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The only source I’ve known to proclaim that dental insurance “pays for everything” is the insurance salesman. To get a better idea of what your prescribed treatment will cost, the dental office can process an insurance estimation called a pre-determination. Pre-determination may be unreliable when dual coverage occurs. The insurance industry is uncooperative in relaying information for dual coverage situations.

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What is prevention?

Dental prevention is action taken so that dental diseases do not start. Thorough tooth brushing teeth three times a day for about three minutes each time is the primary vital action targeting elements of microbial dental diseases. Flossing once a day additionally constitutes good at-home participation. More ideal prevention includes professional cleanings by a dental hygienist twice a year.

Oral bacterial diseases are progressive and cumulative and become more complex over time. Therefore, prevention also is action taken to minimize disease in progress. Brushing and flossing are still essential but a dentist will need to diagnose and treat existing conditions. An example of this is the eradication of a small area of decay before the decay becomes extensive.

A third level of prevention is early treatment undertaken to intercept incipient disease. An example is interceptive orthodontics, which is undertaken before adult teeth have erupted. Another example is the treatment of the cause of cracked teeth.

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What is occlusal disease and what causes it?

Occlusal disease is a number of conditions that occur when the upper teeth position to or contact to the lower teeth in a dysfunctional or harmful way. This can be called functional malocclusion. Malocclusion then is more than just crooked teeth, crowded teeth or overbite. Occlusal disease may be associated with cracked, drifting, worn, loose or sensitive teeth; with muscle or joint pain or headache; with restricted jaw movement; or with the perception that the teeth close together in an uncoordinated or unnatural manner.

Clenching and excessive tooth grinding or bruxism is the most common destructive parafunctional habit. Other harmful habits like biting on objects and intense gum chewing can be damaging. Occlusal trauma is another condition and it happens when tooth surfaces meet stressfully even during regular function.

The condition called temporomandibular dysfunction is multifaceted in nature and may have a psychological overlay. The beginning stage usually involves inflammation of muscles that move the lower jaw. Progressive degeneration can lead to irreversible structural and functional changes.

The understanding and treatment of occlusal disease and malocclusion uniquely differentiates dentistry from all other healing professions. Treatment can sometimes be accomplished with a conservative removable appliance.

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What is gum disease and what causes it?

Gum disease is the dental disease known as periodontal disease or pyoria. It causes destruction of the jawbone that anchors and roots teeth. Gum disease is preventable, but most adults show signs of it.

Toxins (poisons) produced by bacteria promote the damage to jawbone. In advanced stages teeth loosen and drift, gums bleed and swell, and foul odor occurs. Pain may not be present.

Brushing thoroughly three times a day removes the harmful bacteria. Flossing removes plaque (complex sticky bacteria) missed by brushing alone. One should floss every day. Proper brushing and flossing is the best prevention for gum disease.

Identification of periodontal disease is done with x-ray, inspection and observation. If the infection and inflammation of gum disease gets too deep, teeth may require removal. Early stage deep cleaning treatment preliminarily can halt the disease, but bone loss is lasting.

Periodontal disease can be subtle. It can occur in isolated areas. It can disappear and reappear. It can be subject to nutrition, to stress and to an uncoordinated biting pattern. Some forms are contagious. To diagnose this disease see a dentist every six months for professional cleaning and checkup.

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What is decay and what can be done about it?

Tooth decay is the dental disease known as caries or cavities. Caries causes destruction of tooth enamel and root surface. Cavities are preventable and affect young or old. This condition is the single most common chronic childhood disease.

Cavities are formed by acid, produced by bacteria, which dissolves and destroys tooth structure. This is how holes (cavities) are produced in teeth. Sugars and starches (carbohydrates) left on the teeth allow the bacteria to thrive. Residual candy, soda pop, deserts and snack foods are most offensive.

Brushing thoroughly three times a day removes the bacteria and carbohydrates. Flossing removes plaque (bacteria plus carbohydrates) missed by brushing alone. One should floss every day. Proper brushing and flossing is the best prevention for cavities. Chewing gum or using a fluid jet device is no substitute for brushing and flossing.

Symptoms of caries can be subtle and can occur without immediate pain. Cavities can be found on the top, sides or root surface of a tooth. The latter occurs especially in the elderly. Caries can also occur around aging dental work. Left without treatment, caries can cause the tooth to become unable to be restored.

Identification of caries is done during the dental exam by using x-ray, laser and observation. Treatment is done by removal of damaged tooth structure followed by restoration with porcelain, plastic or metal. Modern pain control measures are used throughout.

ARE THERE HIGH TECH SOLUTIONS FOR DENTAL DECAY?

Identification of certain decay has entered the high-tech world. It can now be done without taking an x-ray, without having to pick and prod, without drilling to excavate for depth, without exploratory tooth abrasion. It is done with a great deal of accuracy. We can find out when to restore. We can discover if just extra brushing is necessary. With digital accuracy, the dentist can judge if a restoration or a sealant is the best choice for intervention. This is all being done in the privacy of the dental office. The process is safe and non-invasive. No medication, anesthetic or sedation is required. A laser is used and it takes a matter of seconds.

Restoration of damaged or decayed teeth has also been revolutionized. Wouldn’t it be nice to restore a damaged or decayed tooth with a choice of materials? Wouldn’t it be nice to be able to choose plastic, porcelain or gold for restoration? Gold would be for superior protection against a strong bite. Gold has always been an ideally biocompatible material. Porcelains and plastics are used in the aesthetic zones. In addition, porcelain layered on gold is for strength, biocompatibility and beauty.

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What is this controversy on dental amalgam and mercury?

Patients are asking more questions of their doctors. Consumers are demanding to be more involved in their own health care decisions. The same thing is happening in dentistry.

Some dental patients are concerned about the dental material used in their mouths. Metals, plastics, chemical compounds, disinfecting agents and mixtures of naturally occurring substances can all be used during a single dental visit.

The dental material under the microscope these days is dental amalgam. This is the technical name for what is usually referred to as a silver filling. “It contains a mixture of metals such as silver, copper and tin, in addition to mercury, which chemically binds these components into a hard, stable and safe substance.” ADA

It is the mercury component that has some worried. Mercury is a metal element that is a liquid at room temperature. In this state it is very toxic. But mercury is changed from its liquid form just before the dentist uses the silver filling mixture.

Hundreds of millions of these restorations have been placed over the last one hundred and fifty years. The American Dental Association claims that, “there is no scientific evidence that exposure to mercury from amalgam restorations poses a serious health risk in humans, except for the exceeding small number of allergic reactions.”

Crusaders against amalgam are concentrated in Sweden and Canada. They claim harmful mercury in amalgam liberates with wear in sufficient quality to cause harm. According to them, dental amalgam may be associated with gastrointestinal changes, central nervous system effects and other pathology.

The controversy is likely to continue for years to come. Proof is hard to determine because testing on human subjects is impossible. Yet many patients are requesting dentists to remove their serviceable amalgam fillings just to “play it safe.”

There are considerations in replacing existing amalgam restorations. First, a dentist cannot promise improved health or promise future disease prevention. Second, the financial cost of replacing restorations may be high. Third, a question arises whether the new restoration is any more biocompatible than the one it replaced. Last, the replacing process may damage or injure previously asymptomatic teeth.

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Why does the doctor need x-rays?

Dental x-rays help the dentist do his job. The dentist’s basic duty is to detect, disclose and correct diseases of the mouth. The human eye cannot detect what x-rays detect. Therefore, without dental x-rays, disease may go untreated.

There are two prevalent infectious oral diseases. Gum disease is one of the most common diseases of man. It causes teeth to loosen and eventually fall out. Pain, bleeding gums or foul breath may indicate gum disease. Those who don’t visit a dentist at least once a year almost certainly are prime suspects for developing gum disease.

Tooth decay or cavities is the other widespread condition. If untreated cavities grow in size and eventually cause tooth pulp inflammation, infection or death. Early warning signs for tooth decay or gum disease may not appear. So waiting, “till it hurts,” or “until I have a problem,” usually invites bigger costs.

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Why do I have to get my teeth cleaned?

Professional teeth cleaning at a dental office removes deposits on teeth that can’t be removed. These deposits cause gum disease.

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