This week I saw a patient, Caroline, for a general physical. She has some chronic health problems and only rates her health as “fair.” As part of a routine physical I always ask about dental care. Because she is on a limited income, she does not see the dentist regularly.
Is that important? If you don’t have dental insurance, is it OK to skip your cleanings? What is the importance of healthy teeth and gums?
Because I’m writing about this, I think you can guess my opinion! It’s very important to keep your teeth and gums healthy. I’d like to review what happens when you don’t take good care of your teeth. What are the risks to your health?
When you don’t brush and floss regularly, plaque builds up on the teeth. What’s plaque? It is actually a biofilm of sticky bacteria on the surface of the teeth which extends under the edge of the gum. It is removed when you brush with toothpaste, but builds up again over 12-24 hours.
If you look at the cuticle of your fingernail and push on it a little, you can see that there is a little space under the cuticle above the nail. There is a similar space between your tooth and the gum. Normally the space is very small and your toothbrush gets in there and cleans it out when you brush.
If you don’t brush regularly and the plaque builds up, your body mounts a local inflammatory reaction to protect your gum tissues from the bacteria in the biofilm. The inflammation, over time, weakens the connection between the tooth and the gum. The attachment point gets weaker and the gum gradually separates away from the tooth surface, causing formation of a pocket. Food particles can get trapped and it is difficult for toothbrush bristles to get down in there and clear everything out.
Regular dental cleanings and exams to look for gum redness, swelling, easy bleeding and pocket formation are needed to identify problems early and get your gums back in good shape. If left untreated, gingivitis can progress to periodontitis. Severe cases can require surgery, tissue grafts and sometimes lead to tooth loss, bone loss, and abscesses.
Okay, Dr. Jen, but so what? So I don’t have healthy teeth. Why is that so important for the rest of me?
It turns out that the inflammation of chronic gum disease has a big impact on the health of the rest of your body. I did a quick PubMed search and there have been an absolute wealth of studies published exploring the link between periodontal disease and various medical illnesses including diabetes, heart disease, autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus, and Alzheimer’s disease.
Without fail, it has been shown that better dental and gum/periodontal health results in better overall health. Period.
So if you are one of those people who hates the dental chair, please explore the options to get more comfortable with regular cleanings. Shop around and find a dentist and hygienist that you really like. Some dentists will provide mild sedation for those who are really super anxious.
My hygienist, Barb, knows I don’t like getting scraped. She cheerfully carries on a one-sided conversation while I’ve got a handful of instruments stuffed in my mouth and can only grunt in response, LOL! While I don’t necessarily love the process, I do love having healthy teeth and gums and I know it’s a necessary thing. Sort of like getting Pap tests, mammograms and colonoscopies to check for problems. Uncomfortable but necessary for routine maintenance of your body.
It is very important for you to brush and floss regularly and see the dentist every 6 months for cleanings and checkups. The health of your whole body depends on you having healthy teeth and gums!
PS – If you don’t have dental insurance I would recommend you check out the CWRU School of Dental Medicine’s student clinic. They see both adults and children and provide extremely thorough care at reasonable rates. When I was a student I used that clinic as I didn’t have dental insurance, and I can personally vouch for their excellent care!
QUESTION: Do you see the dentist twice a year? If not, why not?