Today I want to do something special. We’ll call it the Dentist confessional. So I’m going to go through a couple of the most common lies that people tell us and try and convince us are true even though with our experience and our training, we know you’re not telling the truth.
Hi, I’m Dr. Brett Langton. I’m a pros orthodontist and the owner of Dental Implant and Aesthetic Specialists here in Brookhaven, Georgia. Now because we’re nice and polite, we’re probably not going to call you out on it, but these are things that we hear all the time that we know aren’t true.
Lie #1: I Floss Every Day
So the first one and the most common is I floss every day. I can’t tell you how many times we hear this.
Everyone comes in and claims they floss every day. Now, don’t get me wrong, we do have a lot of patients that are really good about flossing and probably do floss two times a day or after every meal. The majority of patients, myself included, don’t floss two times a day, every day for every day of their life.
What Gives It Away
One of the things that gives this away is bleeding gums. So what causes bleeding gums? Basically, bleeding gums are a form of gingivitis, or gingival inflammation, and that just means the gum tissue around the teeth is irritated. So what happens when you floss and when you floss on a regular basis? You’re not only cleaning out the debris between the teeth, but you’re cleaning down in the sulcus, which is the area between the gums and the tooth structure. And what that does is it actually strengthens up the gums and causes them to tighten down to the tooth, which is a great thing because when those gums are tightly adapted to the bone and the tooth, there are not little pockets or areas for food and bacteria to get trapped in there.
So if you’ve got an area that when you come in to see us or all over your teeth that when we do our cleaning and our hygienists do a great job of getting down in those little pockets, the gum tissue is naturally going to get irritated and probably bleed or at least get red and inflamed. And that’s a really big sign to us that you’re not doing an adequate job at home with your flossing.
The Good News: It’s Reversible
Now, the nice thing is that gingivitis is completely reversible. So with proper home care and the proper techniques, and our hygienists and dentists are great at teaching you these techniques, we can actually get you to reverse that gingivitis, get the tissue healthy, and then when you come in and tell us you actually floss, we’ll believe you.
Last-Minute Flossing Doesn’t Fool Us
So another thing that we see that’s very common is you’ll floss the day before because you’re like, oh my goodness, I have a dental appointment tomorrow. I’m going to floss my teeth and make it look like I’ve been flossing all along. I like to compare this to if you showed up for a marathon and you had just run a day before thinking you were ready to go and everybody believed you were a marathon runner, it doesn’t work that way. Your gum tissue heals, and the plaque and debris are taken off the teeth by a constant, repeated pattern of flossing and cleaning the teeth.
So in fact, if you’re flossing once a day or two or three times a week, that’s awesome. That’s definitely better than doing nothing. But I’m just here to encourage you to try to get that ideal level of flossing every day.
Lie #2: I Only Drink Water
Number two is I don’t drink soda or any of that unhealthy, unnatural stuff. I only drink water. I’m guilty of this one, myself. I like to drink Diet Coke.
But unfortunately, if you look at the breakdown in the materials in your Diet Cokes, your regular Cokes, your fizzy drinks, a lot of times you’re adding in sugar acid, carbonation, all these things are really rough and aggressive to the teeth.
The Southern Sweet Tea Factor
It’s okay if you want to have a Diet Coke, a Sprite, or a fizzy drink. It’s just really important not to sip on them all day long. Being in the south, one of the biggest culprits we see is sweet tea. A lot of people will just have a big jug of sweet tea and they’ll just sip on it all day long. And essentially what you’re doing is you’re bathing those teeth in a super sugary saturated material all day long.
Our Advice
So my piece of advice on this is if you’re going to have those things, which is great because I like a nice diet Coke. Now again, also just make sure you only have it at one sitting. And a lot of times if you have it with a meal and then rinse or brush afterwards, the material’s all gone from the teeth and no damage is done.
What We See in Your Teeth
But when you come to see us and we see that outer enamel layer worn off your teeth, flat teeth with pits and grooves in there, it’s really obvious and evident that there’s some kind of acid erosion going on in the teeth. And a lot of times we can tie that back to the dietary habit of sodas, sweet tea, sugary, carbonated beverages.
Candies, Cough Drops, and Sugar Buildup
Along that same thought line, we can really tell if you have a bad habit of using Tic-Tacs, cough drops, sweets, and candies. A lot of times when you eat those or chew on those, you’ll just soak the gumline in saliva, just saturate with sugar in those bad bacteria. A lot of times, you get very obvious decay right at the gum line, whether it’s at the edges of crowns or just right where the tooth meets that gum tissue. And that’s a really telltale sign of dietary habits that involve sugary substances just kind of held down on that gum tissue.
And that kind of hammers home the importance of coming to see it. So we can take x-rays and we can make sure that that decay is not a lot deeper and it can be fixed with just a small filling and a change in your dietary habits.
Lie #3: I Don’t Smoke or Vape
Line number three, I don’t smoke or vape. While it’s socially unacceptable nowadays to really smoke or vape or let people know that you have that habit, please be honest with us, we’re not going to judge you.
Why It Matters
And a lot of times, we can tell anyway, even if you deny it, because one of the most common side effects of smoking and vaping is that you’re damaging the gum tissue and the teeth to a point where you may not see it, but we can really tell.
In addition to that, you reduce the salivary flow so you have a dry mouth, you’re more prone to cavities. A lot of times we see discoloration and staining specifically with smoking. The tobacco does a really bad job and even chewing tobacco, we see changes in the gum tissue because you start to see the pre-cancerous change of that healthy, smooth gum tissue become kind of wrinkly and corrugated and gross.
How It Affects Healing
And that’s really important that you let us know if that’s a habit that you have. So we can talk you through options for kind of mitigating your damage and trying to eliminate that as a habit.
In addition, smoking or vaping creates a lot of intense heat in the mouth, so you actually get gum recession, and you can get bone loss. It definitely impacts healing. And so if you are a patient that either had just had gum surgery or had extractions lost a tooth, or if you had implants placed, if you smoke or vape, that’s going to cause a lot of problems with the healing process because it’s dried out, the intense heat can actually cause the gum tissue not to heal well.
And also, when you’re dealing with implants or extractions, it can cause a decrease in bone production, and it takes longer to heal, and the healing’s not going to be as thorough and efficient. And so that’s one thing to really discuss with your dental professional is if you’re going to be undergoing extractions or implants, we really need to kind of figure out a pattern to get you to stop smoking or vaping for a certain amount of time, hopefully ever, but at least for a certain amount of time so that your body can heal adequately around the dental work that we do.
Lie #4: I’m Not Stressed. I Don’t Grind My Teeth.
So line number four that we hear a lot is, I’m not stressed. I don’t grind my teeth. I may clench every once in a while, but it’s really not a problem.
How Stress Shows Up in the Mouth
A lot of times when we find patients that have a stressful life and let’s be honest, who isn’t under a lot of stress, the way that manifests itself is with nighttime clenching or grinding, a lot of times the patient isn’t even aware of it.
So it’s not really a willful trying to not tell us the truth. They probably aren’t even aware of the fact of what they’re doing at night. A lot of times, there are two main ways we kind of discover this. Either a patient has really worn teeth, so the back teeth are flat. Even the front teeth at some point will start to get really worn down from the constant clenching and grinding, and the patient will complain of headaches in the morning and sore jaw muscles when they wake up. Or a lot of times, partners will tell us. So a lot of times, husbands will claim that they don’t clench or grind, and you’ll look over in the corner of the operatory, and their wife is sitting there shaking her head saying, No, I hear them clenching and grinding all night long.
So these are habits that are probably even more dangerous than habits that you do when you’re awake because you don’t even realize you’re doing ’em.
Treatment Options: Night Guards and Botox
Night Guards
So when you’ve got damage to the teeth from grinding and clenching, it’s really important that we kind of proactively protect those teeth because not only are you causing damage to those teeth, but it’s also potentially an underlying problem with sleep apnea or sleep disorders. And that’s something that’s become really big in the dental field now. One of the first telltale signs of sleep apnea and disrupted sleeping is worn down teeth because the mouth is clenching and grinding at night, trying to wake you up and get you to open your mouth and breathe.
Now, the nice thing is that the solution to this is very straightforward. It’s very noninvasive. The majority of our patients actually have night guards. We can make custom night guards for you. The way we design it in our office is that the bottom side facing the opposing arch is nice, hard, and sturdy so that when you grind your teeth around, everything is nice and smooth, but the inside has a softer lining. So when you put it on, it’s comfortable, you can wear it all night. It’s very sleek. It’s a minimal addition to the tooth, but it’s something that you can do. It’s a small investment that can protect your teeth for the long term.
We highly recommend it, especially for any patients that have had crown and bridge work, veneers, any kind of aesthetic work because that’s an investment as well. We don’t want you grinding and beating up on those teeth overnight and waking up with broken down teeth. So a night guard is a really minimal investment to help protect your teeth.
Botox as an Alternative
So another adjunctive procedure that you can do if you’re not willing to wear a night guard or a concern that even with your night guard, you’re really clenching and grinding is the utilization of Botox. I know a lot of people only are aware of Botox for the cosmetic effect, getting rid of the wrinkles on your forehead, getting rid of the crow’s feet, getting rid of the angry elevens, the frown lines.
But Botox also does a really good job when we use it on the muscles of mastication. And so, specifically, the big muscle right here and the big muscles right here, Botox can do two things. Number one, it can reduce the tension so you’re not able to clench and grind as well, which might help with headaches. But number two, the reduced force of mastication, of chewing of those muscles is going to really cause the jaw not to clench and grind so much at night and allow the whole system of your mouth and muscles to relax. So we can alleviate a lot of that wear and tear on those teeth and jaw muscles.
So the cause for Botox when we do it for cosmetic reasons is less of an investment than when we do it for clenching and grinding. The main reason for that is that the cosmetic muscles, the ones through the forehead and around the eyes, are much smaller, so they need a lot of Botox. These big muscles, the mass and the temporalis muscles, the clenching and grinding, they’re big, strong muscles. So, unfortunately, in order to kind of calm those down to a point of being therapeutic, we do have to use a larger amount of Botox.
Each patient is on a case-by-case basis. You can’t just give a one-size-fits-all all prescription for Botox. If that’s something you’re interested in, come see us. I can sit down with you, and we’ll have a consultation. I’ll walk you through where the muscles are in your mouth, where the contraction is, where the strength that we really need to focus on with the Botox, and we can make a customized plan for you to really help alleviate that clenching and grinding at night.
Final Thoughts
Long story short, you can lie to your friends and your family and your loved ones, but please don’t lie to us because we need to have the truth about your mouth so we can help you take care of it.
One thing I’d like you to know that our office is a judgment-free zone. And what I mean by that is we don’t care if you smoke, we don’t care if you vape. We don’t care if you drink 25 Diet Cokes a day. Everybody has habits. What we want to do is help you overcome those bad habits and help you have a nice healthy mouth and a good smile that lasts a lifetime.
I’m Dr. Brett Langston. I’m not here to judge you. I’m here to help your mouth.
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