If It Doesn’t Hurt, Why Do You Want to Fix It?

–Thomas Duffy, DDS

  • Dental Health   •   August, 2019

This common and very reasonable question deserves a fair answer. To be clear, a dental team’s job is to provide you with accurate information about your oral health so you can make informed choices about your care. Our “want” matters relatively little if you, our patient, feel coerced or confused.

When does a serious problem actually begin?

For example, how many people do you know who have had a stroke or heart attack seemingly “out of the blue”? Or who find themselves borderline diabetic or with a low thyroid, without obvious signs or symptoms? Although some will have a genetic tendency to these serious diseases, the chances are significant they may have been ignoring symptoms, have the need to lose weight or change unhealthy habits, or they have not been having regular checkups.

Likewise, with oral health, many people assume that a classic toothache will be the first sign that something could be wrong. But did it have to be that way?

Below are several examples of advanced dental disease I have seen personally, for which the patient never had any pain. The cavities were large enough to need crowns, possible root canal therapy, or even pulling the tooth—all of which could have been prevented earlier more easily and likely at a lower cost. These examples are not intended to scare you but to illustrate the kinds of painless conditions dentists encounter routinely.

How do we help you decide what’s best for you?

Some problems are clear and need direct intervention. Other situations may not progress if good diet and consistent at-home care are followed, cleaning appointments are honored, and any prescribed medications (if needed) are taken.

As we work with you, we’ll also talk about what current data—trends and averages from many cases observed throughout the profession— tells us. Together we will create an informed, optimal treatment path for you.

At Peninsula Family Dentistry, our promise is “we’ll never just watch a problem grow.” We will talk with you about your situation and help you understand what is happening. Again, it may mean that you treat it at home and we will monitor you in regular intervals. In other circumstances, it may be better to treat it earlier, while it’s small. And remember, treatment doesn’t always mean drilling!

If you have a concern about a dental condition, feel free to schedule a free consultation with me at 253.525.4050.

Painless conditions dentists encounter routinely – Before and After:

Grayscale Guide:

When I view your intraoral photos (inside the mouth) and x-rays, they paint an important picture about the health of your teeth and bones:

    • Healthy solid teeth and jawbone show as medium-light gray
    • Crowns and fillings show as light gray or white
    • A hole or space i.e. a cavity, missing tooth, or nerve chamber show as black or dark gray
Patient 1:
Medium-large cavities in 2017

Medium-large cavities in 2017, patient declined treatment.

2019 - Very large cavities

2019 – Very large cavities at the edge of the nerve chamber, deep below the gumline, still no symptoms. Fillings may no longer strengthen teeth.

Patient 2:
Normal roots in 2012

Normal roots in 2012, for comparison.

2019 - Large infection/abscess on the back root

2019 – Large infection/abscess on the back root (right), starting on the front root (left).

Patient 3:
In 2012 there was a small mismatch where the crown was not sealed to tooth root

In 2012 there was a small mismatch where the crown was not sealed to tooth root, patient declined treatment.

2019 - The patient had been away since 2012, and returned in 2019

2019 – The patient had been away since 2012, and returned in 2019 wanting to reestablish routine care. Crown is lost; tooth has cavity at bone level on a shorter, narrower and less stable root; previous root canal treatment (thick, white lines inside tooth root) is reinfected. Tooth cannot be saved predictably.

Patient 4:
2019 - Growing cavity on the left

2019 – Growing cavity on the left; on the right, cavity under filling closer to the nerve

2019 - After decay removal there remains a very thin layer of tooth

2019 – After decay removal there remains a very thin layer of tooth over the nerve chamber. If the cavity had grown any more the tooth likely would have needed a root canal and crown instead of a filling.