or arrange payment plans with your dentist individually.
My dentist is telling me to get a lot of expensive work done. Is s/he lying?
That depends. Sometimes people come in and they need a lot of work done. It's a shock but this is what can happen when they don't brush and don't visit a dentist for 20 years. However othertimes you've got a perfectly healthy person going to a dentist who's only in it for the money. Some offices are actually structured around sales rather than health, with people earning comissions on how much expensive work they can make patients sign up for.
How do I know if I'm being dicked over?
Ask questions. Look at your Xrays. Make your dentist explain the xrays. (Here's a crash course in Xray reading: white stuff is your tooth. Dark spots are parts of your tooh that are missing. If you look at your tooth on an xray and see dark spots, even tiny ones, you've got cavities. If you look at it and don't see dark spots you're okay.) If your dentist says you've got cavities, have those pointed out on the Xray. Compare it to the healthy teeth so you can actually see the difference.
Ask why s/he is recommending this course of treatment. Again ask for examples in what can actually be seen in Xrays and on your teeth.
Note, too, who's recommending the treatment. There are offices out there who would pay someone like me to talk up treatment to patients - and I have no medical degree! I do, however, wear scrubs b/c part of my job is to sterilize stuff and the chemicals we use for that can stain clothing. As far as any new patient knows I could be a nurse or some such just because I'm wearing that kind of uniform. So double check. Don't assume you're talking to someone knowledgable just because they're in the office.
Also, be aware of the flip side: lazy dentists. Again the key here is going to be Xrays. Ask to look at them, ask for explanations. We've had more than one new patient come in with years worth of damage that should've been spotted by their old dentist yet wasn't.
And, as always, don't be afraid to get second opinions.
Last but not least, the question that got me started on all this:
*curious* what about someone who has *really really* bad teeth (needing partials at least) and a MAJOR chicken due to horrible experiences with two bad dentists growing up? And, working temp and not having dental insurance? Any advice?
Okay we've got a few questions here so I'll hit 'em in order.
First up - how do you know you need partials? Did the dentist tell you that some teeth had to be removed? If so, why?
If some teeth do have to be removed then yeah, partials might be in your future. But if your teeth are healthy enough they might be able to be fixed via crowns which, while not cheap, can be cheaper than bridges and dentures.
As for being scared of dentists - boy do I get that. For that I'd say ask around. Get a recommendation from a friend, co-worker, whoever for a dentist who's got a good bedside manner. Barring that, call around. Ask if you can make a quick appointment just to meet the dentist and say hi. Make sure up front if you'll be charged for that. Make it clear that you're not asking for an exam or anything yet, you just want to come in to meet and greet and see if you click.
There are also various things that can be used to ease the way. Novacaine is the first step, which numbs your mouth to the pain. Next up is nitrous oxide (god am I spelling all these wrong) which isn't so much for numbing as it is for making you stop caring about what's going on ;) Plus you can always get an IV to put you to sleep, which is what I did when my wisdom teeth had to come out.
Certain offices will also have perks to them. The one I work for doesn't but there are those who have TVs in the room and headphones so you can watch movies or whatnot while you're being worked on and distract yourself from what's going on.
Don't be afraid to tell the dentist what you need too. We've got one patient who comes in with a walkman and basically says don't talk to her any more than you have to and just let her listen to her tapes. That's what makes her comfy and we're happy to do it. So if you've got a way to help calm yourself see if you can encorporate that into your treatment.
Finally - the not having insurance thing is tough. Like I said before, paying for insurance on your own is not going to be worth it. You're better off trying to negotiate a payment plan with the dentist, or finding one who takes credit cards.
Barring that there are also dental schools and low-fee clinics out there. You can try those but be aware that they might come with a long wait and not as much personal service. So at that point it then becomes what's most important to you - being able to make the situation comfortable or being able to afford it.
And that's all I can think of off of the top of my head. I'd be happy to answer anything else people have questions about if it's within my power =)
(The names have been ommitted to protect the guilty ;) )
Manual vs electric toothbrush?
Electric toothbrushes have been proven to only make a difference if they have a circular motion of some kind. Brushes that go back and forth really fast, no matter how expensive they are, haven't shown themselves to be any better than what you can do all on your own with a $2 manual brush from the local Rite Aid. Only brushes that have some kind of circular motion (like Oral-B) make any kind of difference health-wise. So if you're going to invest, invest in one of those. You can get them as cheap as twenty bucks, poss cheaper if you go to CostCo or the like.
What's the big deal with flossing?
Flossing is the only way you can clean between your teeth. So not flossing is more or less the equivilant of not brushing a whole chunk of your mouth. If you don't do it you'll be prone to having bad breath and cavities.
Do you floss?
Now yeah.
When I floss my gums bleed! Do I have to keep doing it?
Yes. The bleeding is actually an indication of how much crud you had between your teeth. Keep doing it.
What brand of mouthwash is best?
Health-wise the only one that does anything is Listerine.
If Listerine "kills germs on contact" why do I have to swish it around in my mouth for a thousand years?
Two reasons. 1. your mouth has lots of nooks and crannies for gunk to hide in, so you swish it around a lot to try to hit all those spaces and 2. many people don't brush and floss properly, so even though Listerine does kill the germs it hits on contact, there are often layers under those germs, and layers under those and layers under those and so on. So the swishing helps deal with that as well.
Do I have to use Listerine?
If you brush and floss properly, not really.
What about tooth whitening stuff?
The over the counter stuff is all good in its own way, though most are really stain-removers more than proper whiteners. An actual bleaching system will run you hundreds of dollars though and your insurance won't cover it so really no harm in forking over the twenty bucks for Crest/Colgate/whatever and finding out if it does what you need it to.
If I have caps/veneers/crowns can I whiten my teeth?
You can, but be aware that the cap/veneer/crown will not change color. If it's in the back of your mouth that's no big whoop, but if it's one of your front teeth you might want to rethink the bleaching - or get a new cap/veneer/crown as needed (if you feel like spending that kind of cash).
What does your doc think of silver vs white fillings?
He does both and says he's found no research to suggest that silver's dangerous enough for him to stop using. If patients prefer white fillings he'll do those, and he certainly does those for any fillings that would show. The only other thing to note is that white fillings tend to cost more and don't last as long as silver.
How do fillings work anyway? (Aka "I had a teeny little cavity but the dentist kept using the drill so much I thought he was looking for oil!")
To understand fillings you need to understand cavities. Basically cavities are caused when the crap on your teeth manages to eat through the hard enamal shell that covers your tooth. Once there's a hole in the tooth bacteria has the opening it needs to get inside and start eating away at the comparatively softer material that's there. So it's possible that even though the outside of the tooth only has a tiny hole, the inside could be eaten away, much like a house with termites. (This is one of the reasons why they take Xrays).
So part of doing a filling is drilling into the tooth so that the dentist can literally scoop out the mushy crud that the bacteria has now turned your tooth into (yum!).
The second part is the filling itself. Basically no matter what kind of material the dentist uses, the filling works by acting as a plug. In order for it to stay in place the dentist needs to drill a hole slightly bigger than the cavity, and drill it with an angle like this: / \ The dentist then puts in the filling material, it hardens, and because the bottom of the filling is thicker than the top, it stays in your tooth.
My teeth are sensitive to hot/cold - should I be worried?
Depends. How long does the pain linger? If it's only for a few seconds or even a minute, you should probably try brushing with a toothpaste for sensitive teeth and see if that helps you. If, on the other hand, the pain lingers for much longer than a minute or two then you may have a nerve that's dying (aka a root canal in your future). See your dentist to find out.
My company doesn't give me dental insurance. Should I get some on my own?
If you're not getting it through work don't bother. It's far too expensive and you don't get enough benefits from it. You're better off trying to price-shop on your own, or arrange payment plans with your dentist individually.
My dentist is telling me to get a lot of expensive work done. Is s/he lying?
That depends. Sometimes people come in and they need a lot of work done. It's a shock but this is what can happen when they don't brush and don't visit a dentist for 20 years. However othertimes you've got a perfectly healthy person going to a dentist who's only in it for the money. Some offices are actually structured around sales rather than health, with people earning comissions on how much expensive work they can make patients sign up for.
How do I know if I'm being dicked over?
Ask questions. Look at your Xrays. Make your dentist explain the xrays. (Here's a crash course in Xray reading: white stuff is your tooth. Dark spots are parts of your tooh that are missing. If you look at your tooth on an xray and see dark spots, even tiny ones, you've got cavities. If you look at it and don't see dark spots you're okay.) If your dentist says you've got cavities, have those pointed out on the Xray. Compare it to the healthy teeth so you can actually see the difference.
Ask why s/he is recommending this course of treatment. Again ask for examples in what can actually be seen in Xrays and on your teeth.
Note, too, who's recommending the treatment. There are offices out there who would pay someone like me to talk up treatment to patients - and I have no medical degree! I do, however, wear scrubs b/c part of my job is to sterilize stuff and the chemicals we use for that can stain clothing. As far as any new patient knows I could be a nurse or some such just because I'm wearing that kind of uniform. So double check. Don't assume you're talking to someone knowledgable just because they're in the office.
Also, be aware of the flip side: lazy dentists. Again the key here is going to be Xrays. Ask to look at them, ask for explanations. We've had more than one new patient come in with years worth of damage that should've been spotted by their old dentist yet wasn't.
And, as always, don't be afraid to get second opinions.
Last but not least, the question that got me started on all this:
*curious* what about someone who has *really really* bad teeth (needing partials at least) and a MAJOR chicken due to horrible experiences with two bad dentists growing up? And, working temp and not having dental insurance? Any advice?
Okay we've got a few questions here so I'll hit 'em in order.
First up - how do you know you need partials? Did the dentist tell you that some teeth had to be removed? If so, why?
If some teeth do have to be removed then yeah, partials might be in your future. But if your teeth are healthy enough they might be able to be fixed via crowns which, while not cheap, can be cheaper than bridges and dentures.
As for being scared of dentists - boy do I get that. For that I'd say ask around. Get a recommendation from a friend, co-worker, whoever for a dentist who's got a good bedside manner. Barring that, call around. Ask if you can make a quick appointment just to meet the dentist and say hi. Make sure up front if you'll be charged for that. Make it clear that you're not asking for an exam or anything yet, you just want to come in to meet and greet and see if you click.
There are also various things that can be used to ease the way. Novacaine is the first step, which numbs your mouth to the pain. Next up is nitrous oxide (god am I spelling all these wrong) which isn't so much for numbing as it is for making you stop caring about what's going on ;) Plus you can always get an IV to put you to sleep, which is what I did when my wisdom teeth had to come out.
Certain offices will also have perks to them. The one I work for doesn't but there are those who have TVs in the room and headphones so you can watch movies or whatnot while you're being worked on and distract yourself from what's going on.
Don't be afraid to tell the dentist what you need too. We've got one patient who comes in with a walkman and basically says don't talk to her any more than you have to and just let her listen to her tapes. That's what makes her comfy and we're happy to do it. So if you've got a way to help calm yourself see if you can encorporate that into your treatment.
Finally - the not having insurance thing is tough. Like I said before, paying for insurance on your own is not going to be worth it. You're better off trying to negotiate a payment plan with the dentist, or finding one who takes credit cards.
Barring that there are also dental schools and low-fee clinics out there. You can try those but be aware that they might come with a long wait and not as much personal service. So at that point it then becomes what's most important to you - being able to make the situation comfortable or being able to afford it.
And that's all I can think of off of the top of my head. I'd be happy to answer anything else people have questions about if it's within my power =)
