Dental phobia, according to the website colgate.com, is far more than the condition represented by those two simple words. It’s estimated that between 9 and 15 percent of Americans — 30 to 40 million people — avoid dentist visits because of fear surrounding the prospect for pain. They’ll go to whatever lengths to skirt care, often braving broken teeth and gum infections in the meantime. They’re not only anxious. For them, the visit represents bona fide terror. And the longer the wait, the greater the chance for complications that lead to infection and tooth loss.
Big Word, Bigger Complication
Eric Mehler, DDS, has built relationships in Sunrise around just such cases, providing compassionate understanding amid the patient’s anxiety. He’s also seen the effects of dental neglect (according to the National Institute of Dental and Craniofacial Research, adults between the ages of 20 and 64 lose an average of seven permanent teeth through inadequate care on the part of the patient). An important corollary, he says, lies in the fact that health compromises in other parts of the body can impact the gums and teeth. Among the ill-effects of neglect is periodontitis, a big word for a bigger complication. It’s popularly known as gum disease, and it can destroy gums and even bone; the symptoms can appear without warning. It occurs in four stages, with the earliest seen in gingivitis, or swollen, bleeding gums. Bone loss is thought not to have occurred at this point, making the condition reversible. Stages two and three indicate the onset of periodontal disease, with bleeding often the result of a simple brushing or flossing. Stage four has occurred when bacteria has spread between the teeth and into the gums, possibly resulting in loosening of teeth and pain on chewing. Laser therapy or surgery may be indicated in attempts to reach the infection.
Scaling and Root Planing
Another form of such extreme therapy involves scaling and root planning, a nonsurgical method wherein the dentist or hygienist debrides the plaque, tartar and toxins from the teeth and root surfaces, then smooths the rough areas on the roots to keep foreign bodies from re-adhering (the practitioner often uses a local anesthetic to perform the procedure). The healthiest gum tissue fits easily around the teeth, with a 1- to 2-millimeter tissue depth being ideal. A depth of 4 millimeters or more can invite periodontitis. Moreover, the American Dental Association has cited increasing evidence linking gum disease with other health problems. Tooth plaque, it’s found, can eventually spread to other parts of the body, such as the heart. The association also notes links between dental problems and diabetes, dementia, respiratory ailments, and certain cancers. Meanwhile, the mouth-body connection is well-established in some circles. Hippocrates insisted that he saw an instance of arthritis cured by the pulling of a tooth. The British conducted an adult dental health survey in one community in 1968 and found that nearly 75 percent of adults over 55 had none of their own teeth, having them excised out of an abundance of caution. But in today’s periodontics sphere, follow-up visits every two to four months will usually reveal that the gum tissue has become strong again and that bleeding has slowed or stopped. More advanced conditions may require surgery, but scaling and planning are also designed to reduce the extent of surgery.
You’re On Your Own
Dr. Mehler reminds patients that they can do plenty to prevent periodontitis. Brushing for two minutes twice a day with a fluoride toothpaste; replacement of toothbrushes every three months; daily flossing of teeth and bridgework; and the use of antimicrobial mouthwashes go a long way in assisting the practitioner in his efforts to reverse the effects of gum disease. As to the toothbrush itself, electric and manual models have their own advantages; the American Dental Association approves either instrument that’s proven safe. The bristles vibrate or rotate on the electric type, micro-moving every time you move the brush. Studies show that electric toothbrushes are more effective against plaque and gingivitis than manual toothbrushes. One study revealed that after three months of use, the plaque was reduced by 21 percent and gingivitis by 11 percent. Electric brushes also may be helpful to those with mobility issues, such as arthritis, and with appliances such as braces. Meanwhile, electric toothbrushes are more expensive than manuals. Prices range anywhere from $15 to $250 a brush. New replacement brush heads usually come in packs of multiples and cost between $10 and $45. Disposable electric toothbrushes cost $5 to $8 plus the cost of batteries. Meanwhile, manual toothbrushes have been around since 1938, and the first bristles were made of nylon. Patients can get one almost anywhere for $1 to $3. One study found that people were more likely to brush too hard with a manual, and brushing too hard can damage the gums and teeth. In either case, Dr. Mehler says, the patient is the central figure in the prevention of gum disease and other oral conditions. He and his hygienist staff invite Sunrise into a lasting partnership toward the preservation of a vital resource in the best possible quality of life.