The End Of “Drilling And Filling”

Here’s another example of the miracles of modern medicine:  scientists have discovered a drug that appears to encourage damaged teeth to regenerate — a development that could bring an end to the practice of drilling out cavities and filling them.

normal-tooth_1The drug is called Tideglusib.  It not only is self-evidently unpronounceable, it also has the effect of stimulating and activating stem cells within the pulpy center of teeth, promoting the generation of the hard material that makes up most of our teeth, called the dentin — as anyone who has carefully read the tooth diagrams and tooth charts at the dentist’s office will recall.  Scientists tested the drug on mice, and found that applying the drug to cavities in the teeth of mice, using a biodegradable sponge, caused the tooth being treated to regenerate enough dentin to close the cavity.  (Wait a second:  mice get cavities, too?  They must not be very attentive to brushing and flossing.)

The next step will be to test the drug on humans, but the signs are encouraging that we may be on the verge of a new approach to dentistry.  Speaking as someone who practiced terrible dental hygiene as a callow youth and often found myself sitting in the dentist’s chair, mouth agape, listening to the whine of the drill and hoping it didn’t strike a nerve, I think an approach that lets teeth regenerate naturally would be terrific.  And, for those of us who have dental fillings that date back to the days of Beatlemania, the regeneration of natural teeth would have the advantage of avoiding visits to the dentist because old fillings are finally cracking or breaking and need to be replaced, too.

 

Flossing Fiction

I’m a daily flosser.  I listened to the instructions of the U.S. government, and the hectoring of my dental hygienist, that daily flossing of your teeth is an important part of preventing cavities, removing dreaded plaque, and preventing gum disease.  I’ve even given careful thought to whether it makes more sense to brush before flossing, or vice versa.

IMG_2496Now I learn that the federal government is grudgingly conceding that there really isn’t any scientific evidence that daily flossing does anything to prevent cavities or gum disease.

The government has been telling us to floss since 1979.  It’s been part of the dietary guidelines that the government issues every five years, which as a matter of law have to be based on scientific evidence.  But when the Associated Press used the Freedom of Information Act to ask for the scientific evidence underlying the daily flossing recommendation, the feds responded by admitting that the merits of flossing had never really been researched — and when the government issued its latest dietary guidelines this year, the daily flossing instruction was unceremoniously deleted.  The AP then did its own look at the scientific evidence for daily flossing, and found that the evidence is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”

So, for decades, the government has been telling us to do something and representing that it would produce health benefits, without real evidence in support.  How many public service announcements, pamphlets distributed to kids in health classes, and government websites over the past 35 years have repeated the apparent flossing fiction — and, perhaps, other fictions as well?  It makes you wonder how much more of the lifestyle lecturing we get from the National Nanny is based upon speculation, guesswork, or perhaps artful lobbying by the manufacturers of consumer products.

Since I read the AP article, I’ve been thinking about whether I’ll continue to floss.  I feel misled by my government, sure . . . but I think I probably will.  After all, I’ve got a bunch of floss containers in the bathroom, and I may as well use them up.  And, it’s become part of the morning routine designed to make my teeth and gums feel spotless and invigorated, and I’m a creature of habit.  And, whatever the feds might do, I know that my dental hygienist is going to rip me if I don’t floss — scientific evidence or not — and I definitely don’t want to get on her bad side.

 

No Novocaine

When I was a kid, my trips to the dentist were characterized by two realities:  lots of cavities, because my dental hygiene in the face of mass consumption of sugary cereals was intermittent and appalling, and a steadfast opposition to getting the novocaine shot before the inevitable drilling began.

Shots don’t bother me, but my first novocaine injection was a disaster.  The dentist said I would “feel a pinch” — which seems to have been the standard pre-shot statement used by dentists for the last 50 years, even though no pinch feels remotely like a novocaine injection — and the next thing I knew a huge, bulky hypodermic needle was sliding between my gum and lip and then burrowing deep into the nerve clusters down there.  It hurt like hell, so I started to refuse the novocaine shot in favor of a no-numbing, tough-it-out approach to the inevitable cavity excavation.

This was not an easy choice.  The novocaine shot was painful, sure, but sitting in the dentist’s chair, holding the arms of the chair in a death grip and trying to retreat into my inner world while much earlier, much drier versions of dentist’s drills whined and smoked and chipped away the enamel around the cavity, touching the central tooth nerves with distressing and instantly excruciating frequency, wasn’t any walk in the park.  In fact, it always hurt like hell, too.  Our dentist, a kindly fellow, would notice my eyes watering and my lip quivering and ask if I was okay, and I would splutter, from a mouth filled with gauze and cotton, that I was fine — but of course I wasn’t.  Those novocaine-free cavity-filling visits to the dentist seemed to last forever.

Finally, after a particularly painful multi-cavity-filling visit, I decided that the next time I would try novocaine again.  Sure, my initial encounter with it had sucked, but all of my friends and siblings seemed to go for it without much problem.  Maybe I should change my position on this damned-if-you-do, damned-if-you-don’t choice?  So the next time I visited the dentist I went for the novocaine.  It wasn’t a pinch by any means, but this time it didn’t hit a nerve directly on the way in and it was . . . slightly better.

It was my first experience with choosing between the lesser of two evils.  Only much later did I realize that maybe I should make a more significant and potentially meaningful choice, to change my habits and improve my lax attitude to brushing and flossing and mouthwash and try to take steps that hopefully would eliminate the need to make such a choice in the first place.  I guess that is called the maturing process.

Spending Time With Mr. Inside And Mr. Outside

There seems to be a direct correlation between my age and the amount of time I spend on personal dental care.

When I was a kid, I paid virtually no attention to the need to brush my teeth.  Back then, the only cavity-fighting implements were a toothbrush and a tube of Pepsodent.  I ignored them, ate sugary cereals with reckless abandon, and ended up with a mouth full of metal fillings.  As I matured, I slowly came to realize that getting my yap shot full of novacaine and having my teeth drilled down to the nerve level wasn’t much fun, and was expensive, besides — but the damage was done.

Over the years, new weapons have been added to the dental care arsenal.  First it was the Water Pik, then dental floss, then tooth whitening strips, then tiny brushes to reach the “food traps” between your teeth.  The most recent addition to my toothbrush holder is an odd, angled, double-ended brush with “inside” written on one end and “outside” on the other.  You use it to sweep along the inside and outside of the gums along your back teeth, hoping to avoid deepening “pockets” back there.  Every morning when I use it I inevitably think of Glenn Davis and Doc Blanchard.

With each new dental care device, I spend more time in front of the bathroom mirror, fighting a desperate, rear-guard action against jawbone loss, retreating gum lines, and a mouth that reveals that I am, literally, long in the tooth.  I wish I could say that my morning ablutions are a time of rich personal reflection, but they aren’t.  As I proceed through my progression of brushes, flosses, picks, and rubber-tipped appliances, I hope only that my belated devotion to dental discipline will allow me to somehow avoid crushingly expensive crowns, implants, root canals, visits to oral surgeons, and other literally and economically painful fruits of my youthful dental indiscretions.