Oral Answers

5 Reasons to Be Thankful for Your Teeth

Tom — Wed, 23 Nov 2011 23:07:39 +0000

It's easy to take things that we use everyday for granted. When was the last time you thought about what your teeth do for you? Whether you think about it or not, your teeth do some pretty amazing things for you that you probably don't even notice.

5 Reasons to be Thankful for Your Teeth

On this Thanksgiving Eve, I thought I would mention a few reasons to be thankful for your teeth.

1 - Your Teeth Help You Chew Turkey

Not just turkey either! Your teeth tear and grind all the different foods you eat every day. I vividly remember an experience I had working at a dental clinic before going to dental school. An older man came in for his final appointment to get his dentures. He excitedly told me that the first thing he was going to do was to go down to the local grocery store and buy a vegetable tray. Before that incident, I'd never really taken the time to think about how I would eat without teeth.

2 - Your Teeth Make You Attractive

A smile can go a long way toward improving your appearance. Without teeth, you wouldn't be very likely to smile. Every year, people spend millions of dollars trying to make their teeth look whiter, brighter, and more beautiful.

3 - Your Teeth Help You Speak

Try saying the phrase I'm thankful for turkey. Notice how your tongue touches your teeth during the th and t sounds and your upper teeth touch your lower lip to say the word fo.

Speaking without your teeth is harder than you might think.

4 - Your Teeth Affect the Shape of Your Face

Here's a thought exercise: picture a 101 year old man with no teeth in your mind.

You probably saw a man who's mouth appeared "sucked in" and his face kind of seemed scrunched up and not very tall. Your teeth support your lips and cheeks and make your face appear longer. To learn more, read How Your Teeth Affect the Length and Shape of Your Face.

5 - They Keep Your Jaw Bones Strong

Your jaw bones stay as thick and strong as they are because they work hard by holding onto your teeth. Without teeth, the jaw bones begin to atrophy and shrink from lack of use. This can make it easy for your jaw to fracture — it's also a reason why people who have been missing their teeth for a very long time can't get a lower denture made that fits very well: they simply don't have enough bone to support it.

Why Are You Thankful for Your Teeth?

Did I miss any reasons why you're thankful for your teeth? Speak your mind in the comments section below. Thanks for reading, and to all of my fellow Americans: Happy Thanksgiving!

What’s the Best Mouthwash for Bad Breath?

Tom — Thu, 17 Nov 2011 04:07:45 +0000

Did you know that as many as half of all Americans say that they suffer from bad breath?

Many people have turned to mouthwash to try to curb their oral odor, but does mouthwash really help fight bad breath? If so, which one is the best?

Mouthwash Can Fight Bad Breath

Many mouthwashes used to simply provide a strong, pleasant aroma to cover up bad breath. As time passed, mouthwash manufacturers began adding certain ingredients to their mouthwashes to help fight bad breath.

Today, there are many varieties of mouthwash available. Although most of them have flavors that would appear to freshen your breath, only mouthwashes that contain certain ingredients are able to help fight bad breath.
Researchers wanted to find out whether or not mouthwashes actually helped fight bad breath. The following quote is from a systematic review that combined the results of five different studies to determine the following:
"This review, which included ﬁve trials (293 participants), found that there is some evidence that mouthrinses containing antibacterial agents such as chlorhexidine and cetylpyridinium chloride or those containing chlorine dioxide and zinc can to some extent reduce the unpleasant odour but the use of mouthrinses containing chlorhexidine resulted in noticeable but temporary staining of the tongue and teeth."

As long as the mouthwash contains an antibacterial agent such as chlorhexidine or cetylpyridinium chloride (CPC) or zinc and/or chlorine dioxide, it may be able to fight bad breath.

Before trying a mouthwash to control your bad breath, try one of these five methods to find out if you have bad breath and then try to find out what is causing your bad breath by learning about some common causes of bad breath.

Which Mouthwash Is Best for Bad Breath?

In the United States, mouthwashes containing chlorhexidine are only available by prescription. The only antibacterial that this review found to be effective against bad breath that is also available over the counter in the United States is CPC. CPC in combination with zinc can be found in many mouthwashes.

Breath Rx mouthwash can fight bad breath

This BreathRx mouthwash from Amazon contains CPC as well as zinc to neutralize bad breath-causing volatile sulfur compounds. Crest Pro Health mouthwashes are another alternative, but they have been the target of some rather negative reviews.

You may be wondering where other mouthwash products such as Listerine fit in. Listerine contains a variety of essential oils that decrease bad breath. Although Listerine was shown to decrease bad breath in many of the studies that were reviewed, products containing an antibacterial along with zinc were shown to do a better job at fighting bad breath.

Is Mouthwash the Best Method of Fighting Bad Breath?

Although many people use mouthwash because it is easy to simply rinse their mouth out, there are other ways of fighting bad breath. Good oral hygiene along with cleaning your tongue has been shown to reduce bad breath. Getting rid of the pl

Do you have any questions or comments about mouthwash and bad breath? Leave your comments below. Thanks for reading!

Nitrous Oxide: A Great Way to Calm Your Dental Anxiety

Tom — Tue, 15 Nov 2011 02:29:02 +0000

In order to get certified to administer nitrous oxide (commonly called laughing gas), I have to run a certain number of cases to prove my competence.

Last Friday afternoon, I was able to give a patient nitrous oxide and literally change his perception of dentistry.

He loved it. I asked him about his dental fear and he said something like, "You know when you're in an airplane and there's a sudden rush of unexpected turbulance, you grab onto the handles of your seat. That's how I am at the dentist."

On Friday though, he said he felt great. He was telling jokes in the dental chair and having a great time. He said that the nitrous oxide made him feel great, he said he felt like he was drunk.

He was a fairly young guy that had simply avoided going to the dentist and ended up with a few lost teeth and a lot of teeth in bad shape. Nitrous oxide has given him the ability to overcome his dental anxiety and sit in the chair.

Nitrous Oxide in Dentistry

As you can see in the picture above, nitrous oxide is given to a patient through a mask that is placed over the nose. In addition to nitrous oxide, we run oxygen into the mask so that the patient is always getting more oxygen than they would just by breathing in regular air.

An advantage of nitrous oxide over other forms of sedation is that it works pretty fast. Within a few minutes, the patient is relaxed. Also, when you have finished your dental procedure, the recovery is fairly rapid as well. You are able to drive home after the appointment since you don't remain drowsy.

Is Nitrous Oxide Dangerous?

Nitrous oxide is safe when it is administered with adequate oxygen. Although side effects are fairly rare, the most common side effect of nitrous oxide is nausea.

Nitrous oxide may be harmful with long-term exposure. This doesn't really apply to patients, it's more for those people who work at dental offices and get exposed to it every day for years.

Regarding possible long-term negative effects of nitrous oxide, Pinkham's Pediatric Dentistry textbook states, "Retrospective survey studies of dental office personnel who were exposed to trace levels of nitrous oxide suggest a possible association with nan increased incidence of spontaneous abortions, congenital malformations, certain cancers, liver disease, kidney disease, and neurologic disease."

Conclusion

Nitrous oxide can help many patients overcome their dental anxiety. I have a patient with a lot of dental fear that gets nitrous oxide every time he comes in. He loves how it calms him and allows him to get his needed dental work done.

Do you have any questions or comments about nitrous oxide in dentistry? I'd love to hear what you have to say in the comments section below. Thanks for reading!

Eruption Cyst: A Purple Blue Bump on Your Baby’s Gums

Tom — Thu, 10 Nov 2011 03:44:21 +0000

Many parents worry when they find that their young child or baby has a bluish purple bump on their gums. This is a fairly common development and is known as an eruption cyst or eruption hematoma. For uniformity throughout the article, I will simply refer to them as eruption cysts.

What Are Eruption Cysts?

The easiest way to describe eruption cysts is by talking about how teeth develop. Your child's teeth form inside of a protective enclosure in their jaw bone. When the teeth are done forming, they start to move through the bone, and then through the gums until they make it into the mouth. An eruption cyst occurs during the tooth's final entry into the mouth - after it has already made its way through the bone and is just under the surface of the gums.

The protective enclosure which the tooth developed in can leak and allow fluid to accumulate between the tooth and the gums. If an opposing tooth touches the gums, it may cause fluid and possibly blood to accumulate between the tooth and the gum. This causes a bruise to form in the gum tissue between the tooth and the outside surface of your child's gums. Depending on the amount of blood that accumulates in the eruption cyst, it can be a translucent color, bluish purple, or even dark red and brown.

Although they are unattractive and often cause parents to worry, most eruption cysts are actually painless.

What Causes Eruption Cysts?

The most widely-accepted theory is that eruption cysts are caused by trauma to the gums a few weeks before a new tooth comes in. The trauma doesn't have to be severe — McDonald & Avery's Pediatric Dentistry states that the trauma occurs as a result of normal chewing.

Another reason eruption cysts occur is due to thickened gum tissues. This can result from taking certain medications. Neville's Oral Pathology textbook hypothesized that one reason eruption cysts occurred in a young child taking cyclosporin was due to "collagen deposition in the gingival connective tissue that resulted in a thicker, less penetrable, pericoronal roof." With thicker gums, it may have been more difficult for the tooth to erupt into the mouth, causing an eruption cyst.

Who Can Get Eruption Cysts?

Any child can get an eruption cyst before their tooth erupts into the mouth. As far as race goes, they are reported to be most common in Caucasian children and they are just as common in boys as in girls.

How Common Are Eruption Cysts?

Nobody knows. A scholarly article has state, "Prevalence of eruption cyst has not been thoroughly studied. Extensive review of literature revealed low prevalence of these cysts."

Many parents may not notice that their child has an eruption cyst or may simply do nothing about it and then note that it goes away. Due to the fact that many eruption cysts are not documented very well, it's hard to pinpoint an exact percentage when it comes to how common eruption cysts are.

In an exam of 1,211 children from a Brazilian hospital, it was found that 2 of them had eruption cysts. That's only 0.17% that had eruption cysts at the time that they were examined. However, many more of these children may have had eruption cysts before they were examined. This would lead me to believe that eruption cysts are much more common than 0.17%.

Where Do Eruption Cysts Occur?

Although it has been debated, most articles (like this one) state that eruption cysts occur most commonly in the upper jaw. They most commonly occur with the baby incisors, the baby molars, and the permanent first molars.

How Are Eruption Cysts Treated?

Normally eruption cysts don't need treatment. The tooth will usually break through the cyst within a few days come into the mouth on its own. If the eruption cyst persists in the mouth for more than a few weeks, many dentists will make a small incision in the cyst which will allow the tooth to come through. Depending on the anxiety level of your child, this procedure can usually be done under local anesthesia.

What Else Could It Be?

When we see a swelling over a tooth that is about to erupt, we usually think of eruption cysts. It is possible that it could be something else though, such as a calcifying odontogenic cyst. This case report states, "Other lesions that can cause gingival swellings include peripheral giant cell granuloma, peripheral ossifying fibroma, pyogenic granuloma, and other less common peripheral odontogenic tumors."

Questions?

Do you have any questions, comments, or concerns about eruption cysts? Feel free to leave a comment in the comments section below.

I want to especially thank Leigh for sharing the above photo of her 8 month old daughter's eruption cyst. If anyone else wants to share their photo, you can email them to OralAnswers at Gmail.com or use this contact form. Thanks for reading!

Double Tooth Photos

Tom — Tue, 08 Nov 2011 00:56:58 +0000

Since starting Oral Answers, many people frequently email me photos that would be useful to share with everyone here on Oral Answers to illustrate a particular dental condition. Since many parents end up coming to Oral Answers via the page on double teeth, I thought it would be appropriate to start a collection of double tooth photos.

This double tooth photo collection will start out with the three photos below. If your child has a double tooth (either gemination or fusion), a photo of your child would benefit other parents who come to this site searching for photos and information.

To get your photo below, simply use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

Double Tooth Photos

This first photo is the one I featured on the original post that discusses double teeth. It is Rachel's son, who has gemination:

The following two photos are from Tiffany. At first glance, her son appears to have a gemination tooth on the opposite side as Rachel's son in the photo above:

Here's a close-up of the tooth pictured above:

Submit Your Photos

If you would like to submit your photos that show a double tooth, please use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

If you have any questions or comments, feel free to leave a comment in the comments section below. Thanks for reading!

16 Dental History Pictures That Will Make You Love Your Dentist

Tom — Fri, 04 Nov 2011 22:09:20 +0000

As much as people don't like the dentist nowadays, things used to be a lot worse! Take a look at the pictures below to see how far dentistry has come in the past few centuries.

16 Dental History Pictures That Will Make You Love Your Dentist

A Jolly Man with a "Fixed" Missing Tooth

It's hard to imagine living in an era where people consider their teeth fixed when they are missing.

Teething Trouble? Give the Kid Some Cocaine & Alcohol

Many years ago, it was common to give a teething baby all sorts of concoctions to get them to calm down. My favorite have to be these cocaine drops, followed by Mrs. Winslow's teething syrup, which would now be illegal for those under 21 years of age!

"Gather 'round, children. Let's look at the Mrs. Winslow's Soothing Syrup advertisement again!"

Don't want to get your baby drunk? Here's some natural teething remedies you can try.

Would You Like Your Wisdom Teeth Extracted?

This illustration, The Martyrdom of St. Apollonia, shows the torturous extraction of teeth. I'm glad that this isn't how my wisdom teeth were removed!

German Traveling Dentist

In the picture above, a German dental quack, who looks strangely like Captain Hook, is holding a large tooth that he supposedly extracted from the little midget next to him. If you look closely, you will see a necklace of extracted teeth hanging over the edge of the table.

His cute little assistant is mixing up a variety of powders and potions that this dentist claims will cure complications from kidney stones and pregnancy.

Traveling French Dentist & His Monkey

This French dentist proudly displays a tooth that he recently extracted from the gentleman on the right and it would appear he suffered a great deal.

Perhaps as a marketing gimmick, this dentist has a monkey that imitates his every move!

Although your dentist probably wouldn't extract a tooth without gloves, you should still evaluate your dentist's infection control program.

18th Century Persian Dentist Tooth Extraction

Here's an 18th century Persian dentist engaging in the fine art of a gentle tooth extraction. The gentleness reflects the subtitle of this picture, which was taken from a passage found in the Quran about the need to be kind to your fellow men.

Traveling Dentist in a Dutch Village

I still can't get over the fact that people used to gather and watch tooth extractions for entertainment.

A Surprifing Toothache Cure

If this guy had lived in our day, I am willing to bet he'd be all over the TV on infomercials and all over the internet with affiliate websites peddling his "fmall letter" that would cure a toothache. I can almost hear his voice pronouncing the letter s like the letter f.

A sufferer comes to him saying, "I come to you to get Relief for a moft violent Tooth-Ache." The swindler then responds, "My Letter, that fmells fo very pleafant, when delivered is your Relief."

Interestingly, there are still people like him on the internet that push dangerous, risky, and unproven treatments for toothaches and gum disease.

Backbreaking Work for this Dental Assistant

I guess they don't make dental assistants like they used to! I feel bad for all three, but probably the dentist the most for his poor fashion sense. I promise, you'll never sit in my dental chair and see me wearing pants like that!

An Athletic Italian Dentist

I can't believe that in 3 ½ years of dental school, my tuition still hasn't covered a class covering athletic dental extractions. Hopefully it's coming up soon.

The next patient appears to be drinking some extra alcohol in anticipation of her extraction.

Curing a Toothache with Fire

A suffering patient bends over this brazier fueled by burning seeds. The fumes from henbane seeds were believed to drive the worm out of the aching tooth.

Yeah, people used to believe that toothaches were caused by worms that burrowed into the tooth and caused pain. Even if there were worms, it's more likely that the henbane would've killed the person before it killed the worms, since it is now known to be a very toxic plant.

The Japanese Tooth Extraction: Kneeling Method

I'm betting that she is handling the extractions so well because she knows that she's got not two, but three black, wooden dentures ready for her when she's done.

Arabic Dentist Cauterizing Dental Pulp With Acid

Here's an Arabic dentist injecting acid into the dental pulp of a patient. He uses a protective syringe to keep the acid from burning his hands.

Not sure what dental pulp is? It's the nerve of the tooth - Learn more about the anatomy of a tooth.

The Tooth Drawer

This is the picture I featured in my article on tooth drawers not too long ago. This elegantly dressed dentist advertises himself as the dentist to the Great Mogul. He wanted everyone to know that even royalty subjected themselves to his charming, yet awful dental skills.

The Italian "Oral Surgeon" That Effortlessly Removes Jawbones

I don't know how people believed this one. This Italian "oral surgeon" has just pretended to extract an animal's jaw from his actor-patient. The crowd stares in amazement, the way the surgeon looks at us through the picture easily tells us that he's living a lie.

The main theme in a lot of these pictures is having a crowd admire the dentist's work. Now that we have YouTube, people have turned away from the dental office when they seek entertainment.

Conclusion

Hopefully these pictures from the history of dentistry will allow you to gain a greater appreciation for your current dentist. There's a lot to be grateful for when you think about dentists of today:

We don't stand on you or tie you down to pull your teeth.
We don't travel from town to town with deceitful publicity stunts.
We don't prescribe medications that could cause serious harm to you or your children.
We use local anesthetic so you don't feel the pain of dental work.
We don't try to sell you questionable cures for your problems and base our treatment on scientific evidence. Well, most of us do!
We don't hold your head over a burning pot of flames to cure your toothache.
We can fix teeth, rather than simply extracting them.
We wear gloves and use sterile dental equipment.

Questions, comments, or concerns? Please leave a comment in the comments section below. Thanks for reading!

Why Do I Need a Filling? Six Reasons Why Dentists Do Fillings

Tom — Thu, 03 Nov 2011 01:43:44 +0000

Many people wonder why their dentist tells them that they need a filling. Although having a cavity is the #1 reason we do fillings, there are also many other reasons that people get fillings.

Why You Need a Filling

1 - Cavities

Cavities remain the number one reason that dentists give patients fillings. Even so, not all cavities need fillings. Sometimes very small cavities can be "watched." When this happens, the dentist monitors the cavity and if it appears to be repairing itself, you won't need to get a filling.

I'd like to add a word of caution: Only leave a cavity unfilled if your dentist has recommended that your cavity should be watched. Putting off necessary dental work can complicate your dental health and increase your costs.

If you do have small cavities that your dentist is keeping an eye on, check out these 12 weapons of plaque destruction to see how you can help your cavity heal.

2 - Tooth Fracture

Many times, fractured teeth can be repaired with white composite filling material. You can take a look at a tooth that I repaired with a white composite filling before I started working with real patients in dental school.

Prevent your teeth from fracturing by wearing a mouth guard during these 16 activities.

3 - A Slow Loss of Tooth Structure

When you fracture your tooth, you lose a lot of tooth structure quickly. There are other ways that you can lose tooth structure more slowly, such as abrasion, abfraction, erosion, and attrition. You can learn about those in the article about the four ways you wear away tooth structure.

The best way to prevent this type of tooth loss is by avoiding acidic drinks and acidic candy, not grinding your teeth, and not using your teeth as tools.

4 - Tooth Discoloration

Another reason that dentists do fillings is to cover up discolored teeth. Teeth can be discolored for a variety of reasons, such as staining from antibiotics and dental fluorosis.

5 - Replacing Old Fillings

Old fillings may need to be replaced. Over time, white fillings can discolor and the bond between the filling and the tooth can break down. Silver fillings may also fracture after many years of service. One of the first fillings I did in dental school (unbeknownst to my patient!) was the replacement of a silver amalgam filling that had fractured.

Questions About Fillings?

Do you have any questions about why dentists do fillings or why you need a filling? Go ahead and leave a comment in the comments section below. Thanks for reading!

Halloween Candy and Your Teeth

Tom — Tue, 01 Nov 2011 02:58:46 +0000

I had a fun time trick or treating tonight with my son and daughter. The first thing my daughter wanted to eat when she got back was a bag of pretzels she was given. She eventually moved on to the candy. When I went to brush her teeth before she went to bed, I got one side done and then she wouldn't let me brush anymore.

I could see the Kit-Kat stuck to her teeth and told her we needed to clean them. I took a picture to show her, and then she let me brush. Here's what the Kit-Kat did to her back teeth:

Note that I had already brushed the teeth that are on the right in the photo. This picture shows why people so often get cavities on the chewing surface of their teeth.

If I had simply not brushed her teeth tonight, that Kit-Kat probably woud've been sitting there for many hours, if not all night, since our salivary glands almost shut off while we sleep. During this time, the bacteria in her mouth would have been enjoying the Kit-Kat and starting a cavity.

Find out how plaque cause cavities.

Hopefully this photo provides a good illustration as to why it is important to brush your teeth after eating sugary snacks.

Do you have any questions about Halloween candy and your teeth? Write them below in the comments section. Thanks for reading!

The Tooth Drawer – The Dentist of Years Gone By

Tom — Thu, 27 Oct 2011 02:07:12 +0000

Imagine living in a remote village 300 years ago. After suffering with a toothache for weeks, you see an advertisement about a traveling dentist who will be performing in the village square next weekend. You feel relieved, but somewhat nervous.

Who were these dentists that traveled around the countryside putting on loud, raucous shows whereever they went?

They were known simply as tooth drawers (pronounced draw-ers).

The Tooth Drawer

The tooth drawer would generally travel to different villages and set up shop temporarily. Usually a tooth drawer would set up a stage with lots of decorations as you can see in the picture above.

Many people had to be in extreme pain before they would dare go to a tooth drawer. Tooth drawers ended up getting a bad reputation because many of them weren't very good dentists and simply craved fame and attention. Also, as you can see in the picture above, someone was picking the pocket of the tooth drawer's patient.

On stage, they would act like they were great dental surgeons, but they often did this by tricking their audience.

How The Tooth Drawer Would Trick the Audience

Once a tooth drawer set up shop in a town, they would call someone from the audience who was suffering from a toothache. The tooth drawer actually planted actors in the audience who would pretend to be suffering from a toothache.

After calling the actor up, the tooth drawer would pretend to extract the painful tooth and the patient would then cough out a bloody tooth. In reality, the tooth drawer would give his actor an extracted tooth with blood on it and tell him to cough it out. The actor would then exclaim, "I didn't feel a thing - Thank you for taking me out of pain!"

After the tooth drawer finished with his actor, he would call another toothache sufferer up. Those who really had a toothache would scream in agony at the tooth drawer's rough methods. Unfortunately, by this point, the crowd would be so loud and rowdy that nobody noticed how much suffering the tooth drawer was causing.

Was Every Tooth Drawer Dishonest?

Not every tooth drawer was dishonest. There were some that truly wanted to help people get out of pain. The problem was that way back then, nobody knew about local anesthesia. Nobody knew that teeth could be saved by doing root canals. The main problem was that there was simply a lack of scientific knowledge in the field of dentistry.

In her book Tooth Worms & Spider Juice, Loretta Ichord states, "Even the honest tooth drawers had limited skills and were capable of tearing large pieces of bone off with a tooth, breaking jaws, and causing facial deformities."

If you take anything away from this article, I hope that you'll realize that dentists aren't as scary as they used to be. With modern technology, your visit to the dentist no longer has to be painful or dangerous. And by the way, with the HIPAA privacy act as one of your dental patient rights, you no longer have to worry about dozens of spectators coming to watch you during your dental visit like in the picture below. Thanks for reading!

Teething Baby Pictures

Tom — Tue, 25 Oct 2011 02:27:38 +0000

One of the most frequently read articles on Oral Answers over the past year is an article that I wrote back in January called What A Baby's Gums Look Like While Teething.

That article only showed pictures of the two lower teeth coming in. I figured that it would also be helpful to show what the upper two teeth look like while coming in.

Also, since all babies are different, I figured it might be helpful to see pictures of a different teething baby.

Melissa, an avid photographer, did an excellent job of documenting her son's teething experience.

Her son Logan is now four years old and has all of his baby teeth. Melissa generously allowed me to use her photos in this article to show what his teeth looked like as they came through his gums and how he made it through the teething stage.

How A Baby's Teeth Look As They Cut Through The Gums

Here's a picture of Logan's two upper front teeth as they came poking through the gums:

Here's a slightly different angle of the same picture:

Here's a photo of Logan 8 days after the two above pictures were taken:

Melissa says that Logan's teething lasted about one week per set of teeth that came in (teeth usually come into the mouth in pairs.)

How to Help Your Baby Survive Teething

There are many things that you can do to help your baby survive the teething process — I don't mean survive literally, as modern science has shown that babies don't die from teething!

Melissa states the following about how she helped Logan make it through his difficult teething experience:

"Since he did have one set come in right after another, it was hard to tell when he wasn't teething minus the spike of a fever right before his teeth would come in. We constantly kept a bib on him to help soak up the drool. He had eczema and the drool made it worse, so I used a clear diaper rash ointment down his chin, neck and chest to protect that area and treat and prevent the rash from getting worse. Logan liked small, plastic, water filled teething rings that you put in the refrigerator. He also liked cold, wet wash cloths to chew on. Apples helped for some of his teeth, but he didn't like them every time. We tried Orajel, but he didn't really like it that much. It did seem to help when he would let us get it in there.

Mostly, he liked chewing on our fingers. It could hurt us, but at a certain point you will do anything to give your little one some relief. Baby Tylenol for the fevers and night time pain helped once in a while, but if you have a baby who is constantly teething, like Logan, you can't exactly keep them hopped up on Tylenol. Hyland's has a teething pill that is natural that really helped Logan and I highly recommend. I also nursed Logan until he was 12 months old, and I think that helped. He never bit me, but it seemed to sooth him somehow."

Here's a link to the Hyland's Teething Tablets that Melissa mentioned. They seem to have pretty good reviews on Amazon - I wish I'd known about them with our first child!

Here's a few photos that show Logan easing his teething pain with plastic teething rings, a toy he ripped off his bouncer, and an apple:

Just as a comparison, here's two photos that show Logan teething as a baby, then again as a toddler. It seems like he didn't mind it as much once he got a little big older.

You and Your Baby Will Make It Through Teething

I remember when our oldest son was teething for the first time, my wife and I had no idea what to do. He was extremely irritable. At the time, I was going to school full time and my wife was working full time. We were both exhausted and I vividly remember one night we were both up with our son and my wife ran out to go get some Orajel (which we've since learned more about).

Those days are far behind us and we now have a couple of kids with full sets of teeth. In retrospect, teething was just one small part of their infancy. Although it was uncomfortable for them at the time, it really is just a distant memory now.

Near the end of her email to me, Melissa said:

"Time has a way of making you forget some of the little parts of their childhood."

Teething will be over before you know it, and you and your baby will both make it through just fine!

If you have any questions, comments, or concerns about teething, feel free to leave a comment below. Thanks for reading!

Don’t Wait Until Your Tooth Hurts to Go to the Dentist

Tom — Fri, 21 Oct 2011 23:33:58 +0000

This morning I saw a patient who had been in extreme pain for the last couple of weeks. What started as a small cavity grew into a large cavity that eventually made its way to the tooth's pulp. We were able to take her out of pain by starting a root canal today.

If we end up fixing her tooth, rather than extracting it, it will cost her around $1200. Even then, with the condition of the tooth, it may only last her 5-10 more years.

A bridge to replace that tooth would cost her $1350. An implant to replace that tooth would cost her $2100. And those are dental school prices. It would probably be about twice that in a private practice. You can find the average dental fees in your area here.

Had she come in a couple of years ago, we could have easily removed the decayed portion of the tooth and put in a filling. With the prices at my dental school, that would have cost her only $84 and would have most likely lasted her at least 20 years (she has several amalgam fillings that are still going strong after more than 15 years.)

Find out how long a silver filling lasts.

The Moral of the Story

What I'm trying to get across is that if your dentist recommends getting a filling in a tooth, get it!

If you put it off simply because the tooth doesn't bother you, there's a good chance both you and your wallet will be experiencing some pain in the future.

Dental Patient Rights

Tom — Wed, 19 Oct 2011 20:12:42 +0000

I got an email yesterday from a reader named Harris, who stated, "I paid $5000 to replace a broken crown. The dentist did not tell me what the cost would be until he had already started the procedure."

Harris wanted to know what kind of rights he had as a dental patient when you're not told the cost of dental treatment in advance. I told Harris that it is generally accepted that a dental patient has a right to know an estimate of the cost of a procedure before treatment begins.

I've received many other questions about dental patient rights in the past, and I thought that it would be a good time to discuss the rights of a dental patient. I have listed below what I believe to be 20 core rights that every dental patient deserves, and I'll probably use something similar to this as the patient bill of rights in my future dental practice.

Dental Patient Rights

Keep in mind that these are not legally-binding rights, although they are good recommendations for a dentist to establish a positive, successful relationship with his or her patients.

I have provided links to many other dental patient bill of rights at the end of the article if you want to take a deeper look into the world of dental patient rights.

The Right to Choose Your Dentist

You have a right to choose your own dentist. Many dentists have different philosophies regarding the best treatment and you have the right to choose the dentist with whom you feel most comfortable.

The Right to Quality Dental Treatment

You have a right to receive treatment that meets or exceeds the accepted dental standard of care.

The Right to Know the Education and Training of the Dental Team

You have a right to know about the education and qualifications of the entire dental team, including the dentist, dental hygienist, assistants, and staff. Many dental practices that believe in lots of continuing education post this information on their practice website.

Most states require that a dentist complete 15-25 continuing education "credits" every year. You can ask your dentist how many he or she has taken. Some dentists get by on the minimum, and other dentists take more courses than required.

The Right to a Clean Treatment Environment

The dental team should be using appropriate infection-control and sterilization techniques.

Learn how to tell if your dentist has a good infection control program.

The Right to Confidential Treatment

You have the right to expect that no member of the dental team will discuss your treatment with anyone else unless you authorize it. This is a right granted under the HIPAA privacy rule.

The Right to Know the Cost of Treatment

You have the right to know how much treatment will cost before treatment begins. Sometimes we don’t know what we’ll find before we start working on a patient, so it can be difficult to give an exact fee.

If this is the case, the dentist should be able to provide you with an estimate of the fee based on the various outcomes and treatment options.

Curious about dental fees? Find the average dental fee in your area.

The Right to Know Why You Need Treatment

You have the right to know why treatment is necessary for your particular condition.

The Right to Know Treatment Risks

You have the right to know what risks are associated with treatment as well as the risks of not proceeding with treatment.

The Right to Know Treatment Alternatives

There’s more than one way to skin a cat — You have a right to know what other treatments are available that would also solve your dental problem as well as knowing how long the various treatment alternatives will last.

The Right to Decline Treatment

You have the right to decline treatment if you so desire. You also have a right to know what may occur if you choose not to accept the treatment that your dentist proposes.

The Right to Know Expected Treatment Results

You have the right to know what the expected outcome of your treatment will be.

The Right to Emergency Dental Treatment

You have the right to receive emergency treatment from your dentist within a reasonable time-frame. Many dentists set aside a certain amount of time each day to see emergencies.

The Right to Be Treated Respectfully

The dental team should treat you respectfully and considerately.

The Right to Not Be Discriminated Against

You have the right to not be discriminated against. You should receive quality treatment no matter your ethnicity, sex, religion, disability, or age.

The Right to See the Dentist at Every Visit

You have a right to see the dentist every time you receive dental treatment. Different states have varying laws regarding this, and thus you can clarify this with your dental office if you wish to see the dentist at every visit.

The Right to Know How to Resolve Disputes

You have the right to know what actions you can take to resolve any disputes that might arise between you and your dentist. There are many ways to resolve disputes with your dentist.

Dental peer review is one of these means — here's what it takes to win a lawsuit against your dentist.

The Right to Timely Dental Treatment

If a dentist accepts you as a patient, you have a right to expect that you can make appointments in a timely manner and not have to wait many months before receiving treatment.

Keep in mind that sometimes this is beyond the dentist’s control. For example, if you require IV sedation or anesthesia in a hospital setting, it may take a long time to schedule your appointment so that you can have all of the health professionals available to provide you with safe, effective treatment.

The Right to a Conversation With Your Dental Team Regarding Your Treatment

You have a right to receive answers to any questions that you may have regarding your current oral health status and your proposed treatment.

You also have the right to discuss any concerns you may have regarding the proposed treatment.

The Right to Your Dental Records

You have the right to have your dental records and x-rays transferred to another dentist of your choice either for free or for a nominal fee.

Learn more about how to get a copy of your dental records.

The Right to Reasonable Accommodations for Your Disability

If you have a disability, you have a right to expect your dentist to make reasonable accommodations. For example, I have treated patients in their wheel chair when they are unable to move themselves into our clinical dental chairs.

Dental Patient Rights Available Online

There are a number of dental patient bill of rights available online. My dental school and the ADA have made copies of their dental patient bill of rights available on the internet. Here's a few:

It's interesting to note how Boston University's dental patient rights differs from the other schools' since they are a private university and appear to be more selective at accepting patients.

Questions About Dental Patient Rights?

Do you have any questions regarding your rights as a dental patient? Leave them in the comments section below and I'll do my best to answer them.

Thanks for reading!