We’re talking about some common dental myths that people have asked questions about in the comments below. I’m here to help kind of clear ’em up and provide some information that you may not know about. I’m Dr. Brett Langston. I’m a prosthodontist and owner of Dental Implant, a tech specialist here in Brookhaven, Georgia, and I’m here to help you watch your mouth.
Dental Myth #1: Cavities Are Irreversible
Now this is a kind of common perception that is partly true but partly not true, and it really depends on a couple of things. So let’s start with what is a cavity and what causes a cavity.
So in order for a cavity to happen, you have to have a susceptible host. So the tooth has to be available to have the cavity grow in. And basically what a cavity is, it’s little bacteria that when you feed them sugar, they create an acid and that acid eats away that outer enamel layer of the tooth. And so it’s two things have to happen. You either have to have the sugar for the bacteria to make the cavity or you have to leave the bacteria there for a long enough time to let them work and take away that tooth structure.
So the solutions to this are going to be either don’t feed those bacteria the things they need to eat away your teeth or constantly clean your teeth so the bacteria don’t have a chance to make those cavities.
Saliva in your mouth does a really good job of rinsing away these bacteria, but every time you eat or drink or put something new, you’re basically coating your teeth in another layer of potential cavity-causing bacteria. So it’s highly recommended that you at least rinse or floss after every meal—actually, after every time you eat anything at all.
So Are Cavities Irreversible?
Yes, and no. Smaller cavities that are just starting to penetrate into that outer surface of tooth actually can be reversed if you remove the substrate. If you remove the plaque and the bacteria that are causing that, you can stop the decay. And then if you have the right amount of fluoride and the right amount of nutrients that are going into the tooth, the tooth can actually rebuild that tooth structure.
Now, when cavities have reached into that internal part of the tooth, which is where the nerve is, has the blood supply and the innervation, unfortunately, at that point it’s not reversible because the nerve has been damaged. And so that’s when you have to come see us. Let us take out that unhealthy tooth structure. If it’s reached the nerve, a lot of times you’ll need a root canal, which is basically just a procedure where we go in and take out the internal nerve on the inside of the tooth and fill it up so it doesn’t have any pain or discomfort, and then we can restore that missing tooth structure either with a filling or a crown to protect the whole tooth.
Dental Myth #2: Braces Are Only for Crooked Teeth
Now, while it’s true that the main purpose of braces and orthodontics are just straighten, misaligned, and out of place teeth to further put them in the right path of draws when they’re biting and chewing and functioning, they’re under the right angles of stress.
But there are also many other reasons why we choose to utilize braces or orthodontic therapy.
- Number one might be to close gaps or spaces. If you have a space between your front teeth or if you have some spacing in the back or it’s putting a lot of pressure on the teeth in the wrong direction, braces can help align everything and close gaps.
- Also, we can use braces to make spaces larger. So if you have a space between teeth that’s not quite big enough for an implant or not quite big enough for an aesthetic result, a lot of times we can space those teeth out and give us the adequate space in between the teeth so we can do an implant or a dental bridge.
- Another option for orthodontics is to align the teeth so not only if they’re slightly crooked, it is more important to have them biting in the correct orientation.
So sometimes it’s an aesthetic purpose that we do orthodontics. A lot of times it’s a functional purpose that we do orthodontics, but most of the time the combination of two is to not only put the teeth in a more aesthetically pleasing place, but also to give them the proper support and the bones so they last a long time.
So when I talk about alignment, what I’m talking about is the actual way that the teeth come together. If teeth are off angled or a little not in line and you’re putting a lot of biting force on them, a lot of times that can cause damage to the bone and the root structure of the teeth. So with orthodontics, we actually line them up so they’re hitting right on top of each other in a functional manner so they can support and be strong. One thing that I think people underestimate is the amount of force that your jaw muscles can actually create.
The average pounds per square inch pressure PSI that a bite force has is anywhere in the one 50 to 200 range. You can even go up to three 80 to 400 on some of the more extreme scales, people that have certain jaw types and muscular setup of their teeth. And so when you’re putting that much force and pressure on the teeth, even being slightly misaligned or being a little bit off can cause a lot of damage to the underlying bone and tooth structure. For example, the one 50 to 200 PS, I might sound really random, but it takes about a 90 to a hundred PSI to crush an aluminum can. So if you think about it, your jaw can generate a lot of force and a lot of pressure, and so it’s really important that everything is lined up and is supported in the right angulation.
Dental Myth 3: A Knocked Out Tooth is Gone For Good and You Can Never Replace It
Myth number three, A knocked out tooth is gone for good and you can never replace it. This might’ve been common back in your grandparents’ day. If you lose a tooth, you just go on with your day and you probably don’t have to worry about replacing it. But nowadays, after trauma, especially if a tooth is a vols, which is the fancy word for comes out of the mouth, the number one most important thing to do if you’re an adult is to actually put it back in your mouth because the pH and the saliva in your mouth is going to maintain that as long as possible.
What Should You Do If a Tooth Gets Knocked Out?
Ideally, if you can put it back into socket and you feel comfortable that you put it right where it was, that’s the best. But the second best is putting it in your mouth, leaving it in your lips so you can kind of hold onto the tooth until you can see a dental professional.
This may sound really gross, but if one of your children knocks a tooth out and you don’t trust them to have it in their mouth, put it in your mouth, your saliva and the pH of your mouth is going to hold that tooth until their dentist can put it back in.
Can a Knocked-Out Tooth Be Saved?
If the tooth that came out is actually put back in the socket in a short enough amount of time, a lot of times the tooth will actually integrate back into the mouth. A lot of times we have to put some wires and brackets on there to stabilize it and allow everything to heal. And depending on the trauma, if there’s a fracture to the bone, if there’s underlying damage, it’s obviously not going to heal. But if there was a freak kind of accident where the tooth just shot out, there’s a good chance we can put it back in and you can save that tooth.
What Happens to the Tooth Long-Term?
Now, things to be aware of down the line. At some point that tooth is probably going to have the nerve on the inside dye and it’ll need a root canal, which at the end of the day is better than missing that tooth. Unfortunately though, sometimes the teeth don’t integrate and sometimes they do fail, but the nice thing is now we’ve got the capability with dental implants to pretty much restore and replace that missing tooth to make it look just like you never lost the tooth in the first place.
Dental Myth 4: Fillings Last Forever
Dental myth number four, fillings last forever. In an ideal world, yes, that would be wonderful. I would love for all the fillings that we do to last forever. And in fact, the practice that I purchased has been around for over 50 years, and I’ve seen some patients that have the original fillings that the doctors before me placed in the early seventies.
So it is possible. The most important thing for a dental filling to last as long as it’s possible is number one, you’re in the hands of a good skilled practitioner, so you need to have a dentist who knows what they’re doing. Number two, it has to be a clean, healthy mouth. If you put a filling in a mouth that isn’t well taken care of and well-maintained, that filling is going to fail.
Why Do Fillings Fail Over Time?
So even in an ideally placed filling in a healthy mouth that everything is taken care of, the tooth, once it’s had a filling is weaker than it was originally, and a lot of times judging on the size of the filling, that can kind of actually cause a little bit of wear and tear on the tooth over time because a filling that goes right down the middle can act almost like a wedge and cause the tooth to flex a little bit.
So unfortunately, over time when fillings fail, it’s usually right at the edge where the filling meets the tooth structure. We get a little micro gap created, and a lot of times bacteria can sneak under there. And so when you get bacteria in a cavity right at the edge of a filling, a lot of times we have to go in there and remove that filling, remove that unhealthy tooth structure and either place another filling, or if the filling was large enough, we have to go onto a crown to really protect the tooth. Some of the older fillings, the amalgam, these silver fillings that you see while they may be esthetic, a lot of times they can last a really long time because it’s an inert material and it’s packed into that cavity. And as long as the mouth is healthy, those fillings will last a really long time.
How to Make Fillings Last Longer
So you may be asking yourself, what can I do to make my fillings last longer? And that’s a great question. The number one thing is a nice healthy, clean mouth, good home care, good oral hygiene is going to remove bacteria and remove the potential for decay around the margins and the edges of those fillings. The second thing you can do is avoid things that cause damage to the teeth. So chewing ice, chewing on really hard crunchy objects, especially on teeth that have bigger fillings. You’re really just kind of asking for at some point for that filling or that tooth itself to break down. And there’s a common saying in dentistry that every filling ends up growing up into a crown. And basically what that means is over time as you replace the filling, you do get to a point where all of a sudden you have more filling than tooth, and at that point, you have to protect that tooth with a crown to hold it together.
Why Regular Checkups Matter
So that circles back to the necessity and the importance of coming to see us every six months. Coming for regular cleanings allows us to take x-rays and get really close, magnified inspection of all those teeth, every dental cleaning appointment. Not only are we cleaning your teeth and making sure the gums are healthy, we’re also inspecting all your existing fillings and crowns and bridges and implants because we want to make sure nothing’s sneaking up on us. Because a lot of times in dentistry, especially if you catch something really small, the solution is very easy to fix. A lot of times we can go in there and either patch it up or just replace the filling and keep it small. Unfortunately, if you don’t have someone check on you and don’t kind of catch these things early, they’re going to grow into bigger and more expensive problems.
And this dovetails perfectly into myth number five. Teeth cleaning by a professional is not necessary.
Stay Tuned for Part 2!
We’ve covered some of the biggest dental myths so far, but there’s still more to debunk! In Part 2, we’ll continue breaking down common misconceptions about oral health, including professional teeth cleaning, flossing, wisdom teeth, and more.
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