Dentist

What makes someone decide to become a dentist vs a doctor?

Asked by DrOctagon over 13 years ago

My son is a physician and my MD friend/patient ENT told his son to become a dentist and he did. Seems like the " gums are always greener." I was at the same crossroad when I was considering a profession. I shadowed my physician cousin (who worked much harder than my dentist) and then our family dentist to see what they actually did all day. The dental field seemed to suit me and I was in practice quite awhile before my college classmates finished their medical residencies and fellowships. Medicine in the past was much more lucrative, but now there is some closer financial parity. Incidentally my son left patient care and now works for "Big Pharma", where he is much happier. One major factor is that physicians are held in higher esteem in society than dentists -- no one "likes" going to the dentist.

Wow, even without a checkup you described *exactly* what I'm told my pattern of calculus accumulation is: "behind the lower anterior teeth and the cheek side of the upper molars". After my hygienist showed me how plaque hardened into calculus, I bought one of those hook-shaped metal "picks" at a pharmacy (like a cheap version of what she uses to clean my teeth.) When I proudly told her that I'd been using it to chip off calculus that didn't come off with brushing/flossing, she scolded me again, telling me that I was probably doing more harm than good because I didn't know how to use it. Was she right or just being overly cautious?

Asked by Plaqqqque over 13 years ago

I don't know for sure ??BUT........... some hygienists I've had in my employ and have taught think they are Dentists and their egos may become bruised if you question their authoriy .. only a guess. In the military a Dental Hygienist is a recruit trained to clean teeth, this training and skill is useless in the private sector when discharged, but they do a great job. With a little bit of common sense and training , if she will train you, cleaning your own teeth as you described can be a valuable adjunct to her procedues. Be very careful not to cut or srape the gums and alway floss daily . I din't know if you have ever had a dog , but my vet. bills to have my dog's teeth cleaned is 3 -4 times what I charged so I do my best to "scrape"away the "tartar" to extend intervals between cleanings.

Do I REALLY need a dental check-up every six months, or is my dentist just trying to keep his wallet full?

Asked by scrupulous over 13 years ago

Over 90% of the population has some form of dental disease -- miniscule to major. Of those, approximately 50% will seek treatment. I understand your skepticism with all of the marketing and advertising now in dentistry, but the longer you stay away the "fatter" our wallets get. Routine 6-month check-ups (some people with periodontal/gum disease must go more frequently) can prevent or catch a problem and be less costly in the long run. For patients who have stayed away and need extensive and sometimes costly treatment, the regular check-up protects your investment. The cost of dentistry amortized over the the life of the restorations and treatment is not that great when you consider your upper and lower teeth come together between two to three thousand times per days (eating, swallowing, talking, etc).

How do you put nervous patients at ease? How important is bedside manner?

Asked by NED over 13 years ago

I'll answer your last question first. A good "chairside/bedside manner" usually indicates the treating dentist is more secure in his/her knowledge and abilities. To put patients at ease, I was a bit of a dinosaur, in that I would greet my patients in the reception area, walk them to the treatment area, and walk them back out to the reception desk post-treatment. My staff told me it was a waste of treatment time, but I never had an empty chair. Also, I never had an answering machine; I put call-forwarding to my home, telling the patients they could reach me there. In addition, I took a call-sheet home with me and called patients who had overgone restorative treatment. Mind you, I did not have the "little country practice" -- I had 5 operatories, a large staff, and 4 generations of patients in some families. If you're not happy with your treatment, keep looking, though unfortunately with dental insurance sometime you limit your options. One important thing I neglected with regard to putting patients at ease was Nitrous Oxide Analgesia (laughing gas). As I mentioned in another response, it's very safe and has no after effects. As opposed to systemic sedation we sometimes prescribe.

I brush and floss every day, and yet my dental hygienist scolds me every time I go in for not doing a better job. One dentist explained to me that some people simply build up plaque faster than others and my only recourse is to make appointments every 3-4 months instead of every 6; does that sound right to you?

Asked by Plaqqqque over 13 years ago

Unfortunatey ,as you said, some people need do need dental check-ups more frequently. The 6-month interval is an average and if you have dental ins. you have to have a 6 month plus 1 day interval to be covered. Ins. coverage for shorter intervals has to be documented , but if done so properly, is still covered. Diet can be a factor , but very difficult to detemine. Plaque is soft and removed by routine brushing. The best time is before you go to bed and in the morning, forget after or between meals, everyone else does, but not as critical When plaque "solidifies" into calculus(tartar) it is impossible to remove and that is what the hygienist is doing. Most people have the most accumulation behind the lower anterior teeth and the cheek side of the upper molars, this can be from brushing technique. For the lower anteriors hold the brush vertically, not horizontal and always use a flat tip SOFT nylon brush and change it every month. The soft doesn't seem as abrasive but the bristles flex into every crevice without hurting the "gums", Hold the brush horizontal for the posteriors and aim for the crevice betweeen the tooth and the gingiva(gums). don't waste your money on electronic or high tech toothbrushes, a marketing ploy.

What does it mean when a dentist advertises that he or she specializes in "dental chickens?" Is that just a marketing gimmick, or are certain dentists specially trained to handle over-anxious patients?

Asked by BobbyZ over 13 years ago

You answered your own question, it's a marketing ploy. I'm glad to see a thoughtful consumer. Dentists are able to prescribe anti-anxiety drugs, but I would suggest a dentist who uses Nitrous Oxide Analgesia (Laughing Gas). It has a relaxing and calming effect, no after-effects, and leaves your system within minutes after breathing room air again. No one really "likes" going to the dentist -- I've even had many dentists as patients over the years who could be classified as "chickens." The oral cavity is very sensitive inutero and infants put things in their mouths for identification because it is our most acute, tactile sense at birth. Add to this nurturing, affection, aggression, and communication and you can begin to imagine the psychological impact along with physical impact when we invade this area with necessary treatment. Hence, "chickens." Dentistry, with its prevention programs (e.g. flouride, 6-month check-ups), is slowly negating the need for our routine services. Therefore more advertising and marketing has found its way into the profession.

My dentist insists that I should get an electric toothbrush. Do you think that's a good idea?

Asked by kj over 13 years ago

My opinion -no I don't think mecahnical/electricl toothbrushes do a better job. The best way to avoid plaque build-up is to brush before you go to bed and when you wake in the morning. Plaque buils up mostly while you are sleeping. Scrubbing your teeth with a washcloth if you lose your or forget your brush does a pretty good job ( the furthest you can get from mechanical), but I've been recommending a SOFT FLAT NYLON BRUSH AND CHANGING IT EVERY MONTH for 39 years and have seen great results. Use a circular motion with the tip of the bristles aimed at the crevice where the gums(gingiva) and teeth meet. Also brush your tongue as far back as you can(without gagging) and you entire gum and palate.

When I was a kid, my cleanings used to include a part where I bit down into a mouthguard thing that had flavored gel, and held it for 5-10 minutes. But I notice that doesn't happen anymore...did dentistry abandon that procedure and why?

Asked by dday13 over 12 years ago

No we find it very efffective - but as you intimated it is a process which is most effective on younger patients ( and of course In$urance will pay for it to prevent decay but not in adults unless they are on Chemotherpy, or have some other debiltaing oral condition, etc) When the  secondary/permanent teeth erupt into the oral cavity in childhood the Enamel is susceptable to the bacteria in the oral cavity(see ans. above). The Flavored Gel/Fluoride Treatment  "hardenens" the enamel surface and prevents tooth decay/caries. It is so effective that we are slowly preventing ourselves out of business when it comes to the most common routine procedure we as dentists performed in the past, ( we also prescribe fluoride vitamins depending on your  drinking water supply)Hence "marketing" has entered the profession to $uppliment lost dollar$.

Toothpaste has all the fluoride you need as an adult .

Do dentists still use laughing gas?

Asked by brikhaus over 12 years ago

Yes between patients and after hours it's great. Oh do you mean on Patients? Yes it's a wonderful adjunct to local anethetics , especially with chilren .It acts as a mild hypnotic and amnesiac and young patients can tolerate most procedures without "novacaine" when introduced to Laughing Gas (nitrous oxide analgesia). Additinal training is required and it is more time comsuming so some dentists don't use it because it is not cost effective. I never charged addtionally for the "laughing gas"(nitrous oxide) and it was a practice builder.

I find the fluoride mouthwash absolutely disgusting! With today's food science, why can't they make it taste better?

Asked by rootinpootin about 12 years ago

You should taste it without the flavoring. I don't recommend Fluoride mouthwashes for adults (assuming you are an adult) unless there are special circumstances,such  high caries index, or preriodintal disease, "dry mouth" (xerostomia) from cancer treatments or medications, and other such conditions. If you are not one of these special catagories then  brusning with a fluoride toothpaste before bed and upon rising is suffient.

I suggest to patients if they want additional fluoride treatments to apply toohpaste to your finfeiger and rub it accross your teeh before showering or bathing and rinse after bathing this is long enough if done daily and inexpesive. Another suggestion is to buy an inexpensisive self-moulding "football" mouthpiece and after following the instructions fill it with a small amout of toothpaste  again before you get in the shower or bath and brush away residual after removing the mouthpiece , same effect as mouthwash and in some cases better. 

   The bacteria and enzymes start ther diigestive process --see above-- and the acidic resulting saliva decalcify the Enamel surface of your teeth the fluoride bonds with the remaining calcium matrix----    Ca-Ca + acid = Ca--- , add Fl then Ca--Fl = stronger enamel surface . Very, very simplistic explaination but I think you'll get it.

 

 

why do dentists talk to you when your mouth is filled with tubes and stuff and obviously you can't talk back.

Asked by bkb94 over 12 years ago

BECAUSE WE CAN..... all kidding aside it's basically to distract from and inform you of the procedure being performed. The sound and vibration of the "drill" resonate and vibrate through the bones of the jaw and skull and are quite unsettling. Add to that all the psychological factors tied into the oral cavity (scroll up to first Q and A) most patients welcome the distraction. Plus we can expound upon or politcal views, family interactions, etc and your not going to disagree. I wouldn't with a diamond "drill" turning up to 500,000 RPM milimeters away from your tongue. And , it's great therapy for the Dentist...Thanks for listening. PS: it's when we're no talking is when you should be concerned-most procedures are routine but when we stop talking the procedure is more critical or difficult. and if you hear OOPS!!!!! then start to worry

Were there any particular procedures you REALLY hated doing, knowing how much pain it would cause the patient?

Asked by Sam J. almost 13 years ago

Yes, Billing ---------. I think that early on in practice anterior or palatal (roof of the mouth) injections were very painful for the patient but I soon go over any trepidation. Dentistry is relatively painless today with the use of local anesthisia and anagesia. The majority of patients realize that and those that present in pain can't wait to be "numbed"

Does dentistry become boring after years of practice?

Asked by sensito over 12 years ago

Not really--   It takes about 14-15 years to reach your peak performance and proficiency and all patients present with miriad of problems and personalties-so no two are the same. It remains exciting and intersting during this process and much more lucrative(one of the reasons I chose this profession).

We are required to take 20 Continuing Education Units (CEU's)/year to maintain our licenses.Each course is weighted differently -eg. an 8 hr course may only be 4 CEU's so we spend a fair amount of tine honing(no pun intended) our skills and expanding our knowledge. As I said in the opening sentence, as we become more efficient and re-educate ourselves we may add procedures that may have been referred out to "specialist" in the past.

        That being said there are "tedious" aspects of Dentistry such as dealing with --EPA, DEP, OSSHA, govermental and legal beauocrocies, etc. but that is endemic to our society.

       I approached Dentistry as an art form and often used the line , "I could sculpt a bicuspid to fool God" but any avocation eventually becomes a vocation and then morfs into just a job. My belief is no matter how much you enjoy pursuing and engaging in a field ,eventually or unfortunately it comes down to just "work". To keep the excitement and enthusiasm alive I branched out into Teaching(part-time only 2 days/week) and started a couple of businesses all based on my knowledge and education in dentistry. In my opinion there is no coasting in life.  As far as "boring" I recevied this question approx. 2:30 AM????????????. 

          I hope I answered your question-- to have to "work" at staying "fresh" in your chosen field.

   

What's something that used to be standard in North American dentistry, but which has now been proven to be 100% wrong?

Asked by BritBrit about 12 years ago

It took some time to answer this b/c there is nothing thaCasanova thinks of or find that  satisfied your parameter of 100% wrong. There have been procedures , armamenterium, and medications that have changed or modified ans improved by what came b4.  In the USA medications and procedures have to satisfy a medical and legal standaoff of care

I developed tooth pain after a filling, and now my dentist says I need a root canal! Is it because the filling wasnt done properly? She says it's "normal", but all I know is I had no pain, got a filling, and now need a root canal. Is that her fault?

Asked by root_canal over 12 years ago

There are so many possibiltities it is hard to answer with a limited ability to diagnose your condition. First of all there is nothing "normal" , but there are routine procedures. It can happen that you may need a "root canal" (endodontis treatment)but as you susupect "normally" there is some indication prior to having the filling, but there are exceptions. I'm not hedging or defending ( I spent some time as an expert witness in the past) but it is really hard to determine and give a definitive answer without more information. If you r not happy with your dentist move on.  Get back to me with more info.

I never understood why oral sex is not a high-risk activity for HIV transmission. Even without an open sore in your mouth, wouldn't bodily fluids make their way down to (and easily permeate) membranes in the throat or stomach?

Asked by James over 12 years ago

I'm Dr. D. not Dr. Ruth----Wel lhere goes,,,,,,,,,, Digestion begins in the mouth, the saliva contains lysitic  enzymes and is acidic on the pH scale. Do u remember iin 7th grade Science the experiment chewing a saltine cracker  until it became sweet? The saliva and mastication process (chewing== not what you're thinking) render the simple carbohyrates into sugar in a matter of seconds. Stomach acid that continues digestion is so strong a drop on your arm would causd a severe burn.  Your oral cavity and all other parts of your digestive system ----to the other end --contains various strains of bacteria that aid in the digestive process and are highly competitive in their niche with the virus; HIV/AIDS is virus and somewhat fragile to the digestive "juices" and bacteria's lysitic action. With the acception of Herpes Simlex which is always present in small quantities in the oral cavity and become prominent when your immune systems is "taxed".("cold sores" on the lip and genital ares as well))

HIV/AIDS is an Acquired Immune Defiency disease meaning you need repeated innoculation (exposure) to contract it, since the immunity to it has to be "worn down" to take hold ( again another exception--blood transfusions, etc.). Most STD"s (sexually transmitted diseases) are bacterial in nature and can be contracted orally as you descibe. They are easily ???? treated with antibioics. This is a simplistic answer in lay terms( or should I say layman's terms) of a complex procees.

            Do your parents know you talk like this??? Anyway practice safe sex and all this is a moot point.

  

Are USA Dentists using (Audio tooth Implants... And please do not lie!) and if someone does it illegally without your permission through a local dentist ... Can anyone sue the dentist or person(s) involved, especially if it was used for entrapment!?

Asked by Franky almost 12 years ago

Watching a few too many James Bond movies ,are we? I have no knowledge of this being done, I suggest it is more of an urban lengend.

If you have had any metal restorations in your mouth and ever touched with a tarnished fork or a piece of aluminum foil( or hte dentist's autoclaved explorer) , you would have experienced a sharp pain called "galvanic shock". With two disimilar metals and an acid saliva enviorment you get a shocking sensation transmitted to the nerves of your tooth and eventually to your central nervous system---ouch!!

This is how a battery in your car or flashlight, etc, functions----two disimilar metal in an acid medium.

That being said , back to your premise-- with some sort of metalic ,or electric power source implanted in your tooth it would have to be heavily insulated and selective for certain frequencies-- since your teeth come together 2-3000 times per day, swallowing, blood flow background noise and breathing and speech I'm not sure how succesful reception would be.

I'm sure anything is possible --but I have no real knowledge this was used or successful.

For example our military went from the U-2 Spy Plane to th eA- 12 Blackbird to the SR-71 and then to satellites, And we found  the most successful way to obtain data is the almighty US DOLLAR. Still the most effective tool.

CIA-U-Around

I have my diploma in Russia and I want to continue a specialty in France is it possible?

Asked by Kappoo about 7 years ago

Can salt water actually cure a cavity?

Asked by DS over 6 years ago

One of my top, front teeth is becoming shockingly loose (I'm 55 years old). I have no money to pay a dentist. I've been doing some research. I think a splint would work for me at least temp. Can you tell me a ballpark $$$ Upstate NY? TY

Asked by All_I_Want_4_Xmas about 10 years ago