Notice how the gums wrap tightly to the teeth like spandex.  Note the bright coral pink color.  (people of darker skin may have harmless patches of pigmentation in covering some of the pink areas)  They are not red and puffy from gingivitis, and they do not bleed when prodded with dental probes or floss.  This is what your gums can look like if you take great care of them with daily flossing and brushing.  It doesn't matter if you're 9 or 99, it can look like this.

What makes this case even more remarkable, however, is that this is not some 21 year old Swedish model's teeth.  They belong to a very smart 14 year old high school freshman:

Braces make it really, really hard to clean your teeth.  Most weaker minded teenagers just don't bother.  The result is them a bloody, swollen red mess full of tartar, plaque and germs.   My own two front teeth have permanent white scars (train tracks) from not taking care of my teeth during braces.   Oh, to be a teenager again, but perhaps a smarter one.  Kudos to JS for having some seriously good hygiene habits at a very young age.  This guy is going to go far. 

It's never too late to start, either.

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If your dentist is not careful, you can end up with an unnecessary root canal treatment.  A proper diagnosis of every toothache usually includes an x-ray, cold test, percussion (tapping test), biting test, and periodontal probing (gum check).   A positive biting or tapping test during or after a recent cold or allergy event may just indicate sinusitis, not a dental problem.  If dental findings are inconsistent or inconclusive, you can be referred to your medical doctor for a consult.  We had one or two such cases last year, and possibly one this morning.  I routinely ask my patients with dull toothaches, especially on upper teeth, if they've had recent sinus infections, colds, flu, or allergies.  The best way to get correct diagnosis, as always, is to be thorough (collect a lot of data), and look at all the facts, not just the dental ones.

Our office, because it's only four years old, has much more high tech gadgets than the dental office you may have grown up in.  Sure, we have digital xrays and cameras.  We also have high definition monitors for movies at the chair.  But at the end of the day, the fundamentals of dentistry haven't changed.  You still have to be open, honest, and fair with people.

A lot of dentists have purchased all the right gear for all the wrong reasons.  People are starting to wise up to the sell, sell, sell, high pressure techniques of large dental chains.  But when you get oversold on a car, you're just out money.  Dental procedures are almost always permanent and irreversible.  If you get oversold on dentistry, you can end up with lasting physical consequences.  

Our approach to patient education is very simple: illustrate the problem, discuss the solutions, and let the patient make the decisions on their own timeframe.   It is my goal to help you make informed decisions.  Technology is there to help me detect problems, or to illustrate them to you or the insurance company.   Most dental problems are asymptomatic; you don't usually feel them until its too late.  So it's important to use technology to communicate problems, which naturally leads to an open discussion about possible solutions. 

Here's a photograph of a cracked tooth:

Here's another one showing a less subtle cracked tooth:

When light abruptly stops in the middle of the tooth (rather than fading away), it's cracked.  These are examples of using technology to document and communicate the conditions we see.  And as an added bonus, good intraoral photography also reduces the rejection rate of dental claims.

Technology can be used to maintain transparency and integrity.  In a field where so many have damaged the public trust, it's vital that everyone can not only see what's going on, but be engaged and active in the treatment planning process.   I never try to "sell" my patients on anything.  We don't make them sign treatment plans immediately or leave down payments.  You have the luxury of thinking things over.  I routinely tell patients to go home and discuss significant treatment plans with their spouse.

If people can see what's going on, and they are given all the pros and cons of the possible choices (and doing nothing should always be listed as a possible choice), they will almost always make the right decision on their own, no high pressure required.

For every new twitter follower we get between now and the end of the year, we'll donate one toothbrush to a child  in need.  Pass it on.