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!

Related posts:

1. Rubber Dental Dams: What They Are and Why Dentists Use Them
2. Why Do I Need a Filling? Six Reasons Why Dentists Do Fillings
3. Why Dentists Take Dental X-Rays

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!

Related posts:

1. Why Dentists Take Dental X-Rays
2. OA Links: There Are Lots of Good Dentists
3. Rubber Dental Dams: What They Are and Why Dentists Use Them

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."

Related posts:

1. OA Links: Why Is Dental Work So Expensive?
2. Antibiotics Before Dental Work for Joint Replacements
3. No Dental Work Is As Good As Your Natural Teeth

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!

Related posts:

1. How Your Teeth Affect The Length and Shape of Your Face
2. 6 Reasons Why Biting Your Nails Is Bad For Your Teeth
3. Six Reasons Why You Should Visit Your Dentist Before Trying to Whiten Your Teeth

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!

Related posts:

1. How To Know If You Have Bad Breath: 5 Easy Ways
2. Cleaning Your Tongue Can Get Rid of Bad Breath
3. Get Rid of Bad Breath By Eating These 12 Foods

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!

Related posts:

1. Dental Fear Central: Calm Your Dental Anxiety
2. Rubber Dental Dams: What They Are and Why Dentists Use Them

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!

Related posts:

1. Seven Reasons Your Gums Are Enlarged
2. Bleeding Gums When Brushing and Flossing: Is It Normal?
3. What a Baby’s Gums Look Like While Teething

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:

Here's an updated photo of Tiffany's son now that he's two years old:

Submit Your Photos

I would love it if you would submit your photos of a double tooth to help parents gain a better knowledge of what double teeth can look like.  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!

Related posts:

1. Double Teeth – Gemination and Fusion
2. How Much Does the Tooth Fairy Pay Per Tooth?
3. What to Expect at Your Child’s First Dental Visit

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.

Related posts:

1. History of the Tooth Fairy
2. How to Make Your Own Dental First Aid Kit
3. 25 Things That Make You More Likely To Get Cavities

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!

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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!

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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!

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