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.

 

Tooth Technology

Last Tuesday night I was watching TV when I suddenly felt a pebble in my mouth.  “What the,?” I thought.  “Where did that come from?”  Except it wasn’t a pebble.  When I fished it out of my mouth, and then went and looked in the mirror, I saw that part of a tooth had somehow broken off.  Fortunately, the nerve wasn’t exposed, and it wasn’t painful, but it sure looked and felt weird.

broken-teeth-repairI don’t know what caused a part of the tooth to break off like that.  I hadn’t been slugged in the chops or hit in the face by a hockey puck.  My understanding is that, even long after we reach adulthood, our teeth keep moving slightly along the gums, like the tectonic plates shifting under the San Andreas fault line.  The tooth in question had been increasingly pressing against its neighbor, and it may have been that the stress finally caused a fracture.  (Or, it may have been that I like eating almonds, and also like crunching on ice cubes, but I’m going with the “moving tooth” theory because it leaves me blameless.)

I groaned when I saw the broken tooth, because I thought the lack of structural integrity in the tooth might require some major dental repair work, like a crown or maybe even an implant.  But when I went to see my dentist yesterday morning he took a look at the breakage, expressed his sympathy, said he’d have me fixed up in no time at all, and went right to work.  First he slathered on some goop, then he did some sculpting to give it the appropriate tooth shape, then he stuck a plastic sheet between the tooth and its neighbor to create the appropriate dental floss gap, then he used some kind of heat ray/laser light gizmo that looked like some throwback to a Flash Gordon movie.  The process ended with him grinding and polishing the reconstructed tooth so that it felt like a natural tooth, and then handing me a mirror so I could check it out for myself.  To my amazement, the rebuilt tooth looks (and feels) exactly like the old tooth — and the whole process took less than a half hour, without any need for novocaine or gas.  Within an hour or so, I was eating a pot roast sandwich for lunch without missing a beat.

Everybody makes fun of their trips to the dentist, me included.  We’re all anti-dentites, I guess.  But I’ve got to give credit where credit is due — when the chips were down (pun intended) and my tooth and I needed some serious help, my dentist came through and did a great job.  And it’s interesting that we’ve got the technology that allows a busted tooth to be reconstructed in the time it takes to watch your average TV sitcom.

Toothless

Anybody who’s leery of going to the dentist will undoubtedly appreciate this story:  a man from Indiana went to the dentist to have four teeth pulled, only to awaken from the procedure to find that all of his teeth had been removed.

dentures-anchorage1The four teeth were being yanked out to allow the dentist to deal with an abscess — which is a disgusting enough problem in the first place, when you think about it.  According to the patient’s wife, the dental surgeon then decided to pull all of the teeth to prevent the spread of the infection. The dentist’s office is limited in what it can say about the patient because of federal health care privacy laws, but has released a statement that every patient receives a thorough explanation of the treatment plan for their condition and the issues that might arise, and then executes an appropriate consent form.  Either way, a guy who had a full set of choppers when he was put under later awoke from the procedure with a gaping void where once his teeth had been.

We tend to take our teeth for granted — until they aren’t there, I guess.  I can’t imagine what it would be like to wake up and find that all of my teeth were gone, but having read the story about that guy from Indiana I’m sure going to do what it takes to avoid ever having to deal with that nightmarish scenario.

Excuse me while I go brush my teeth, will you?

 

When Teeth Are Like Garage Floors

Yesterday I had one of my periodic tooth cleaning appointments.  This time, after already using the pointy-ended scrapers and the flat scrapers, the ultrasonic scaler, the water spray, the buffer, and the dental floss, the hygienist frowned thoughtfully.

“The tongue side of your teeth still has some staining,” she said with some impatience, as her rubber-gloved hands probed my incisors.  “I’m going to try a new procedure.”

Whhgl?” I responded.

The procedure first involved draping me with towels that covered all parts of my upper body except my mouth and left me unable to see — which was itself a weird sensation when you know the person hovering over you is wielding sharp implements.  “There’s a bit of a spray,” she explained.  She then proceeded to blow puffs of particulate matter against my teeth — which was an even weirder sensation, because humans normally seek to avoid getting clouds of dust in their mouths.  But after numerous puffings and rinsings and suctionings, she removed the towels and expressed evident satisfaction at the result.

All this, to address the apparent dinginess on the back side of my teeth that no one sees.

If you go regularly to a dental hygienist — as 9 out of 10 dentists say you should — you eventually realize that the hygienist community is simply borrowing cleaning techniques initially used in American garages.  First, it was simple scraping and scaling, like a homeowner using a hoe to try to remove flattened globs of gum or tar from a cement floor.  Then it was powerwashing, with those pulsating jets of water that leave your face coated with a fine, wet mist.  And now, with this dust-puffing device, hygienists have adopted sandblasting.

What’s next?  Using powerful chemical solvents?  If you want to see what’s coming down the pike in periodontal technology advances, I suggest you just check here.

Floss First, Or Brush First?

The other day we were getting ready for work and I noticed that Kish flossed her teeth before brushing.  I follow the opposite approach.  My morning routine is inviolate:  first brushing, then flossing, then use of the mini-bottle brushes for the “food trap” spaces between my teeth, and then finally pressing this weird rubber tip device against my gums.  (Why do I do all of this stuff?  My dentist recommends it and says I will lose my teeth if I don’t spend every waking hour focused with laser-like intensity exclusively on dental care issues.)

Kish’s use of a different approach made me wonder whether there is a “right” order to the brushing and flossing activities.  Surprisingly, it turns out that there has been a lot of chatter about this.  Some people say floss first, so that the brushing can whisk away the plaque that has been loosened by flossing.  Others say brush first, and then the flossing will sweep away the remaining toothpaste grit.  I brush first because I am desperate to get rid of the disgusting morning breath in my mouth before I do anything else.

Some quick internet research determined that the American Dental Association has actually considered this issue.  They conclude that it really doesn’t make any difference what order you follow, so long as you both brush and floss.  I briefly wondered whether any research had been done before this pronouncement was issued, or whether it was of dubious scientific merit — like the chewing gum ads that said 7 out of 10 dentists recommended a particular gum for their patients who chew gum.  Then I realized that it was an incredibly boring topic, anyway, and I had spent more than enough time getting to the bottom of it.