Does dentistry last forever?

This is a question I’m frequently asked, especially when a patient is considering a significant investment of time and money into some form of cosmetic dentistry, such as:

• Porcelain veneers
• Bonding (tooth-colored fillings)
• Porcelain crowns and bridges
• Teeth whitening
• Even Six-Month Braces

It’s a very understandable question, and the simple answer to the question, “How long will my dental work last, Dr. Payet?” is “It depends.”

Just like a car, your teeth and gums require regular care to ensure that they are working properly.  Sure, you can go 10-20,000 miles between oil changes given how improved cars are nowadays, but do you really want to take the risk?  Same thing with teeth……….some people go for 5-10 years with no dental check-ups and are fortunate when they come in to find no problems, such as cavities or gum disease. But it’s not many people that are so lucky!

I always remember a quote from some lecturer at a dental conference years ago telling us his response whenever a patient asks the question, and it’s really the most honest, best answer that can be given, “Clearly the teeth that God gave you haven’t lasted your entire life, and since I can assure you that my work is not nearly as good as God’s, unless you die first, the work I do (no matter how excellent) will not last forever either.”

So what can cause your dental work to fail?

• Grinding your teeth — when the human jaw clenches, it can create an amazing amount of force, and over time, enough clenching will cause teeth to crack and break.
• Acidity — anything that increases the acidity in your mouth is good for the bacteria that cause cavities in particular, including Acid Reflux, Sodas, Power drinks (Monster, Red Bull, etc), Sports drinks (Gatorade, Powerade, etc).
• A very sugary diet — the bacteria that cause cavities love sugar.  High sugar content means the bacteria feed like crazy, produce acid, and the acid is what eats away the teeth to cause cavities.
• A compromised immune system — your saliva contains important antibodies that help keep the cavity-causing bacteria under control.  If your immune system is knocked back due to a disease or some medication, those antibodies will be decreased, allowing the bacteria to grow uncontrolled.
• Decreased saliva (dry-mouth syndrome) — again, due to medications or illness, the amount of saliva may be decreased.  With less saliva, there is less “washing” action of the teeth.
• Trauma — obviously.  LOL  One of my patients a few years ago fainted and fell face-first into a brick wall, shattering a front tooth.  Another ran into a pole, shattering another front tooth.  Clearly, if you are injured in such a way that your natural teeth would break, any dental work will break, too.
• Bad habits like chewing hard candy or ice regularly — hard candy and ice are just that — HARD!  Ice, in particular, is easily as hard as your enamel and as porcelain or bonding.  So if you bite down on ice frequently enough and/or hard enough, you can break your teeth and dental work.

That covers most of the major causes of dental work failing.  With regular care, use of appropriate mouthrinses and toothpastes, proper brushing and flossing, regularly scheduled check-ups and dental x-rays, using a nightguard, and being aware of diet, etc, your dental work can and should last a very long time.

But always remember — my dental work isn’t as good as the natural teeth God gave you, so my work probably won’t last forever either.  😉

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Skipping your dental checkup now could cost you more long-term

The Chicago Sun-Times reported today that more Americans are choosing to cut back on visiting the dentist due to the current economic downturn……….with potentially far more expensive consequences than most think.

Click HERE to read the full story in the Chicago Sun-Times.

We understand the tempation to skip a regular check-up at your dentist’s office when times are tough and budgets tight.  We also hope you understand that staying on track with regular check-ups could literally save you hundreds or thousands of dollars in dental treatment later.  Think about it this way:

• Skip an appt. now or decide to wait to get the filling done for $1-200……..and when the cavity gets much bigger, you might need a build-up filling and crown for $900-1300.
• Skip getting the build-up filling and crown now for $9-1,300 and you may end up needing a root canal, too, which could add another $800-1100.
• Wait too long entirely and your tooth may not even be fixable and have to be extracted, and getting teeth replaced can be FAR more expensive than saving them.  Just 1 dental implant and crown in Charlotte can cost $3500-5000; what if you need more than 1?
• Wait too long and multiple teeth that before only needed fillings, now need crowns and root canals?
• Wait too long and the early-stage gum disease that can be easily controlled now might progress to the point that they can’t be saved and you end up in dentures.

I know that I’m dramatizing the potential risks a bit here, but the thing is…..those risks are real and happen every day.  It makes us really sad when patients put off the inexpensive treatment now and then have to pay a lot more, maybe even suffer a lot of pain, because they waited.

At Smiles by Payet Dentistry, we offer several options to help you afford your dentistry now, and of course we are glad to help prioritize your treatment to get the most urgent items taken care of first.  Some options:

1. CareCredit Interest-Free Financing for 3-, 6-, or 12-Months.
2. Smiles by Payet Dentistry In-House Discount Plan
3. And we have a couple others – Download our Payment Options worksheet for details or call 704-364-7069 for details.
   

The most important take-home message is simply this: don’t wait, because it will only get worse.

Philosophy of Dental Care

We could also perhaps name this…..”How do I know if my dentist and I are on the same page?”

While there are an infinite number of variations on this theme, you can break it down into 2 basic groups of dentists.  While both can serve you well, given how important the doctor-patient trust relationship is, I recommend you be willing to ask questions of your dentist and his/her team to make sure that you have the same goals for your mouth and dental health.  Here are the 2 basic breakdowns:

(1) “If it ain’t broke, don’t fix it.” Dentists who subscribe to this theory generally don’t recommend any treatment until something actually hurts or breaks or is obviously decayed.  In other words, let’s say you have a tooth with a crack in it, such as the ones I showed in this post from January ’09: Cracks in Teeth.  This group of dentists generally won’t say anything about these teeth unless it actually starts hurting you or the tooth breaks.  Given that it is impossible to actually predict when a tooth like that will break or hurt, you may go for many years with teeth in that condition, so the ADVANTAGE of this philosophy is that you don’t spend any money until it actually happens.  The DISADVANTAGE is that – when the tooth finally breaks and/or hurts, it is generally in much worse condition than if treated earlier, which means that it will probably be more expensive to fix.  Plus, of course, you might have to deal with the pain, and for some reason, these things always happen on nights or weekends when the dentist isn’t available.

(2) “Here’s a potential problem; let’s go ahead and fix it now before it breaks and hurts.”

In this philosphy of care, the dentist will evaluate you for all current and potential problems, inform you, and give you the option of choosing to have the treatment done before the tooth breaks and/or hurts.  Of course, the dentist should NEVER try to force you into anything – always remember that you are the ultimate decider of when to have your treatment done.  But if you have some trouble brewing in your mouth, wouldn’t you prefer to get it fixed before it gets really bad?  Before it gets more expensive?  Before you have to suffer?

It’s probably pretty obvious which philosophy we choose at Smiles by Payet Dentistry – #2.  We will inform you of any and all problems that we see.  We’ll give your our recommendations based on the years of experience and advanced training and available research.  We’ll tell you what treatment options you can choose.  And then we will sit back and let you decide how much to do, when to do it, and how you want to do it.  Please ask us questions until you feel completely comfortable, and don’t worry that you’re hurting our feelings if you decide to wait.

We understand that you will be ready when you’re ready, and we are here to help you when you are.  Our goal is simply to make sure that you are fully informed so that you can make the best choice for yourself.    Call us for an appointment, or request one through our website by clicking here:  Request an Appointment.

So I grind my teeth, Doc – what’s the big deal?

Many people grind their teeth.  Many people clench their teeth.  Many do both.  The worst part is, though, that many have no idea that they do it, or how much damage they’re doing to their teeth — or how much it could cost to fix.  Sadly, too, many dentists don’t do anything about it either.  Here are 2 examples of just how badly one can damage teeth by grinding/clenching.

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Teeth damaged by grinding & clenching become short, chipped, worn, jagged, sharp, and ugly

How teeth can look after years of grinding and clenching.

Look how uneven the teeth are as they’ve been ground down.  See the gum recession and the deep “notches” in the teeth?  These things are NOT caused just by growing older and our mouths aging.  It takes incredible force to wear down enamel, which is the hardest substance in your body.  But once you wear through enamel into the second tooth layer – dentin – that wears down much faster and the damage accelerates.

Both of these gentleman wanted better-looking smiles.  The first one was completed over 4 years ago; we are still in the process of completely rebuilding the mouth of the second gentleman.  Needless to say, it is very expensive to rebuild teeth like this.  Sadly, it could have been almost completely avoided if they had known about and used a nightguard years ago.

So if you think you grind your teeth – call us today!  Sure, your nightguard might cost several hundred dollars………but what is that compared to thousands and thousands of dollars in treatment and many hours of time in the dentist’s chair.  You’re investing in the future health of your mouth.

Don’t wait like these gentlemen did.  Call us at 704-364-7069 and make your appointment to have a nightguard made and protect your teeth!

Visit our Smiles by Payet Dentistry page on this for more information on the NTI-tss nightguard.

New Patient Education videos now in the office!

Oh, it feels so good to finally be able to announce this, as I’ve been working on it so hard for so many nights after my family has gone to bed, but FINALLY I have begun producing some new Patient Education videos to help explain a number of options that we offer by using pictures of many similar cases.

Over the last 4 years, I have amassed a catalog of about 38,000 digital photographs of the work that we do.  You can see my Photography Blog post on the subject of Patient Communication with Digital Photography for more info on how/why we take pictures of our work, but now I’m finally able to turn a lot of those photos into various video formats to highlight problems that many patients have, often without even realizing it, and to let our patients actually see what they can expect once the treatment is completed.  It’s really quite exciting!  We’re not talking about “stock” photography here, of work that someone else did.  EVERY SINGLE ONE of the pictures that you’ll see were taken by Dr. Payet (me), and every completed procedure was performed by Dr. Payet (me) and my Team.  (Hope you don’t mind me talking about myself in the 3rd person for a moment there; I was having a Bob Dole flashback after reading some political articles.  🙂

We’ll look forward to showing you these new videos when you come in!

Don’t have any of those videos in Web format quite yet, but keep an eye on our website, Smiles by Payet Dentistry, for them to begin appearing there within the next few weeks.  You’ll be able to see and understand so much more easily, I promise!

Migraine and Tension Headache Treatment

One of my favorite therapies to offer patients is the NTI-tss, also known as the Nociceptive Trigeminal Inhibition – tension suppression system. From the name, it’s easy to see why we simply call it the NTI, though.  🙂  Why is it one of my favorite therapies?  For a very simple reason: it’s not often that you can literally transform someone’s life for the better in a couple weeks or months with no medications, no surgery, and at a very reasonable fee ……. but that is something that we do regularly with the NTI.

It’s such a simple-looking device, and it’s often difficult for people to understand how such a small nightguard can make such a dramatic difference, and often even more difficult to believe that a dentist can help them, even after they have  been to every other kind of doctor and had every kind of test and scan imaginable.

So how does a dentist treat migraines with the NTI-tss?

The essential basis for why the NTI is so effective is this: we now know that many migraines and chronic tension headaches are triggered by either CLENCHING or GRINDING of your teeth.

“WHAT?!?!?!”  might be a natural question at this point, so please feel free to express your disbelief at this time.  🙂  Don’t worry – that’s a common reaction.  But think about an analogy that I often find effective with patients. Imagine that you decided to work out your biceps every day for 3-5 hours/day with a 2-3 lb. weight.  Sure that’s not a lot, but for 3-5 hours per day?  For weeks on end?  For months on end?  Maybe for YEARS on end?  How do you think your biceps would feel?  Ok, now imagine how all the muscles involved in opening and closing your jaws would feel if you decided to work them out for 3-5 hours every night for days, weeks, months, or years on end?  Don’t you think that, in either scenario, the muscles involved would probably hurt like crazy?

I’m not going to get into all the details, as that gets extremely complicated, but if you’ll bear with me a moment and accept that this is a possibility, then wouldn’t it be logical if – by stopping or at least minimizing that clenching or grinding action — you could stop all the incredible muscle fatigue and pain, and the headaches would either go away or be greatly decreased?  Well, that is just what the NTI does, and it does it far more effectively than any other type of nightguard I’ve ever prescribed for patients.

The NTI is not just a device to minimize/stop clenching and grinding, though — it can be a very effective tool in diagnosing the problem itself.  In fact, it’s a critical part of the use of the NTI; we don’t just make one for you, put it in and say, “Bye – hope it works!”  It’s a process – one that can take just a few days to be effective, or one that may take many months of very careful analysis and refinement to figure out precisely what the muscular problem is and how the NTI should be best adjusted for the individual.

Here’s a brief PDF video of how the markings that I see on the NTI help me determine what’s going on; also look carefully to see how different the patterns are to understand how much it varies from one person to another.  And in future posts I’ll expand on this whole process more.  If you’d like to ask specific questions, please comment!

The NTI-tss and diagnosis by analysis

What hides under old silver fillings?

As I’ve mentioned, there are 2 basic “philosophies” of dental care, although I didn’t really spell them out.  They are (approximately, please understand!):

1) Watch and wait until it it actually hurts or breaks,

OR

2) Diagnose and recommend treatment BEFORE it actually hurts or breaks.

As a general rule, at Smiles by Payet Dentistry, we follow the second philosophy.  The key to remember, though, is that it is ALWAYS up to YOU to decide when to actually proceed with treatment.  I’ll show you what I see by digital photography and x-rays, give you my recommendations, and then it’s up to you to decide what to do about them.  We understand that the treatment has to fit into your life – your budget, your schedule, your priorities.  I give you my word — I will NEVER pressure you into doing any treatment.  I MAY make some very strong recommendations and urge you to proceed with treatment so that you avoid pain, loss of teeth, or other complication, but it’s still your decision, and we promise to respect that.

One of the tricky parts of dentistry is this: we can’t see through old fillings and crowns and bridges, not even with digital x-rays, digital photography, not even with the Zeiss PICO dental microscope that I use.  We can only see things AROUND them.  And quite honestly, as much as I believe silver amalgam fillings are a perfectly acceptable treatment, I also believe that they hide a multitude of evils.  I already showed you the cracks that are often associated with big, old silver fillings, especially in patients who grind their teeth.  What I didn’t show you, though, is how much decay (cavity) can be hidden from us by old silver fillings.  They may not hurt, but it is not uncommon for there to be so much decay under them that a root canal becomes necessary when it’s all removed — and often times it can not be seen on x-rays!  This makes it frustrating for patients, can’t understand why we recommend replacing a filling with a new filling or a crown.

So along with examples of the beautiful dentistry that we provide, I’ll also regularly show you the problems we often encounter when treating teeth, which should help you, the patient, better understand the WHYs of our recommendations.

A perfect example: This lady had these fillings for many years, probably over 20.  The molar had just recently started bothering her a little with sensitivity to cold and sweets, but nothing serious.  The main reason she wanted them replaced was for appearance, though — the greyish color really showed through on the front of the teeth.  You’ll see that they don’t actually look all that bad to an untrained eye.  After seeing thousands and thousands of them, though, I had some idea of what to expect……..but even I didn’t expect the problem to be so extensive.

Oh YUCK!  See all that black crud?  That’s decay — mushy, soft, and definitely NOT healthy.  And this is fairly normal to find under 20+ year old fillings, to tell the truth.

Just some food for thought: maybe your dentist has recommended some treatment, perhaps to replace those silver fillings that have been there for 20-30 years, and maybe they’re not even bothering you, so you think, “Nah, I’ll just wait, doc.  Thanks but no thanks right now.”  Consider this: another 6 months, and this lady probably would have needed at least 1 root canal, maybe even 2.  Not only would that have required more time, possible a lot of discomfort, but probably would have added another $1500-2000 in treatment costs.

Do you really want to wait?

Smiles by Payet Dentistry – Welcome!

Welcome to the Dental Blog for Smiles by Payet Dentistry, the office of Dr. Charles Payet, where our goal is to provide Beautiful Smiles and Lifetime Care.  This blog will keep you up-to-date on happenings in our office, about our Team, new technologies that we’re adding, articles about how dental care (or the lack of it) impacts your daily life.  Here’s a little video to introduce you to me……

As of May 20th, Smiles by Payet Dentistry is moving to a brand-new dental office on Park Rd., just a couple miles and less than 10 minutes from our old office near the SouthPark Mall, in beautiful Charlotte, NC. We are very excited about the move, as we will have more rooms available, we’ll be hiring more great team members to care for you promptly and with great customer service.  Want to read what many of our current patients have to say about us?  Read our Google reviews!

We offer a unique combination of services that allow us to treat the entire family, from kids up to retirement and beyond:

LANAP: comfortable and truly effective treatment for gum disease with the Periolase

Dr. Payet now offers Six (6) Month Braces for amazing Smile Makeovers in Charlotte, NC.

Dental care for the whole family is affordable with the Quality Dental Plan.

To make an appointment, you can Request an Appointment Online or call us at 704-364-7069.

We’ll look forward to meeting you soon!