Sinuses are simply chambers in your head that allow air to circulate to get warm and moist before it travels down to  your lungs.  Normally, the body is able to keep the sinuses clean and healthy, despite the dark, moist environment that bacteria love.

However, when conditions are right, bacteria can grow out of control in the sinuses, causing a sinus infection.  One cause of sinus infections is the common cold.  Interestingly enough, teeth can also cause sinus infections.

Before we get into a discussion on how teeth can cause sinus infections, we'll talk about where the sinuses are located.

Where Are Sinuses Located?

There are a few different sinuses located in the facial area — around the cheeks, nose, and above the eyes.   The diagram below gives you a little better idea of where the sinuses are, and how they look when they are healthy, versus how they look when they are infected.

If you look at the diagram above and imagine a row of upper teeth, you can see how the roots of the upper teeth come into close contact with those sinuses on each side of the nose.   These sinuses are known as the maxillary sinuses.  While there are several sets of sinuses, the maxillary sinuses are the only sinuses that can also be infected by a tooth-related problem.

How Often Do Teeth Cause Sinus Infections?

Hupp's Contemporary Oral and Maxillofacial Surgery textbook states, "Periapical or periodontal infections of maxillary posterior teeth may erode superiorly through the floor of the maxillary sinus.  Approximately 20% of cases of maxillary sinusitis are odontogenic."

Basically, that's a fancy way of saying that tooth and gum abscesses of the upper back teeth can eat through the bone and invade the maxillary sinus.  It further says that about 20% of all maxillary sinus infections are caused by tooth infections, rather than another cause.

Below, you'll find a couple of examples of how tooth infections or abscesses can cause sinus infections.

A Case of an Abscess Close to the Sinuses

Here is an x-ray of a tooth that had a root canal and crown done previously, but the infection at the roots had never quite healed.  I have outlined some of the important structures below for those of you who are not accustomed to reading x-rays.

I colored the sinus blue and the tooth infection red in the x-ray below:

As you can imagine, the infection and the sinuses do overlap, as you can see in the x-ray below.

Although it looks like the sinus and the infection are overlapped on the x-ray, it doesn't necessarily mean that the infection has broken into the sinus and causing a sinus infection.  It could be that the abscess is either in front of or behind the sinus in this x-ray, because the x-ray is simply a snapshot of the whole area and doesn't tell us if things are closer to the front or the back.

If you take a look at the x-ray above, you can see how close the maxillary sinus is to the upper teeth.  Sometimes there is only a thin membrane separating the roots of the upper teeth and the sinus, making it very easy for an infection to travel into the sinuses.

Although this person wasn't exhibiting any symptoms of a sinus infection, but the x-rays do a good job of showing just how close the abscess is to the sinus.

A Case of Sinusitis Caused by a Tooth

This person had chronic sinusitis for the last few years, that started shortly after she had a metal post put into one of her upper back teeth.  Upon looking at her x-rays I noticed that the metal post that was put in one of her upper teeth looked like it had pierced through edge of the tooth and gone slightly into the bone.  This caused an abscess that was leaking into her sinus.

Here's the x-ray of her upper right teeth:

To make the x-ray below easier to see, the tooth is green, the infection is red, and the sinuses are blue:

Sadly, due to the fracture in the tooth caused by the large metal post, the tooth had to be extracted.

The oral surgeon who extracted the tooth told me that the tip of the tooth broke off just above the metal post, causing the root fragment to get pushed into the sinuses during extraction.  He had to open up the sinus to retrieve the root and he was able to suction out a lot of the infection — he said it was a pretty bad infection.

Teeth Can Cause Sinus Infections

While sinus infections can cause teeth to to hurt, hopefully this post has helped you see that infections from the upper back teeth can easily make their way into the sinuses and cause sinus infections.

It is important to remember that unhealthy teeth are just one cause of sinus infections, and that there are several other causes.  If you suspect your sinus infection is caused by a tooth, you should see your dentist to confirm this.

Do you have any questions, concerns, or comments?   Feel free to leave a comment in the comments section below.  Thanks for reading!

This was a big problem with anesthetics back over 100 years ago.  Then, something exciting (to dentists anyway) happened!  A guy named Abel discovered adrenalin (a more common name for epinephrine) in 1897.   In 1903 Braun suggested using adrenalin as a "chemical tourniquet" to make anesthetics last for a longer period of time.

This Braun fellow recommended using epinephrine at the very small concentration of 1 part to 10,000.  That may seem weak, but we've found that even diluting it to 1 part to 200,000 still retains the beneficial effects of epinephrine while minimizing the side effects.

Epinephrine is what is known as a vasoconstrictor, which is just a fancy word for something that causes your blood vessels to constrict, or get smaller.

Why Dental Anesthetic Has Epinephrine

It is this vasoconstrictor effect of epinephrine that makes it so useful in dental anesthetic.  By constricting your blood vessels, it benefits you and your dentist in the following three ways.

1 - The anesthetic gets absorbed more slowly into your body because blood flow to the injection site is decreased.  Since blood levels of the local anesthetic are decreased, the risk of having an "overdose" of the dental anesthetic is minimized.

2 - Since there is less blood flow, the dental anesthetic stays put right around the nerve for a much longer time, allowing it to work for a longer period of time than it would without epinephrine.  This means that you stay comfortable throughout the entire procedure.  It also means that you might be numb for a few hours after leaving the dentist - a sometimes unwanted and embarrassing side effect!

3 - Minimizes bleeding where the anesthetic was administered.  This is great if the dentist is performing a more involved surgical procedure involving the gum tissue since it makes it much easier to see what we're doing if there's hardly any bleeding.

Epinephrine is the most common vasoconstrictor used in dental anesthetic in the United States.  In Europe, a vasoconstrictor called levonordefrine is commonly used.

If you prefer to not have these beneficial effects of epinephrine or if you have had heart problems, your dentist may elect to use a dental anesthetic without epinephrine. If that's your preference and you want to seem like you know what you're talking about, just ask your dentist for Carbocaine without epinephrine. That's the most common brand name of dental anesthetic without any epinephrine.

If you have any questions about dental anesthetic and epinephrine, feel free to leave a comment below.  Thanks for reading!

They called this the epinephrine reaction, and I blindly believed it. I even wrote a post about why dental anesthetic makes your heart beat faster. Until one day, this belief was questioned by a comment on that article (which actually caused Gavin to post a rather entertaining comment).  I realized that I'd blindly believed what I'd been taught without doing any research of my own.

In this follow-up article, I'll answer the question: Can dental anesthetic really make your heart beat faster?

A few weeks ago, a woman told me that she hates getting injections because it makes her heart beat really fast.  I asked her if a dentist had ever offered her the anesthetic brand Carbocaine (a type of dental anesthetic without any added epinephrine).  She told me that she'd never heard of it.  I tried it on her and she told me that it was the first injection she could remember where she didn't feel like her heart was beating out of her chest.

Naturally, this (along with other similar experiences) made me a believer that regular dental anesthetic with epinephrine can indeed make your heart beat faster.  As a dentist I realize that stories, while fun and exciting, may not be a very good source of evidence, so I decided to do some more in-depth research.

Can Dental Anesthetic Really Make Your Heart Beat Faster?

The main question here is whether or not the small amount of epinephrine inside the dental anesthetic makes your heart beat faster or if it's simply caused by the epinephrine your body releases in response to being afraid of the crazy dentist that's about to poke you.

Many years ago, it was thought that the tiny amount of epinephrine in the dental anesthetic made no difference in your heart rate, and any change in your heart rate was simply caused by the "fight or flight" response.

Many studies have since confirmed that the epinephrine in dental anesthetic can cause an increase in your heart rate.

One study states that "intravenous administration of 0.015 mg of epinephrine with lidocaine results in increase in the heart rate ranging from 25 to 70 beats per minute, with elevations in the systolic blood from 20 to 70 mm Hg."  For your information, one cartridge of dental anesthetic contains 0.018 mg of epinephrine — that's even more than the amount that has been shown to increase the heart rate by 25 to 70 beats per minute.  Here's a link to one of those studies that discusses this.

Malamed's dental textbook on anesthetic even confirms what I'd discovered.  It says, "Contrary to a previously held position that the intraoral administration of "usual" volumes of epinephrine produced no cardiovascular response and that patients were more at risk from endogenously released epinephrine than they were from exogenously administered epinephrine, recent evidence demonstrates that epinephrine plasma levels equivalent to those achieved during moderate to heavy exercise may occur after intraoral injection."

That simply says that the epinephrine in dental anesthetic can make your heart beat very fast, even tricking it into beating as fast as it would if you were exercising.

The author goes on to state that even if your dentist does inject slowly and "pull back" to ensure that they don't inject into a blood vessel, your heart can still beat faster: "However, even following usual precautions (e.g. aspiration, slow injection), sufficient epinephrine can be absorbed to cause sympathomimetic reactions such as aprehension, tachycardia, sweating, and pounding in the chest (palpitation): the so-called "epinephrine reaction."

More Evidence That Dental Anesthetic Can Make Your Heart Beat Faster

Even more evidence that dental anesthetic can make your heart beat faster comes from the American Heart Association.  They recommend that any patients with heart disease receive a maximum of 0.04 mg of epinephrine from dental anesthetic.  That's usually the equivalent of just two cartridges of dental anesthetic.  For comparison's sake, a normal person without heart disease can receive up to eleven cartridges of anesthetic.

This shows that the AHA believes that the epinephrine in dental anesthetic can have an effect on the heart, and that's why they recommend limiting it so strictly.

The textbook Dental Management of the Medically Compromised Patient confirms this by stating "If [a vasoconstrictor] is considered essential, use cautiously (maximum 0.036 mg epinephrine or 0.20 mg levonordefrin)."  Levonordefrin is similar to epinephrine, but it is mostly used in European countries, not in the U.S.

Lastly, the American Acamedy of Pediatric Dentists even has guidelines for dentists telling us what to do when a patient has a reaction to the epinephrine in dental anesthetic.  They say to reassure the patient, ensure they're breathing well, and to check their vital signs if necessary.

Dental Anesthetic Can Make Your Heart Beat Faster

In summary, the most recent studies and evidence all point to the fact that the epinephrine (or levonordefrin for my European friends) can definitely make your heart feel like its beating out of your chest!

Do you have any questions about dental anesthetic and how it affects your heart?  Feel free to leave them in the comments section below.  Thanks for reading!

"Your child has a cavity."

Not many parents want to hear those words, especially if their child has dental anxiety.

Last summer, I saw a three year old child who needed to have a filling on one of his upper molars.

The only reason he sat still in the chair long enough for us to remove the decay and get a filling put in was because we told him we were going to give him a yellow colored filling.

He loved tractors, and wanted it to be yellow like his toy tractor. When he was all done, we took a picture of it and gave it to him so he could show his friends and family.

I've found that giving children a colored filling (along with some other things we do to make the comfortable), helps them to sit in the dental chair and get their needed dental work completed.

Find out why baby teeth need to have fillings if they just fall out.

Colored Fillings

Colored fillings are made of the same composite materials as tooth-colored fillings, they simply have more exciting coloring added to them.

At our office, we have five colors to choose from: blue, green, yellow, orange, and pink.

To the right, you can see how the pink filling looks on a tooth - it's what most of the girls end up choosing.  That filling, as well as the green one above, was placed to fill in a cavity that formed between the teeth, which is one of the more common places you can get a cavity.

While we can do a colored filling to repair most cavities in baby teeth, nobody has had us do one on a front tooth yet!

A recent survey by the American Dental Association found that just under half of all Americans floss their teeth daily.

What about the other half?

My guess is that they're the ones who floss twice a year — right before their dental checkups.  They think they can pull a fast one on us, but here's a little secret: dentists can tell when you've been  flossing and when you haven't.

How Dentists Can Tell When You're Not Flossing

The way we can tell if you're not flossing is if your gums are bleeding.  Although there are other, less common conditions that can make your gums bleed, gingivitis is the main cause.  Gingivitis is when the gums are inflamed due to all of the bacteria in your mouth collecting right between the gums and the teeth.

The problem is that it takes about a week of daily flossing for gingivitis to go away and make it so your gums don't bleed when they are cleaned.

The most authoritative book on the gums — that's 1,328 pages dedicated to your gums! — states the following:

The presence of plaque for only 2 days can initiate gingival bleeding on probing, whereas once established, it may take 7 days or more after continued plaque control and treatment to eliminate gingival bleeding.

So, if you end up brushing and flossing really well right before your dental cleaning and exam, your teeth will be clean, but your gums will still show the main sign of inflammation: bleeding.

If you really want to trick your dentist into thinking you're brushing and flossing regularly, you'll have to do it for at least seven days before your visit. And if you're gonna do that, why not simply brush and floss every day?

Upon first glance, many parents are understandably concerned that their child has a serious problem in their mouth.  The photo I used in the original article isn't very clear, and I thought it would be good to post a couple more photos that were recently shared with me.

Photos of Eruption Cysts

The photo above shows two eruption cysts over the permanent upper front teeth.  The teeth are still white, the purple color is due to bruising that has occurred between the gums and the permanent tooth.  Usually, no treatment is necessary and the teeth will come through within a couple of weeks.

This photo shows an eruption cyst where the upper left six-year molar is preparing to come into the mouth.  Many parents may not even notice eruption cysts when they occur this far back in the mouth.

Fact: Since many eruption cysts occur on the back teeth and only last a few weeks, they often go undetected.  Because of this, nobody really knows how common eruption cysts really are.  Most estimates say that they occur in under 1% of all children.

To Treat or Not to Treat

Normally, eruption cysts don't need any treatment.  The tooth will usually poke through the eruption cyst and come into the mouth on its own within a couple of weeks.  If the eruption cyst is causing lots of pain, or if it is causing concerns due to its appearance (as in the first photo), it can be cut open to expose the tooth.

You can click the following link to check out a picture of a tooth after its eruption cyst has been opened.

More Pictures of Eruption Cysts

You can find more photos of eruption cysts in this article that appeared in the Indian Journal of Dental Research.

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

It's been estimated that half of all Americans don't go to the dentist regularly.  If you find yourself in that half, how about making a New Year's resolution to make it to the dentist this year?

Here are five good reasons why you should.

Five Reasons to Go to the Dentist

1 - Catch Problems While They're Small

If you regularly visit the dentist, your dentist will be able to tell you about smaller problems that you can easily and inexpensively get fixed.  The quicker you get a cavity filled, for example, the longer the filling will last.  If you put off getting a cavity filled while it's small, it could cost significantly more to get it fixed when it needs a root canal and crown a few years down the road.

You won't feel any symptoms with most dental problems until they are advanced.  If you have gum disease, it's important that you get it treated.  However, unless you develop a gum abscess or have gum disease that is at a very advanced stage, you likely won't experience any pain.

2 - Dental Care Is Better Than It Was In the Past

If you had a bad experience in the past, let me assure you that dentistry has come a long way.  There have been many recent advancements in the kinds of materials that we can use to fix your teeth.  Many modern restorations such as crowns and veneers look completely natural and can give you the kind of smile you've always wanted.

3 - There Are Ways to Alleviate Dental Fear

There are many drugs that you can take before you go to the dentist to make you drowsy so that you will be less anxious during your procedure.

Also, if needles frighten you, many dentists can fill small cavities using a laser without any anesthetic.  If you do require an anesthetic, there are very strong topical gels that can be placed on your gums before the injection to make the injection nearly painless.

We've come a long way since the dark ages when dentists were a little crazy — check out these pictures of old school dentistry if you don't believe me.

4 - There Are Better Deals Due to the Economy

Many dentists are running new patient specials due to the fragile state of the economy.  They figure it's better to get a new patient in even if they charge a really low price than to have empty slots.

If you perform an internet search with the terms "dentist the name of your city", you will likely find some good deals that will allow you to have a free or low-cost exam and x-rays to get an overall idea of your general dental health.

5 - There are Financing Options Available

Also due to the economy, some dental offices are willing to accept payments for dental work performed rather than requiring the full amount at the time of service.

Another excellent option that we offer at my practice is called Care Credit.  This allows patients to have the dental work performed and then make 12 equal, monthly payments over the course of the year without paying any interest.  If you do go this route, just make sure that you make all of your payments on time.  If you don't pay on time, then they will charge interest, which is how they make a lot of their money.

There's No Time Like The Present

If you've made it this far, go ahead and make that appointment!  If you're hesitant to make a dental appointment, feel free to leave a comment below and let me know why.  I'll try to get back to you and resolve any concerns you might have.

Have a great year!

Before I talk about the solutions to these lines that can occur in our teeth, I'll give an overview of what they are, why they happen, and how to get rid of them.

Craze Lines: Vertical Lines in Our Teeth

These vertical lines in her front teeth are actually known as craze lines.  Over years of use, our teeth tend to develop tiny cracks in the hard outer layer known as enamel.  These cracks normally don't cause any pain, but can easily stain, causing embarrassing discolored lines on your front teeth.

What Causes Craze Lines?

Craze lines can be caused by stress placed on a tooth.  This can happen over the course of a lifetime of chewing or by any other process that causes a lot of stress on our teeth.

Some common causes of craze lines are  biting your nails, grinding your teeth (many people do it in their sleep without realizing it), using your teeth as tools, trauma to your teeth, or simply routine use of your teeth.

In Dr. Cohen's textbook about root canals, he states, "Craze lines are merely cracks in the enamel that do not extend into the dentin and either occur naturally or develop after trauma."

This case report describes a situation where craze lines were caused by biting on hard objects such as the top ring of an aluminum soda pop can. Speaking of metal rings, wearing tongue rings can cause craze lines in your teeth.

Interestingly, some research points to temperature changes as a possible cause of craze lines.  That's a great incentive  to not chew ice cubes (especially after drinking hot coffee!)

One other cause of craze lines that should be discussed is going to the dentist.  This research article states that he process of drilling away a cavity and filling a tooth can cause craze lines.  That's certainly not a reason to avoid the dentist, though, since craze lines are harmless whereas untreated cavities can lead to significant complications.

Do Craze Lines Mean Your Teeth are Cracked?

Although craze lines are very tiny cracks in the outermost layer of your tooth, you don't need to worry about your tooth cracking in half.

One good way to think about craze lines is to take a look at the photo of this porcelain doll.  The cracks in the porcelain occurred after years of use.  Although they are cosmetically displeasing, the cracks don't mean that the doll's head is about to crack open!

If you suffer from craze lines, you'll be pleased to know that the way that our teeth forms makes the enamel highly resistant to cracking.

A recent study looked at the crack resistance of the enamel in our teeth compared to a synthetic enamel.  The study concluded, "While enamel is the most highly mineralized tissue of the human body, the microstructural arrangement of the prisms promotes exceptional resistance to crack growth."

If that isn't enough, this study says that "The microstructure of enamel is functionally optimized to guide cracks from the more brittle outer enamel inwards where they experience higher growth resistance and are prevented from causing fracture and chipping."

This study found that enamel is about three times as tough as the naturally-occurring crystals of hydroxyapatite (the crystal that our tooth is made from.)

How to Get Rid of Craze Lines

So, what should you do if you have craze lines and you hate how they look?  There are a few alternatives.

The least invasive option is to try teeth whitening.  Many craze lines show up because tiny amounts of debri get into the crack and stain the crack, making it visible.  Teeth whitening can bleach away the stain and make the craze lines very hard to detect.

There are other options that involve actual dental work.  Before trying these options, it's good to keep in mind that craze lines can be caused by dental work, and that no dental work is better than your natural teeth.

These options include having an aesthetic tooth-colored filling material placed over the crack or having a veneer.  To do the filling, your dentist will simply smooth down the tooth in the affected area and add some filling material that is the same color as your natural tooth.  To do a veneer, your dentist will smooth down the whole face of the tooth and place a thin piece of porcelain over the tooth (kind of like a fake fingernail.)

Conclusion

With these alternatives in mind, it's worth noting that most dentists agree that there's no need to treat craze lines since they rarely lead to further breakdown of the tooth.  Some studies (like this one) do argue that the small lines may serve as a future site of a cavity, but if you're going in for your regular check-ups, your dentist can usually detect potential problems.

Do you have any questions about craze lines or cracks in your teeth?  Leave a comment in the comments section below.  Thanks for reading!

Why is it necessary to suction after local anesthetic?
Why is it necessary to suction when doing a filling?
Can blood be involved in both of the above procedures?

I'll answer the first two questions later on in this article.  In response to the last question, blood can be involved when giving anesthetic and doing fillings, but many times it is not.

First, let's talk about the two main types of suctions that dentists routinely use.

The Two Main Types of Dental Suctions

There are two main types of dental suctions that dentists use: the saliva ejector and the high volume suction.

The saliva ejector does exactly what its name implies; it sucks saliva out of the mouth.  This is the suction pictured at the upper right of this article.  Many times dentists will have the patient close down on this suction so that it can suction away any remaining saliva in the patient's mouth.

The other main type of dental suction that we use is the high volume suction.  This suction is so strong that the dental assistant simply holds it close to where the dentist is working and it will suck away any nearby debris, much like a strong vacuum cleaner can suck away crumbs without actually touching them.

You can see the high volume dental suction pictured below - try to pardon the lack of glove use by that dentist!

Why Dentists Use a Dental Suction

Now that the introductions are over, let's talk about some of the different reasons why dentists will use a suction.

For Patient Comfort

Keeping the patient comfortable is a high priority.  In response to Jeanny's question, we suction after giving anesthetic because the anesthetic has a bitter taste, and most patients prefer to rinse out with water and use the saliva ejector.  Also, if the anesthetic sits in the back of your mouth for too long, it may start to slightly numb the back of your mouth and could give the patient a gagging sensation.

We will also use the suction to make sure that you don't get too much water in your mouth while we are working.

To Clean Away Any Excess Dental Materials

When a dental hygienist cleans and polishes your teeth, you can get a lot of cleaning paste in your mouth.  We use the suction to help clean all of that away.  Also, when dentists are do amalgam fillings, pieces of the soft amalgam can sometimes fall away from the tooth surface.  We use the suction to help whisk them away.

To Keep The Tooth Dry

During some procedures, such as white fillings, it is important that the tooth stay clean and dry.  The suction helps keep the tooth dry by sucking away any saliva, blood, and water that may have accumulated around the tooth.  If the cavity went below the gum-line, then it's pretty likely that the gums will bleed during the filling.

To Help the Dentist See

As I mentioned in a previous article about the dental drill, the drill that dentists use to do fillings sprays out a lot of water to keep the tooth cool and clean.  Unfortunately, that water can quickly build up in the mouth and get on the dental mirror.  In order to ensure that the dentist can see the tooth while working on it, it's necessary to use the high volume suction to suck away all of that debris.

Those are the four main reasons that I came up with as to why dentists use the dental suction.  In conclusion, let's take a look at a question that I asked my dental hygienist as a child.

Where Does The Stuff Go After It's Sucked Away?

I remember sitting in the dental chair in Dr. Arnold's office as a child wondering what happens to all of the stuff that gets sucked down the suction.  Maybe I was hoping that the tooth fairy would somehow be able to save the bad part of my baby tooth that the dentist removed and put it back together once my tooth fell out.  After gathering up the courage to ask, I think I was slightly disappointed by the answer.

After your saliva, tooth debris, etc. gets sucked away, it travels through the suction line to a vacuum separator that will separate out any solids.  After that, your spit makes a journey down the pipes and into the sewer system.

It is now recommended that dentists install amalgam separators in their suction lines to separate out any dental amalgam and keep it from getting into the public sewer systems.

Questions?

Do you have any questions about why dentists use suction?  Leave a comment below and I'll try to get back to you.  Thanks for reading!

1 - There are two main types of dental drills: the high-speed and the slow-speed.  The high-speed drill rotates around 250,000 RPM.  That means it spins around more than 4,000 times each second!

Even the relatively slow dental drill rotates at about 8,000 RPM.  By comparison, this DeWalt Drill is three times slower with a top speed of 2,500 RPM.

2 - After using the dental drill on your tooth for 30 seconds, your dentist is subjected to as much bacteria as they would be had you sneezed right in their face (Source).  That's one of the reasons most dentists wear face masks.

3  - The high-speed dental drill shoots out water as it spins, as you can see in the photo above.  If it didn't, the friction would cause your tooth to get so hot during a filling that it could possibly damage the nerve inside your tooth.

4 - Many dentists now refer to the dental drill as a handpiece to make it seem more friendly and enticing.

5 - The dental drill has to withstand the rigors of sterilization after every use, which means it gets heated to 250° Fahrenheit with pressurized steam for at least 15 minutes.

6 - The very first dental drill appears to have been a bow drill used by an ancient civilization about 9,000 years ago.

7 - The drill bits that dentists use are made of tungsten-carbide.  Some have blades to cut teeth, like in the photo below, and others are coated with diamonds to give a sandpaper-like smoothing effect (see photo above).

8 - As recently as the early 20th century, many dentists used drills that were powered by a pedal that the dentist would pump with his foot.

9 - The distinct shrill sound that the high-speed dental drill makes can be a major factor in people's fear of the dentist.  Even for those who don't have dental fear, the dental drill's noise can be very unpleasant.

10 - Dental drills can be expensive, with many costing over $1,000.  That's a lot more expensive than your average home-improvement drill.

Questions?

Do you have any questions about the dental drill?  Want to share an experience you've had with the dentist's drill?  Leave a comment below.  Thanks for reading!

Don't be surprised if during your next visit to the friendly skies you hear the faint whine of the dental drill. Two major airlines are poised to announce the addition of the DentAir program to their flight services. The program has been in its trial stage since January 1, 2012 and has met with such success that it is now being expanded throughout both airlines. After years of cost-cutting, many airlines are trying to woo back disgruntled fliers by offering extra in-flight services that cater to their frequent travelers.

I hate to be a naysayer, but I did have my doubts when I first heard about this program. I mean, dentistry in the air? But after discussing the idea with both patients and other dentists, I have to admit that being an aerodentist is actually something I could see myself doing after I graduate from dental school.

The program is currently offered on about 5% of domestic flights, as well as several international destinations. Patients can requests services while checking in online up to 24 hours in advance or they can request an appointment once they get to their gate. A full range of services are offered, including routine cleaning and exams, custom whitening trays, and restorations.

What Patients Are Saying About the DentAir Program

We all know how difficult it is to fit dental check-ups into our busy schedules nowadays. But with the addition of the DentAir program, people can fly where they need to — and get an exam on the way.

Kerri Zrisk, creator of the DentAir concept, explains, "Whether you are a business traveler or a retired couple vacationing around the world, you probably struggle to find the time to get to your dentist. With this program, the dentist comes to you. We realized that passengers already had time slots open in their schedules — the only problem was that they were flying on airplanes during these lulls in their day. So we started thinking, 'How can we get the dentists to these people?' The DentAir program naturally followed."

Phil Mitewth, DentAir Conniseur

Many patients expressed relief that they had access to dental professionals while traveling. After all, dental emergencies rarely occur at convenient times. Phil Mitewth, director of sales for Mardott International, said, "As a busy executive, I simply don't have time to go to the dentist. With my busy schedule of flights, it's easy to get my dental work done - and I have to say that there's nothing quite as exhilarating as having a root canal over the Panama Canal."

Passenger Joseph Miller was equally excited. "I couldn't wait to get caps on my badly-stained two front teeth. Getting it done in the air was awesome and I would even say it was the crowning moment of my whole vacation!"

What Dentists Are Saying About the Dental Air Program

View from DentAir Dental Chair

New York Dentist Dr. Mo Lerr, DDS stated, "Many patients are flying down to Mexico to get their dental work done at a fraction of the cost. By being an airplane dentist, I have some time to persuade them to get their dental work done in-country. I can even offer cheaper prices since there are no taxes in the friendly skies!"

Dr. Daryl B. Payne says, "A lot of my colleagues were skeptical at first, but I will always remember doing my first 'mile-high' filling. I just revved up the drill and waited. As an aerodentist, I've learned to just hold the drill in the mouth and let the turbulence guide me to the decay. It works every time, and I've never had a patient leave."

Most dentists that were interviewed said they feel like an integral part of the flight team, despite their unique role. Dr. Timothy DeKay chimed in, "Everything has gone fairly smoothly so far. One time the pilot did tell me to lay off the suction since it was decreasing cabin pressure, but other than that we've had a pretty good working relationship."

The Stewardentess: A Fulfilling Career Choice

Meredith Russell, Stewardentess

Aerodentistry, like traditional dentistry, requires specially-trained support staff. After a recent flight, I was able to meet up with long-time Delta stewardess Meredith Russell. She returned to school last year to get her dental assisting degree and has recently been certified the first stewardentess in the nation.

In our interview she mused, "Sometimes it gets really boring during the downtime after I've collected the empty drink cups and pretzel bags. I felt like there was something I was missing out on as a stewardess and I wanted more out of my career. In-flight dental assisting was just a natural extension of my duty to make everyone's flight perfect."

The Future of Dentistry

Whether aerodentistry will really take off remains to be seen. But one thing is clear: dentists are branching out and considering unconventional treatment venues. It could be the recent economic recession or just a shift away from traditional care models, but whatever the reason, dentistry is expanding to reach more people.

"It's hard to say what the next 5 or 10 years will bring, " says Dave Capitt, dean of Michigan State School of Dentistry, "but if you ask me, the future of dentistry is up in the air."

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!