f13.net

Okay. I just had another patient that had bugs crawling all over him.  :ye_gods:  I can't even describe how gross this is.  That's two in a week. 

How does that even happen?

I have no idea.  And these weren't lice.  They were bugs you'd expect to find on a corpse.  /shiver.  :ye_gods: :ye_gods:

Edit:  I'm actually going to start a thread on E85, I think

I think I'm going to just take a sledgehammer, locate ATT's IS department, and start hitting their damn servers with it.

All I want to do is LOG IN AND PAY MY GODDAMN BILL. I can't DO THAT because whatever fucking moron is running their system has decided the proper response to a "login request" is a "404 error".

Brilliant show there, old chap.

Welp, just put braces on the wife.  If I don't post again you know it's because she stabbed me.   :oh_i_see:

Was there necrotic tissue or were they just that filthy?  :ye_gods:

 As to how it happens, I'd go with psychosis of some sort but hey, you'd know better.

The guy was actually relatively clean-ish, but just had these bugs crawling on him.  They looked like little cockroaches.  I think you're probably spot on about the psychosis. 

Was she struggling or did you drug her first?

No, she actually asked for them.  Trust me, it was not going to happen until she did.  Not only am I married to her, she's a pediatric dentist so she knows somewhat about what I'm doing. 

Maybe you have some kind of weird reverse acid flashback where you see bugs crawling on other people.

Wait.  Does ghost equal grunk???

ghrost?

Edit:  And that may have been possible, Ingmar, but my assistants saw it too.

Meh, dentists always said my teeth were pretty borderline as far as needing braces, and since the decision was left to me (a child at the time)... :oh_i_see:

I kind of want to get invisalign some day, but it's going to have to be in a few years...and by then I'll be past 30, so I'm not sure there will ever be a reason to.

If you've made it this far there's probably no point.  The dirty little secret of orthodontics is that braces won't make your teeth any healthier at all.  You won't be at less risk of periodontal disease or cavities, and recent research actually points in the opposite direction for periodontal disease.  It's almost 100% an esthetic venture. 

I just had the staff put braces on me.  This should be an adventure.....

Right, I would just be doing it for looks, as I have some small gaps in the upper teeth, and minor crowding on the bottom.

I've been pretty lucky with dental health up to now, so that's not the issue.

Here's another pro tip.  If you have crowding on the bottom and spacing on the top you might be able to save yourself some money by simply going with veneers or bonding.  When you have that going on the normal deal is that the upper incisors are too narrow.  Even with braces you might have to have at least bonding, and probably veneers.  Nobody sees your bottom teeth typically so just save yourself a step and some money and get the veneers.  Unless they are grossly out of whack, then you'll probably need both.

How much do braces cost? Last time I was at the dentist I priced out veneers...would have needed 4, and it was not cheap.

NOTHING from a dentist is ever cheap.

Thus why they always have tons of free toothbrushes and pens! :-p

I typically charge around $6000 for Invisalign.  The thing I am trying to save you the pain of is getting Invisalign for a similar price and then having to pay for veneers, etc. on top of that.  The best thing you can do is get to see a very good dentist (preferably one that isn't trying to sell you Invisalign, to take out bias) and see if they can do veneers on you as is.  If so, it may cost you $6000, but that is it, and your smile looks better immediately.  Whereas with Invisalign it may take a year or more.  

Edit:  As Chimpy said, nothing at the dentist's office is cheap.  You will be doing yourself a great favor to get a well respected dentist that will help you to spend the least amount of money possible to get the result you want.  It may not be cheap, but you'll want to get the best value, which means cost, appearance and longevity.  If you spend half as much but it lasts a tenth as long you haven't won the battle. 

Yeah, the office wasn't actually trying to sell me anything. Shoddy maintenance aside ( :oh_i_see: ), the hygienists were saying they thought my teeth were actually alright and were actually sort of trying to dissuade me from the idea. Part of the concern was cosmetic, but I've also chipped my front 2 pretty well and I thought veneers would provide protection (once as a child, and then once as an adult when it was cold out and my teeth with chattering and one of the incisors somehow got *caught* on a lower tooth and chipped).

I ended up coughing up a few hundred dollars to get all my back teeth sealed, since at the time (Sept 09) I thought I was going to a 3rd world country with no dental care fairly shortly.

That was actually a pretty wise investment. 

Well, I personally think Invisalign is a pretty shoddy product in a lot of ways, and from what you are telling me I almost always expect that the upper teeth are too narrow.  It's tough to tell and I think some expert help would be in order.  Just go see an orthodontist and see what they tell you.  It can't hurt and they usually won't charge you anything for the consult.

My ortho had to widen my mouth with an activator.  Really, I'd not do it again if I had the choice.  I could have lived with the overbite.

Yeah, we used to believe that shit worked.  I had to wear a headgear, which come to find out can make about a 2-3 mm difference when all is said and done.  Sounds like great results for the year and a half I had to wear that thing.  

Edit:  Anyway, I guess let's stop shitting up the entire board with teeth  :ye_gods:.  If anyone has any questions about anything feel free to PM me.

My dentist's first words upon seeing me as an adult (late 20s, first time I vistied the guy. Used another dentist prior) was "So, your orthodonist just give up on your bite then?"

He's agitating to get me to have my jaw fixed (surgery), insofar as I'm apparently damaging my soft teeth and it can cause 'migraines and other problems'. I'm 35. If it starts CAUSING migraines I will revist the issue.

As it is, I have soft teeth. I have yet to have one pulled, cracked, chipped, I have not had a root canal, I've basically been okay on the teeth front, despite soft easily ground away teeth. (Apparently too much flouride? I can't remember the reasoning. I know my orthodonist had a hell of a time getting brackets to stick).

Other than that, he just cleans them and does an occasional filling. He's approximately 94 million years old, and the guy is awesome. Part of it is because he grasped early that I'm happier when someone is explaining WHAT they're doing to my mouth as they're doing it. So I get stuff like "This? This is basically a cheese grater. For your teeth. I've got to grind off a bit to get this filling to sit properly between your molars. Sadly invented by Nazis. Useful tool, sad experimental process."

Which reminds me, need to get my kid to an orthodonist before Oct 1.

Unfortunately I dropped the ball late last year and wasn't able to sign up for dental during open season, so... :oh_i_see:

Even if I really could see someone for free, we're not allowed to take time off during training, so I'm SOL.

Just got out of my mine after 8 months (they were only moving like three teeth).
I got them done at the Ortho school clinic at our local teaching university.

Cost me $100 per tooth and since they put on 6 brackets it cost me $600 bucks. This included all follow on maintenance/check ups as well.
Had to go back to get three brackets re-attached as they popped off my teeth which had porcelain veneers on them.

Last time I was in the chair, the dentist asked if I'd been grinding my teeth. Now, I obsessively and constantly grind my teeth, in fact it's one of my secrets to good timing when playing music, I've always ground left-right-left-right to the beat. I promised him I'd try to stop and went home and saw what concerned him - cracks showing up on several of my front teeth. Now I'm constantly trying not to grind my teeth, but it's so automatic.

I also wish I'd have had my wisdom teeth removed as a kid, to relieve some of my lower jaw pressure, it's tight in there. Always break some floss.

So who's ready for Saturday night?   :grin:

This cup of coffee tastes great. I think I'll make a second pot, then go powerwash and scrub all the winter detritus off the boat.

I just split this into it's own thread. I find it interesting.

I've had teeth whitening, unfortunately while it made my teeth's color look great I do have discoloration near the gums on one of my incisors. My dentist said that it's likely calcium deposits and that a veneer is the only way to get rid of it.

Sadface.

I also have one root canal and a bunch of cavities. I get them near the gumline which makes it really difficult to manage. Fortunately my dentist is one of the best in the nation, he was apparently voted so in a thing where all the dentists in the country vote on themselves. He's done me good!

I had all 4 wisdom teeth removed at once about 5 years ago. I was so incredibly loopy from the meds, I didn't care about anything that week.

Oh fuck me another terrifying thread... I have a solid aversion to dental visits due to the fact my childhood dentist never actually believed me when I said I could feel white hot pain when he was drilling. Never seemed to numb me up effectively enough to drill without me noticing or shooting my ass off the seat when he hit a sore spot.

That said, I am now dealing with his deep drilling by having most of my molars root canalled because, a) over the years, decay set in on the edges of the old fillings and b) I never go to the dentist given my past torturings. However, all three of the root canals were perfectly painless and the last was insane with the dentist only using a single shot of septocane and a follow up when I started feeling a twinge once he opened the root. The prior ones were painless, but novocain was used liberally.

Anyone have teeth pulled? Christ it sucks... no real pain, but pressure up the ass and watching the dentist struggle and feeling his arm shake from all the force he was putting into the extraction is enough to push me to the panic attack envelop.   :ye_gods:

I hate this thread.. :grin:

He wasn't doing it right.  Always try to go to an oral surgeon for your extractions, if you can. 

I got an oral surgeon in Amsterdam.  She was truly talented.

I would have to  assume that she was doing it right.   :grin:

Give me some reference as to how it is SUPPOSED to go... Since I need two more pulled.  :ye_gods:

Pressure is typical to feel, however he shouldn't be shaking.  Teeth generally aren't that tough to get out.  Pay the extra dough and get an oral surgeon to do it.  They can even sedate you for the procedure.   :awesome_for_real:

I was home brushing my teeth after lunch because they felt odd. Feel this roughness after brushing. Look in the mirror and WTF it looked like the insides of my lower fronts were all jacked up. I floss it good and it doesn't help. I start to panic, think about calling the dentist, start feeling the odd-looking spots with my fingernail. Some gritty substance comes away...oh, I just found out what plaque looks like. I've never had to deal with plaque in my life, which is good I guess.

I just got chewed out by the hygenist on my last visit, she was sure I wasn't flossing. I think I've figured it out, for breakfast each day (at work) I eat a fruit and nut bar. The dried fruit and sugary binders are probably getting lodged in there, as I often feel the fruit in there. The binder is so gluey and I don't brush again until the evening so it sits in there all day, every day. So much for those bars!

Kinda laughing that I just found out what plaque looks like at 41.

Are there any other vile bodily secretions you're unacquainted with? I'm fairly familiar with all forms of mucous at this point...

The shaking was from rocking it back and forth in the gums. The excuse given was that my roots were so long that they could not just wiggle it out but had to pry back and forth till it loosened up enough to be pulled.

One of my widsoms rotted and had to be pulled after the dentist hit the nerve and it started bleeding.  Luck had it that their oral surgeon was onsite that day.  So they numbed it good and sat me down.  I was amazed to see that he only had two tools on his tray:  A rod with a metal loop on one end and a pair of pliers. 

It was all pretty easy, just scary for the first time.  It was over so fast I didn't know what to think.  I got some percocets for the pain, of which I didn't need any. 

The last tooth I had pulled, I felt nothing. It was amazing. Just a ton of novocaine, no laughing gas or sedatives of any kind. But my dentist took it reeeeeal slow. My jaw was killing me halfway through the procedure. But I'd rather my dentist took his time and give me an aching jaw for an hour, than feel that pressure on my tooth. (Panic reflex indeed!)

Last time I went to the dentist I got three (small, though one apparently was in a nasty spot) cavities filled and a telling off for not having been for a check up for three years. I also got told to stop drinking lots of sugary drinks, which confused me since I don't. In fact I'd say I've had maybe one non-diet soda in the last 4 months and that's more than usual. I don't drink fruit juice much either. He didn't offer any other explanation (beyond saying beer wouldn't be causing it) so I assume he just thought I was lying. Which isn't a big deal but I'm left wondering if my cavities were normal or ordinarily the kind of thing only people who are drinking lots of sugary drinks suffer with. Anyway time to see him again in the next couple of months so I'll see how things have been for the last year! :ye_gods:

How old are you ??

 :ye_gods:

My grandfather still gets laughing gas -- he had to find a dentist that offered it. Otherwise he'd -- no kidding -- take the filling with nothing.

The man can't handle a novacaine shot, not there at least. (I've yet to find a way to say "He can't take a shot in the mouth" without it sounding pervvy).

The guy was ex-Army, boxed golden gloves, and I've seen him tear a chunk out of his arm and basically just pour alcohol on it to sterilize. And of course has had fillings done without anesthesia. But he'll practically hyperventilate if you mention a novacaine shot to deaden your gums.

Last time he needed real work done, they just sent him to an oral surgeon and they sedated him.

Is nitrous obsolete or something? My dentist offers it routinely along with the standard Novocaine shots.

Back when I was living with this psychopath girl, her dentist actually still offered ether. Honest to god I would not have believed it but I went with her and damn if he didn't. Of course this was back in 2001 and he was near 70. But still... fucking ether.

My dentist office offers it.  I always get the shots, but when my partial fell out last week the assistant asked if I wanted shots or gas.  My dentist is my age, and the rest with the practice are about ours or younger.

(No cracks that my dentist is old, either. :-P)

I have lovely teeth.  :grin: Well, health-wise, anyway. My lower teeth are kinda crowded and once in a while they go blah blah tartar build up blah and I nod and point out it's not covered and then they don't say anything about it until a year has gone by.

The only problem REALLY is that our dentist never. shuts. up. EVER. And it distracts him from what he's doing, or sometimes he'll stop doing whatever he's doing so you can answer him, etc. He does good work, but MAN. TALKY.

Nitros has to have a special scrubber and vent system set up any more, I'm sure that add the amount on the bill.

Sedation if I remember right, is four levels (found this off another site, since I don't have a membership at the ASA):

Minimal sedation:  Also known as anxiolysis.  A drug-induced state during which the patient responds normally to verbal commands.  Cognitive function and coordination may be impaired.  Ventilatory and cardiovascular functions are unaffected.

Moderate sedation/analgesia (conscious sedation):  A drug-induced depression of consciousness during which the patient responds purposefully to verbal command, either alone or accompanied by light tactile stimulation.  No interventions are necessary to maintain a patent airway.  Spontaneous ventilation is adequate.  Cardiovascular function is usually maintained.

Deep sedation/analgesia:  A drug-induced depression of consciousness during which the patient cannot be easily aroused, but responds purposefully* following repeated or painful stimulation.  Independent ventilatory function may be impaired. The patient may require assistance to maintain a patent airway.  Spontaneous ventilation may be inadequate.  Cardiovascular function is usually maintained.

General anesthesia:  A drug-induced loss of consciousness during which the patient is not arousable, even to painful stimuli.  The ability to maintain independent ventilatory function is often impaired.  Assistance is often required in maintaining a patent airway.  Positive pressure ventilation may be required due to depressed spontaneous ventilation or drug-induced depression of neuromuscular function.  Cardiovascular function may be impaired.

The idea that nitro can cause you to slip into a deeper state of sedation is one worry that the dentist would have to think about, plus the documentation probably required for sedating pt's.  I don't know what the ADA or Texas (that is where Ghost is at if i recall), handles out pt sedation for dental work.  I know more on moderate, deep, and general anesthesia, it is a labor and paperwork intensive procedure, and it should be, since you run the risk of your pt stopping breathing (or are stopping their breathing to intubate them during R.S.I/C.A.I.).  I do laugh at one thing ASA came down with, was the use of propofol (diprivan) only by Anesthesiologist for moderate sedation, since ER MD's can't manage an airway.  I've never seen ER doc's so pissed!  They were yelling at them that they don't cancel the case like they do if they can't get a tube down, they have to get it down (and it becomes a team effort, where every person who can intubate may ended up doing it, and all adjuncts are used).

My teeth hate me (and I hated them for half of my life) and will probably need replacing one day in the future, I have little doubt.


I've had four pulled when I got braces as a kid, I had 4 wisdom teeth out as well. I've cracked one of the front ones, but the dentist fixed it somehow, though I don't know how much of it is actual tooth anymore or how much of it is dentist magic tooth replacement stuff.

My teeth are naturally rough and shitty (they apparently had holes in them too, not cavities, just natural holes), and I fucked them up even more as a kid because of poor brushing/flossing habits and my love of acidic and sugary drinks. They are stained too from the braces and my shitty brushing as a kid. My cavity rate has gone down since then, only like 2 a year now  :awesome_for_real:

I don't think I have a single tooth that doesn't have some kind of filling or shielding or whatever on it.

My first dentist as a kid was apparently, terrible at his job. My parents and I didn't know this until we went to a new dentist and she went  :ye_gods: at our teeth. I also had a good 4 year time period as a kid without any dentist, I'm sure that helped loads!


They aren't HORRIBLE to look at, but movie star straight and white they are not, not even close. They still chew food at least, for now.  :why_so_serious:



I always get the needle when work needs to be done, it doesn't bother me.

I always go for needle and gas. I've switched dentists a few times for various reasons and every time I've done it the new guy expresses horror at how awful the previous guy was and explains that every single filling must be replaced immediately.  It makes me a little suspicious really.

I'd like to hear more about this, as I've been considering orthodontic work with the primary goal of improving my tooth health.  

Right now I've got some crowding and the crowded teeth inevitably have plaque between them when I go in for my biannual cleaning.  My dentist thinks if I got the teeth straightened out it wouldn't be as much of an issue, and less plaque would mean fewer gum problems.  I've also been having some intermittent TMJ pain over the last couple of years and I feel like my increasingly crooked bite might be partly to blame for that as well, although that's not supported by anything my dentist has told me.

If straightening my teeth out isn't going to help any of that, I'd rather just save the $6k or however much, but it makes sense to me that having straight teeth would be a good thing health-wise.  What am I missing?

Last one did just that.  Luckily it was only one filling, but they replaced an old style metal-whatever with what I'm assuming is the newer stuff the current one uses.  At least it's clear-ish.

I've only had two cavities in the last 7 or so years.  Before that, just one during college.  I've had a lot of teeth pulled for braces in the past (13 total, 8 adult teeth).

Last cavity filling was somewhat annoying.  They keep injecting me with novacaine but the tooth area just wouldn't go numb.  I think they were up to 5 shots before I said to just get on with it.  After that I got progressively more numb to the point where I couldn't feel the left side of my face for a few hours.

Maybe it's the term "laughing gas". I think that's a WW2 term or something.  :grin: (And no, I'm not that old either!)

The last hygienists I went to actually liked having me...not because my teeth are super awesome or anything. I think it's mostly because I had no problem admitting that my flossing was...inadequate. And the plaque on the back of the lower front-4 is always bad with the crowding - after my last cleaning, there was actually a visible gap between the lower front-2.  :oh_i_see:

It seems to make sense, but any research they've ever done on the issue says that it is a wash, at best.  The most recent research, a huge meta-analysis done by a chick up at Washington, says that teeth are actually periodontally worse off for people that have had braces.  It's a very small amount worse, but it was statistically significant.  Also, TMJ problems are almost never corrected long term by braces.  Usually people will get better for the short term (while the braces are actually on the teeth) and then will regress again over time.  For adults I usually will tell them that the only real reason to get your teeth straightened would be if you don't like the way that they look-  and that is a very valid reason, in my opinion.  There is good research that shows that people with good looking teeth do better in school and in life (job, etc.). 

So, about a year ago, I went in to the dentist to get my teeth looked at.  While there, the dentist tells me that my wisdom teeth are bothering me because I have no lower wisdom teeth, and so the top ones have dropped down a bit, and that I should just get them removed.  He mentioned something about oral surgery that sounded, to me, like it wouldn't be out of place in a Hellraiser film.

My question is, couldn't they just slap some novocaine in there, and yank them out?

Usually, but not if they're impacted.  http://en.wikipedia.org/wiki/Tooth_impaction

I took my buddy to get all four of his done at once and they put him under.  He was back out in the anesthesia waiting area in about ten minutes, I swear they used a cordless Dewalt drill and a hammer/chisel on him.  He never knew the difference though, just had a couple stitches.

They could, and I have done it that way many times, but for reasons Hawkbit mentioned the sedation is usually the best way to go.  Again, go with an oral surgeon if you can for wisdom teeth.  The complications involved with these teeth have the potential to be much worse than for other teeth so let an expert do it.

And hope you don't have a poor reaction to ambien and lodine if that's what they give you.  It was a very unpleasant four days until I figured out it was the lodine and not the pain causing my nausea.

Edit:  you meant Lodine.  That's still a damned weird combination.

Is that an average across all types of braces?  I can see how normal braces could cause harm by making cleaning harder, but removable braces (e.g. Invisalign) wouldn't have that problem, right?

Yeah, Invisalign wouldn't be applicable to that study because it only includes traditional braces.  My caution on Invisalign is be careful about what you are being told about it.  A lot of general dentists will try to use it and don't know what they are doing.

My dentist gave me a referral to an orthodontist, so hopefully he'd know what he's doing.  I still have yet to go because the expense is unnngh, but on the other hand my teeth aren't getting any straighter on their own.

I believe there is an orthodontic residency where you are (San Francisco, right?).  You could get Invisalign through them at what would probably be a cheaper fee.  It will probably take longer, but the way residencies work now you'll get good treatment.  There's a lot of supervision.

UCSF Orthodontic Residency (http://dentistry.ucsf.edu/admissions/postgraduate-programs/orthodontics)
Pacific Orthodontic Residency (http://dental.pacific.edu/Academic_Programs/Graduate_Orthodontic_Program.html)

I used a lower case 'L'.  I didn't mean Iodine. ;D

Ambien was for the conscious sedation.  I'm told I was able to run to the restroom prior to the surgery, but I don't remember it.  Apparently mid-operation was another moment, and I was somewhat awake when they wheeled me out to the car and did the final purging.

I had Lodine and Vicodin for home, but I wasn't able to keep the vicodin down long enough to help until the Wednesday after surgery, which was Friday.  Unfortunately I suffer from excessive inflammation after any surgical procedure, so the pain alone kept me mostly unconscious the entire weekend.  On the plus side, I heal well and quickly overall (no pain reduction though, and I seem to hold true to red-heads needing additional pain meds).  I always surprise doctors with the extremes of both.

I'm considering a single implant (#18).  Are these things primarily for the rich?  The one quote I've gotten thus far could get me a decent used car...

^This. This is what I mentioned I did earlier. Braces (with six brackets for upper teeth to make some minor adjustments prior to bleaching and replacing 20 year old veneers) and it was $600 all in including upkeep, maintenance, and the retainer.

btw I hate  :drill: the retainer. Big stupid chunk of plastic in my mouth all the damn time. Worse than the braces.

Yeah, I read it wrong :awesome_for_real:.  I was caught off guard by the Ambien as sedation.  That is not normal protocol.  

You'll be looking at $3-5,000 probably.  Again, go to a dental school if you can.  You'll get a much better deal.

That's what I did!  He just shot me up with a needle and then got his pliars out (oral surgeon).  He asked if I wanted to go completely out or just localized and I chose local because I wanted to make sure he pulled the right ones (I am paranoid something fierce about tooth extraction).  I watched him work in the reflection of his glasses and it was pretty surreal.  Three came out easy, the 4th was partially grown into the lower jaw bone and thus required some more effort to get out.  He said "you'll be sore there for a few days" and he was right.  They gave me oxycontin for the pain and it made me nauseous & sick, so I stopped taking it after a day and suffered through the pain.

Interestingly enough he had all sorts of tales of being a young dentist in a ghetto neighborhood of Detroit and how bad people's teeth were - that's how he got so good at pulling teeth.  Most of the patients who came in had teeth in such poor shape there wasn't anything left to do but pull them.

A retainer is a tiny piece of plastic compared to an activator.  That's a solid piece of plastic split in the middle with the goal of widening your upper jaw, so the braces will actually fit.  Really, really, sucks.
College pharmacy.  They fill it with the cheapest equivalent they can.  I forget what the script asks for.  It worked just fine, other than making me ill, as I have about 30 seconds of memory from about when we pulled up to the place and when they put me into the wheelchair.

That's pretty similar to how my wisdom teeth came out, only they knew before hand they were not gonna put me under (I'm asthmatic and they just straight up would not put me under unless we were in a hospital JUST IN CASE), so they only did two at a time, 'cause the oral surgeon felt the number of shots involved would be a bit overwhelming for someone (and honestly, he was right as far as I was concerned). One of them had hung up on the molar in front of it and took some doin' to get out, but they all came out pretty easy and I healed quickly. I didn't swell up at all, barely bruised (and only on the second round), and didn't need any of the percocet they gave me. Pretty much as pleasant as an experience as one could expect.

The sedation dentist I talked to said the prescribed pill he gave out was halcyon. I chuckled a bit on the phone as I had one of those in my wilder days and he asked if I had sedation dentistry before. I denied it and I think he got the message.

Implants..is that the titantium stud into the jaw, screw the fake tooth on one?

I've a friend that got those -- all four front teeth. (She had issues and never smiled. She does now). They look...damn real.

Ambien is typically used for sleep issues (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000928/).  It has an amnestic effect, just like other benzodiazepines but I have never heard of it being used for sedation.  Typically used medicines include versed and valium.  I have heard of halcion being used too, but again wouldn't use it myself because versed is just so much better. 

It worked fine other than me getting ill.  But it's now on my short list of meds to make sure I never receive.

It's pretty damned spectacular if you have insomnia.   :heart:  It's saved my ass a few times when I was super stressed and couldn't sleep. 

I tried Ambien, it worked great for knocking me out, with only one minor side effect: No dreams.  None at all, and after a week I was completely scatterbrained, forgetting conversations I had just had a few minutes before (I can normally remember conversations word for word years later).  No REM cycles, for cognitive purposes I might as well have been on a 7-day amphetamines tweak.

--Dave

Yeah, you can't really take it every night, although I know some people who have for a while.  When I take it I feel like I wake up seconds after I go to sleep. 

Probably so, But just for clarity's sake my retainer isnt the normal small bit of pink plastic for the roof of your mouth with the wire in the front. Because I already have veneers on the wire/metal would scratch them. So I have this clear plastic thing that fits over my entire upper teeth and upper soft pallet. Its like wearing a full on sports mouth guard 24/7 except when eating or brushing my teeth.


If they had subjected me to this much irritation at Gitmo I'd have admitted to acts of terrorism by now.

I'm puzzled by that combo too, Lodine is a NSAID (nonsteroidal anti-inflammatory drugs), the cream of the crop is still Ibuprofen (brand names Motrin, Advil, Nuprin), when I got my ass beat, I didn't swell till 2 days later then I was like freakish looking, they had tried naproxen on me first, but otc 800mg of Ibuprofen three times a day took the swelling down and helps with the pain to this day.  We tell lots of the arthritic and chronic pain people to just go with an open mind and try it for 3 days, many are amazed how it works.  We do give them the low down on how it is risky, you really need to keep your stomach in shape and healthy if doing a regiment like that so you don't develop a GI bleed (I take otc Zantac 75mg in the morning and night, others would do Pepcid 20mg am & pm).  I know some surgeons will give it pre-op, but many won't due to bleeding risks, but I do remember some oral surgeons that did give it and seemed to have less problems (currently only the heart surgery says don't take motrin pre-op, so FDA looks like okay pre-op for other procedures).

Just curious Ghost, but for oral sedation, does Texas have a certification course and training program?  I don't think I've ever seen a crash cart at a normal dentist office, so I would hope even with oral sedation the staff would be trained to handle emergencies if the pt did slip into a higher level of sedation that required interventions.  No offense, but having the thought of some of the dentist I know having to code someone would be pretty horrible (then again, that is most of the doctor offices too!)

Jimbo,

I think that varies from person to person though. Ibuprofen might as well be a sugar placebo for all the good it does me. Naproxen on the other hand is like mana from heaven.
Stuff works miracles.
But now with it being sold over the counter as Aleve, I simply buy a bottle of that and pop three in order to get the prescription strength.

I'm the exact opposite.  Ibuprofen works wonders for me, but Aleve/Naproxen does nothing.  I literally don't feel different with them. 

My wife, on the other hand, is allergic to Ibuprofen but Naproxen does the trick for her.  Weird how people react differently. 

I've had my upper wisdom teeth pulled because they weren't being kept in the best of shapes (they weren't fully deployed so they were hard to reach AND they were pushing against the other teeth in my upper jaw). We only did one at a time but all he did was give me some local anaesthetics (no idea which type) and went to town. The first one he was luring slowly but surely out, and the only thing I felt was a pressure against the lower jaw as the tooth came out further and further so I had to open up the jaw more. The other one I think let go a bit more violently. Neither of them really gave me any pain or swelling, nor did they bleed profusely.

Thankfully the lower wisdom teeth have never appeared, so unless they decide to start fucking with the other teeth, they're going to stay where they are, deeply buried under my gumline.

Yes, there is a certification course and training program.  No, it probably isn't good enough and no, most of them don't have crash carts or even the stuff to do intubations.  However, most of the dentists that do oral sedation are giving low doses of benzodiazepines so a depressed respiratory response shouldn't be a problem.  On adults it usually isn't an issue because they are giving a dose that a physician would typically give for anxiety as a regular prescription to be taken in their home.  If the dentist is having a problem it is because they didn't choose their patient appropriately.  As a whole I don't have a problem with light oral sedation being given by dentists in their offices. 

Kids are a whole different ball of wax and can head south on you in a hurry.  There are a lot of general dentists that are sedating kids in their offices that are not even remotely qualified to do so.  That is one reason that I usually recommend people send their children to a pediatric dentist if their kids need to be sedated-  pediatric dentists are required to take PALS and have at least done some intubations.  Whenever you hear those horror stories about some poor kid dying in a dental office due to massive sedation it is always in a general dentist's office.   For adult sedations the only people really qualified to deal with consequences would be oral surgeons and possibly periodontists (depending on the training program). 

(rise from the dead)

Ghost, any thoughts on the following?

- startup called ClearCorrect which is competing with InvisAlign
- ThermaFil for root canals

Will offer reasons after so as not to bias you.   :oh_i_see:

Aligner therapy is limited, be it Invisalign or Clear Correct.  It's good for some things, not so good for others. 

Thermafil is shite.  My Endodontist friends wouldn't think about using it on a patient. 

Thanks, that's pretty much what I expected.

- I interviewed with Clear Correct a couple of weeks back.  They have some internal issues...

- Half my root canals were ThermaFil.  Half of those are having to be redone.  My dentist is saying all of the right things, just wanted to verify.   :why_so_serious:  :uhrr:

Yeah, I don't know if I would sign on with Clear Correct right now.  They have a lot of issues to overcome, many of them external.  If you're going to get root canals re-treated, I would recommend going to an endodontist.  Their success rate is much higher than a general dentist because that's what they do, all day, every day. 

Here's one for you - I had a root canal a few months back, on a molar. Went great. Dentist then put in for approval on a crown. My medical only covers 50% on crowns, and currently I can't afford it. So long as I avoid eating peanut brittle, how vital is it to crown a root canal?

Extremely. I was in the same boat as you and eventually that tooth, my upper right molar, crumbled to pieces - and I haven't eaten anything in the way of hard textures in years... not that I did before. The dentist who did the extraction of the stub that was left said to me that he's seen it a lot and it almost always comes down to the patient not being able to cover the cost of the crown and then they lose the tooth anyway - so it basically costs the patient the coin to get the root canal and then the extraction of the root canal. You might not feel the need to get it crowned right now, but shortly, that thing will start to develop stress fractures within it from the pressures and it will crumble away. Of course, this is mostly from my own experience so Ghost will have to chime in for a more official remark.

It's pretty damned vital, for a couple of reasons:

1.  Temporary fillings aren't meant to work as long term solutions and you will typically have leakage into the interior of the tooth after a while.  This means that all the same bugs that got in there and caused you trouble before can lead to recurrence of the infection (possibly years after you get the crown placed  :ye_gods:) and, therefore, pain.
2.  The tooth has been significantly weakened by the root canal procedure.  The crown acts to keep the tooth from having a vertical fracture, which is almost universally catastrophic (i.e. you're getting an extraction and probably an implant when it happens).  The example I use is the old barrels that had multiple staves would have a few metal rings surrounding them to hold everything together.  

So my advice it to get it done ASAP.  It's worth a credit card purchase.

ASAP is a bit of a misnomer, of course the sooner the better but it will last at least a year as-is if I remember what my ortho told me when I had mine.

No, ASAP means immediately, if possible.  But hell, it's Bunk's tooth and his money.  

Just for shits and grins I polled my endodontist buddy for you, Bunk-  he recommends starting the final restoration in the first 4-6 weeks.  That is what they put in their informed consent, and if the patient waits longer they won't guarantee the outcome.  If you have a temporary crown on the tooth that may be okay, however the temporary crowns and cements many dentists use are quite suspect.  He also recommended that you do wait 1-2 weeks before starting to finalize things to make sure that the root canal treatment has taken care of the problem.  You don't want to get the final restoration on and still have pathology going on.

Its been a couple of months and I had good results from the treatment, no recurring pain at all. I'll likely have to wait till November (extra paycheck month) but I'll get it done. Yay living paycheck to paycheck!

I do not support dentists using the phrase "for shits and grins".  :ye_gods:

I'm glad there is a thread for this because I don't want to sort through 45 pages of google.

What is the current thought on how you are supposed to brush your teeth?

Up and down vs side to side or in circles?

I put a vibrating toothbrush in my mouth  :oh_i_see:

Circles.  But, in reality, it doesn't matter.  What's more important is diet, in particular how much sugar you eat, and flossing.  Flossing is much more important than brushing. 

Any sugars, or do you make a distinction between complex vs simple sugars?

Yes that. I have been told by my dentist that using a electric toothbrush is really a lot better than doing it 'by hand'.

Also, I am going to have a wisdom tooth removed in about a month (in preparation of getting braces >.>)
Is there anything I can do before/after to speed up recovery and make it painless? Except eating lots of painkillers and putting something cold on the cheek?

My advice is to not watch a youtube video of wisdom tooth extraction the morning of your surgery.

I remember one of my wisdom teeth extractions. The fucking tooth had roots growing in 4 different ways and the dentist had to cut it into 4 parts to get the thing out.

She scheduled an hour for the next one in case it was the same, but this one she literally went *Pull* *Twist* Yank* and it was out. And she stood there with my bleeding tooth in a pliers in her had, looked at me all full of anesthetic and in shock and brightly said said "you know, I have really strong arms. I water=ski!" and I said "Weahhy?"

But don't let me put you off. Enjoy!

When I had all four out everything went well except for when I was told I yelled "it felt like my whole body was orgasming" in the recovery room. General anaesthesia is fun.

I had all four of mine out under a general unaesthetic as well when I was 18 and they gave me percodans to pop 3 times a day. Thats what it said to do on the bottle so i figured I'd better do it in case it was an antibiotic or something.  I never noticed anything myself except for the occasional attack of hiccups but other people told me I was in an exceptionally good mood that week  :awesome_for_real:

Glucose, specifically, is the primary foodsource of Streptococcus Mutans, wich is the primary source of cavities.  So glucose/sucrose are going to be the big baddies. 

Don't smoke.  Don't drink through a straw.  Don't eat or drink obnoxious foods.  Take an anti-inflammatory dose of ibuprofen.  Cold for the first 24 hours, but use heat after that. 

DON'T be dosed to the eyeballs on Percoset/Oxycodone the following day, look at your hand and think "I feel really good. I don't feel any pain at all. You know, I bet I could smash this hand with a hammer and not even care. That would be cool, is there a hammer around?"

My first thought after waking up the next day was "Thank god I was too lazy to go downstairs" because I would have totally done it.

I got mighty paranoid about dry socket when I was having some teeth pulled, and lived off of ensure and jello for about 3 days after the extractions. I managed to not smoke for 24 hours after the first, and then smoked a few a day for the rest. (We spaced the individual extractions over the span of 3 visits.)
I never got dry socket , only a few bone splinters once. :)

Those bone splinters are pretty normal and you can even get them up to 6 months after having the surgery.  Smoking is the most important cause of dry socket, and, unfortunately for smokers, I'm not even sure it's entirely related to active smoking, i.e. I think there's something that makes smokers more apt to get dry socket even if they don't smoke for a few days after the surgery.  You almost never see dry socket in people that don't smoke. 

Vicodin and lots of it.

I was allergic to lodine and within fifteen minutes of taking one I'd vomit for half a day.  I couldn't even keep vicodin down.  It was four days before I figured out it was specifically the lodine, since I thought it was the pain at first.  As I tend to become inflammed easily, it was not a happy four days.  (Yes, wisdom tooth extraction, massive inflammation, and NO painkillers.  Joy.)  Although the next four weren't so bad once I could keep the vicodin down.

Also found out ambien does not agree with me.  Not that I remember much of those three hours.  Conscious sedation is fun.  Just don't have a bigger smart-ass than yourself take you to the appointment.

I can't really do conscious sedation given the fact I used pretty much all the stuff they prescribe for it recreationally back in my hey-days. I was asked if I would like that as an option once, to which I replied 'not for a dental procedure, but they work wonders at house parties.' My dentist was slightly amused.

As for wisdom teeth, I had mine out almost 25 years ago so my recall is at best vague. General knocked me out and I have fleeting images of my grandfather dragging my corpse to the car along with my mother. Oddly enough, it was Percodan that was my first foray into drug induced hazes. My mother feeding me those wonderful pills once every 6 hours the first two days and having The Cure's Disintegration on repeat on my new CD player was pretty intense. Outside of that, I had no bruising or swelling and my recovery was fairly easy given my teeth are a god damn dental travesty. Not the parts you see, but the roots are long enough to be up into my sinus cavity and just for more lulz, curled slightly at the ends. My wisdom teeth were equally as long and coming in perpendicular with one even starting to press downward. I can't even imagine the noises coming out of my mouth as they extracted them.

Why were you taking Iodine?  That is not something that is typically given after wisdom tooth extraction and I can think of no logical indication for a dentist to ever give you iodine.

She probably meant Iocane. It takes awhile to build up a tolerance to it and I'd think you'd probably be ill for the first few days of it.  :why_so_serious:

Yeh, that Iocane is a bitch.  I hear it makes you grow testicles the size of watermelons.

Lodine.  With an ELL not an EYE.  I'm also having deja vu about this discussion.

Oh.  I gotcha.  Lodine is an NSAID type medicine, so they are probably giving it more for inflammation/swelling than for pain.  It's still an odd choice.  Good old ibuprofen at 800 mg every 6 hours works great for that purpose.  It can induce problems with the stomach lining, but usually not over that short of a period of time.  I found that most of the time etodolac (Lodine) was given to people that were suspected drug seekers because they wouldn't know what it was and wouldn't bitch. 

Vicodin is a great drug for pain, but it has a tendency to induce nausea/vomiting.   Definitely need to take it with food.  I found that, when I was taking out lots of wisdom teeth, that most people confuse the concept of pain relief and the buzz that you get from Vicodin (and I'm not saying that's the case with you, just relating relevant information). 

...beaten by the scary dentist.

I am not surprised you got sick given that is some different form of Ibuprofen - shit bugs my stomach if I go over 800mg. And if you are getting sick of Vicodin, you are doing it wrong (i.e., taKing too much).  My rule is, if it is a narcotic, take half a pill and in 2 hour if you don't feel it or feel sick, take the other half. Then try the full pill. I had an overzealous endodontist give me a higher than normal script for vicodin - was my first root canal and he took enough time to calm me down and figured my pain threshold was too low given my dental history, so he followed with projecting that out to my aftercare. BIG GOD DAMN MISTAKE! Shit made me so nauseous I questioned whether my pills were tainted since I KNEW what to look for with this med.  :grin:

800 mg every 6 hours is the maximum safe dose of Ibuprofen. 

I have no problems with Ibuprofen.  I can take it all day long without bothering my stomach.  And I did so once I realized it was the Lodine giving me problems.

Vicodin usually doesn't bother me either.  I may get a little nauseous, but I found that only happens when I take it right before eating.  Yeah, I know it's the inverse of everyone else.  Unfortunately I've had ample opportunity to confirm this.  5mg is plenty for all but the worst pain, and I've got the pain receptors of a red-head.

Also, since I never miss an opportunity to mention it, Tramadol sucks.  I'll hack off a limb before I let anyone give me a script for it again.

Yeah, Ultram is pretty well useless. Now Toradol, that is the nectar of the gods.  That is great stuff.

That's me, I'm that person.   I had all four removed two years ago, and followed all my instructions precisely because I was afraid of all the dire dry socket warnings, but ended up with dry socket in the lower two after day three (apparently as a patient of 'advanced age', i.e., 38, this increased my odds).  It lasted about 10 days, during which I went back to the dentistsurgeon every two days for him to cram sticky strips of goo in them which, despite the horrid taste, did really help for that day and sort of helped the next. 

It was... I dunno, I wouldn't say painful per se, more like maddening.  Sort of a dull throb that would ebb up and down for long periods of time.  It was in some ways worse when it was gone because I'd get my hopes up that it was over, but then it would come back.   I tend to get a lot of canker sores though, which may either make one more prone to this (I am making this up right now), or make me more acclimated to awful mouth pain, who knows.

It was nothing that a shitload of Percocet and sleep didn't fix, though I basically did no work for the duration and had to get a Percocet refill. 

It's so awesome this is a drug thread now!

I have amanita amerimuscara in my yard. It's ironic because I used to hunt the stuff when I was a kid and now it's just something that gets mowed under like anything else.

Mushroom identification seems difficult.  It's odd to think that people just take whatever people sell them illegally. 

I concur. It sucks when you take it and it sucks for 2 days afterwards too.

It sucked the first time I took it. Then I had a back pain flare up and my hydrocodone was all gone, so I took it again, gritted my teeth... and it was fine. I can't explain it.

Reading some of this makes me vaguely jealous that 3 of my wisdom teeth never budded and the fourth popped out like nothing when I had it removed.  I never got to have the good drugs!  WAAAAAH!

Trust me, it's not worth the effort.  Just complain about some back pain and get your vicodin that way.

It's Norco thank you.  :why_so_serious:

Toradol is awesome.  It's relieved the worst pains I've had in the last 10 years since I discovered it and it's awfully nice being able to ask for it without your doctor wondering if you're just a drug addict.  Toradol just kills pain and doesn't make you high or even drowsy.

Considering the last 3 times I've been prescribed various painkillers they didn't exactly help and just made me extremely nauseous or so out of it I couldn't function (and then got sick) I stick with good old Ibuprofen for everything.

Dental surgery question: Sinus lift, how long and how grueling? I have a very low sinus cavity and would need one to get an implant done.

Depends on who is doing it.  If it is an experienced Oral Surgeon or Periodontist I don't think you'll have a lot of trouble.  Some General Dentists will do them, but it is a bit of a bigger surgery and there is absolutely no training on this procedure in dental school, so most general dentists learned how to do them at a weekend course or two.  These types of procedures I always recommend a specialist.  Otherwise, you'll be talking about sinus precautions for a while (limited valsalva pressure, no lifting, careful with sneezing, no blowing nose, etc.) and some discomfort.  It's worth it to get the implant though.

Between us we beat the odds!  :awesome_for_real:

After taking out thousands of wisdom teeth (and seeing quite a few dry sockets) the rate was quite low for non-smoker dry sockets.  I saw probably 25 dry sockets in smokers for every dry socket that I had to deal with in non-smokers.  Most literature will give you a rate of 4 or 5 to one, but that wasn't what I saw in my residency.  Meaning it's not so rare that you're never, ever going to see it.  It happens. 

Other interesting factors include:  Skill of the surgeon, length of time for the surgery, and whether or not it is a single tooth extraction versus multiple.

Skill of surgeon and length of surgical time go hand in hand, however some wisdom teeth are a real bitch to get out and take longer regardless of skill level.  The single tooth extraction versus multiple appears odd and counterintuitive at first glance, however in my opinion it makes sense because people are often getting a single tooth out due to decay (which usually means infection in the bone).  Multiple extractions at once is quite often healthy teeth, i.e. premolar extractions for orthodontics or all four wisdom teeth. 

Yeah, my wisdom teeth had been in for years.  The top two were perfectly fine, but the bottom two were basically at a 45-degree angle butting up against the next molars about halfway up the exposed part of those teeth and had stopped there.  After a decade the dentist finally badgered me into getting them removed because nobody could clean the backs of the 'real' molars, and the top two had to go because they would then have nothing to bite against (I was dubious of this reasoning for the top ones, but whatever).

So it was sort of complicated to remove them, apparently (they sure looked sideways in the X-ray) but not as bad as it could have been if they were totally impacted/hidden away/some really weird angle.  But maybe my sockets got used to having teeth in them for so long, or maybe it was because I was 'old', or maybe because I play saxophone a lot it's sort of like smoking in long-term tooth-socket effects with the air/pressure swirling around in there, who knows.  Or the new theory, because Ratman_tf didn't get it the universe had to balance out.

So, just as a side to this, how many specialists don't you refer people to vs how many do you refer people to? I think about the people from high school who became doctors and how many of them I would never never go to who seem to be doing well, but were totally incompetent in high school.

That entire week sucked, so don't be jealous.  After three days without painkillers for two wisdom teeth that were 100% under the gums, but close to impacted, I needed the drugs to not curl up in as tight a ball and heal the rest of the week.

I rank it up there with my tummy exploding on the fun scale.

Can you clarify your question?  Are you trying to ask if there are a lot of specialists that I don't refer to because of incompetence, or are you asking if there are procedures that I sometimes send to a specialist versus a GP? 

Incompetence.

Most specialists in dentistry are very good.  It's much tougher to specialize in dentistry than in medicine, therefore you're typically getting the very best students that end up as an endodontist, orthodontist, oral surgeon, pediatric dentist, etc.  However, it's not always the case that these people are universally competent.  Some of this is due to philosophical differences, i.e. doctors using information that is outdated or biased on anecdotal evidence, but most times the incompetence in specialists is due to greed leading to compromises in treatment related costs, recommended overtreatment and poor staff hiring.  I find that the doctors that are primarily interested in money are the worst when it comes to treatment quality and patient experience in the office.  General dentists, in my recent experience, are a really mixed bag.  There are a lot that are fairly competent and run horrid offices or run horrid offices and are completely incompetent.  Again, the greedy ones are the people to avoid.  If the office looks like a 3 million dollar house, odds are good it's a money factory and you'll be overcharged or overtreated.  I would estimate that there were about 4-5 people in my class of 45 that graduated dental school that I would let perform dentistry on me.  That number has probably gone up as people got more experience, however all of those 4-5 went on to specialties and about 10 overall specialized.  Contrast this with my medical school graduating class where about 70% specialized and I couldn't come up with a number that I would let treat me as you aren't competent to do anything when you graduate from medical school. 

Is this answer what you were looking for?

Yes, thank you.

So as a dentist do you brush 3 times a day and floss every day? 

I brush 2 times per day and yes, I do floss every day, 2 times per day.  It's more important than brushing, in my professional opinion.  I also use Listerine twice a day, as it is the dental equivalent of the nectar of the gods. 

You need to invent a liquid floss.  (And subsequently make me rich for suggesting it to you.)

Ahh listerine. If I miss a brushing, I always make it a point to at least hit the listerine before bed. Though that rarely happens now that I have built flossing into my routine before bed. I do wish I had been as diligent about brushing twice and flossing as a kid, but that sihp has sailed.

There is some research out there (albeit probably biased research) that says that using listerine 2 times per day is the equivalent of flossing.  I'm not sure that it is the same, but Listerine is a great product.  If you floss and limit the sugar in your diet you probably don't even need to brush.  And you 're never too late to take care of your teeth unless you're in a denture. 

My Hygienist said the same thing about flossing.   As a guy who's had fillings almost every time he's gone to the dentist since moving to Kentucky, I'm inclined to agree. (They say they fluoridate the water but I swear they don't at this point. Even cutting back on sweets and soda compared to 1/8th of what I did when I lived in Ohio my teeth have gotten worse the longer I lived here.)

I bought that Oral-B flosser w/ the disposable heads.  Thing is a godsend for folks like me with a small mouth and giant teeth and makes it easy to pick-up and use after brushing. Much simpler than the old "tie it off and cram your fingers in your mouth" of the old days.

The purple Listerine is awesome and I've noticed some help since using it for the last year.  I agree with Lant, though. We need a liquid floss of some sort.

Question ghost:   If I run out of heads, how bad is it to reuse one the next day?  The hygienist explained to me that you floss in part to expose bacteria at the gumline to air and get food out of the pockets.  Since it's anerobic bacteria I'm not screwing myself by dropping more of the buggies down in there if I'm forced to reuse, am I?

ed: Oh another tip the Hygienist gave me this last trip. Ask for fluoride if you're having problems.  Evidently a lot of offices don't even offer it to patients since they get all screechy about only doing what the insurance will cover.  The treatment was $32 total, and they said if my insurance won't cover it they'll knock it back to $12.  Pretty damn cheap compared to the $90 filling co-pay.

Ah, they're your bugs and most of them are probably dead from being out in the open air, so I wouldn't worry about it too much.  I wouldn't make a habit out of it though.  The purple Listerine would probably be great for you as it also has fluoride built in.  As for the Kentucky thing, you're probably just getting meth mouth from being in such close contact to all the eastern Kentucky dirtbags.   :why_so_serious:

I use the Crest no-alcohol stuff, Listerine is too unpleasant.

Or you have a dentist that is bilking you.

Listerine is obnoxious, but it's much more well researched and proven than any of the other mouthwashes.  It's the very, very best when it comes to periodontal disease.  It is one of the first ADA accepted mouthrinses (and for a long time was the only one).  I would rather see you use that and cut it down 50/50 with water to get used to it. 

You're lucky I use mouthwash at all! Take your small victories!

Just let me soapbox.  You'll survive.    :oh_i_see:

Hah! I knew all of those tasty new mouthwashes couldn't be as reliable as my good old Listerine!

Meanwhile, I brush twice a day and that's it, motherfuckers. And I have fabulous teeth!

YAY FOR RANDOM GOOD TEETH GENES

We grew bacteria in listerine in high school. I've always considered it pretty ineffective in killing bacteria. I'd imagine swishing vodka in your mouth would be 100 times more rewarding.

Nope.  Sorry.

He said rewarding, not effective!

I know several alcoholics that did their worst damage with Scope and Listerine.   :awesome_for_real:

Seriously, one attorney I knew growing up would keep like 7 or 8 bottles of scope in his Ford Explorer all the time.   :oh_i_see:

Furiously must be drinking.  Listerine is pretty well-proven to kill bacteria, it's not just a marketing slogan.

No-alcohol mouthwash is mostly a waste of time, the only benefit from it is the fluoride and there's something like 1/1000th the concentration of fluoride in mouthwash that there is in toothpaste.

The bacteria on your teeth and under your gums are in something called a biofilm, which is basically lots of bacteria living together in giant colonies surround by polysaccharides and other stuff they secrete. This makes them very, very resistant to things like antibiotics and also protects them from exposure to air, which kills them. One of the very few things that penetrates biofilms is alcohol. The other thing you can do is physically disrupt the biofilm. i.e. with flossing or interdentals.

What I've been told by my dental hygienist & dentist is to rinse with Listerine, use inderdental brushes (TePe's) and then rinse with Listerine again. Wait 30 mins and then brush your teeth with any toothpaste at all as long as it's got fluoride in it and then don't rinse the toothpaste out after brushing. Spit out, but don't rinse, and then don't eat or drink anything for an hour or so. I do all that twice a day and it's a giant pain, but it does seem to be slowly shifting my periodontal disease.

So the interdental brushes disrupt the staph biofilms, the alcohol in the Listerine gets to penetrate them a bit and kills any loose bacteria floating around, and then the high fluoride concentration in the toothpaste gets to sit on the gum/tooth/air interface area for a while doing it's thing.

Does that all sound correct ghost?

Your initial part is wrong.  Listerine is well proven to kill bacteria and is quite effective as a preventative measure.  As for the rest, it may be a good plan for someone with moderate to severe periodontal disease, but all of that rigmarole is quite unnecessary in those that have relatively healthy bones and gums.  I.E., it's preventative, not a treatment.  The problem that you run into with moderate to severe periodontal disease isn't the biofilm, it's the fact that the biofilm is deep in pockets around the teeth that can't be accessed by anything.  That's why your periodontist has to flap open your gums and do the scraping under direct visualization. 

As far as the fluoride being important, yes, it's important, but it has absolutely no effect on periodontal disease causing organisms and is only in toothpastes, etc. to help with the strengthening and remineralization of enamel which is only present on the crown of the tooth.  But even the fluoride in toothpaste is overrated a bit-  the most important fluoride you get is integrated into the tooth as it is being developed through water supply fluoridation and/or diet supplementation. 

The bottom line is this-  Diet is the most important factor in the prevention of cavities.  The singular bug that causes cavities uses primarily glucose to live on.  Cut glucose and cavities go away, more or less.  As far as care, the mechanical action of brushing is the most important part (particularly for those with periodontal disease).  Flossing is the most important thing you can do for your teeth.  It's where people get cavities typically and the interdental area is the petri dish where periodontal disease begins.  Adjunct routines like mouthwashes can be tailored to need and may help out, however they should never be a primary form of prevention.  Brushing and flossing, with or without toothpaste, is where all of the good action is.

I didn't realize the mouthwash had to be Listerine specifically. I've been using the loser store brand mouthwash  :ye_gods:

Mouthwashes are very different from brand to brand.  Listerine is specifically more active against bugs that cause periodontal disease.  If you have a tendency towards cavities you would want to use something like ACT or the purple Listerine that has fluoride in it. 

The purple Listerine is no where near as nasty as the Old Gold standard.  I recommend buying one of the "TSA Compliant" travel bottles and trying it out if you're wary.   It's got a minty flavor to it and only burns your mouth if you've managed to scrape up your gums or cheeks somehow.

The hardest part is knowing the right amount and swishing it for the full minute.  Oh, and no eating/ drinking for 30 mins afterward.

When I got my wisdom teeth removed, I got a prescription for Biotene, which at the time wasn't over the counter. I guess it is now. I thought it was awesome. I'd be using it now if it wasn't $30/bottle.

Biotene is typically more used for dry mouth.  It's odd that they gave that to you.  More typically the oral surgeon will give Peridex (chlorhexidine gluconate), a mouthwash that has been shown to very effective in killing bugs.  I wouldn't prescribe anything but Peridex after wisdom tooth removal (and probably wouldn't even prescribe that.  It's too tough on the exposed tissue. 

As far as Listerine goes, it definitely gets less obnoxious as you use it.  I typically will recommend that people start by diluting it down to 1/4 or 1/2 and work their way up over time.  It's just such a more effective agent than the options when it comes to periodontal disease and gingivitis. 

I think this is the most I've talked to people about Listerine since dental school   :awesome_for_real:

Whoops, you're right, it was Peridex. Great stuff. I got the two confused, since I once did take biotene for dry mouth. It was weird because it has a sort of fuzzy effect and everything sloughs off rather than the antiseptic Listerine tang.

The big problem with Peridex is that it can turn your teeth a very funky color, tastes like ass and is expensive.  But yeah, it's awesome. 

Cheers ghost, yeah I do have moderate to severe peridontal disease, been trying to shift it for a couple of years now. Since starting the rigmarole the bone degradation has stopped completely, most of my medium pockets have closed up and the deep pockets are about 1/2 the depth they were.

I knew that fluoride was for strengthening teeth rather than for any anti-microbial effect. Any idea what it actually is in Listerine that's the effective agent?

My hygienist said, last time I saw her, that after one more round of her scraping under the gums she'd refer me to a dental specialist at a hospital to see if there was anything further they could do to try and get rid of the periodontal disease for good. I'm in the process of moving house now though so I'm going to have to go through the hassle of getting on the register & queue for an NHS dental practice in the area I'm moving too :/

Good on you for getting a good regimen and trying to get it under control!  It's tough to get a complex routine like that down.  Perio disease is much more difficult to deal with as it's much more limited by the effects of diet.  A lot of it is "you just got bad bugs" and there is probably more of a genetic predisposition to perio problems. 

The active ingredients in listerine are menthol, thymol, methyl salicylate, and eucalyptol (http://en.wikipedia.org/wiki/Listerine).  It also contains a high concentration of ethanol, although it isn't particularly active at the concentration used. 

Regarding the specialist, I find that specialists are much more competent at dealing with periodontal disease here in the States.  The general dentists are too focused on elective, cosmetic procedures and implants, typically (the higher paying stuff) and patients hate periodontal treatments.  Specialists also typically have access to more up-to-date remedies through a more modern professional "database", if you will.  I don't know if this will be the same in the UK (that is where you are, right?).  You'll just have to check around and see, but I would personally try to get in with a specialist for at least an examination.  If they think you're okay at the GP, then that's great. 

Cheers man. I suspect there is a genetic component - my mother, two of my uncles (on my mothers side) and one of my brothers all developed the exact same problems around 40-50. Being told at the age of 41 that you're in danger of losing *all* your teeth within 10 years tends to focus the mind a little bit and makes sticking to a regime much easier  :awesome_for_real:

Yeah I'm in the UK, which means that I either need to get referred to a specialist by my general dentist or hygienist, or go private, which I really can't afford. The way it works here is that the hygienist can refer me to a specialist after 2 complete deep cleaning passes. We've got 1 more visit for me to be at that stage since she splits the deep cleans up into 2 sessions, so hopefully soon I'll get a referral.

I use the regular old minty listerine. I got the no-alcohol version once by mistake because I didn't realize that was even a thing, I just grabbed the bottle of the correct flavor. I tried to stick with it for a week and tossed it out for the good old alcohol version. The burn is good, but I also use 90% rubbing alcohol for aftershave.

So what's this about the purple kind? Is it better than the regular green or blue or whatever it is I use?

My mother has pretty bad perio, mine was up to 6's in the back but over two years I brought it down to 3's in the worst spots. I'm bummed because we have a new hygienist and she's nowhere near as good with the perio treatments. I'm considering going to the practice she went to, even if it means a 45 min drive each way. What's that compared to your teeth? But I love my dentist, so it's a tough call. Anyway, note that I was a dumbass and didn't go to the dentist for 18 years after high school, and got away with only one crown and a filling for that. In my defense, having no insurance in the 'greatest country in the world' is fucking balls.

I think the purple stuff has a Fluoride supplement to it. It is, however, the worst tasting shit in the entire listerine line, including the good old GOLD. I got a smaller bottle of the purple once since it was on sale. Horrible horrible horrible. I'm with you on the good old green mint - and if it isn't burning your mouth, it isn't working.  :awesome_for_real:  Been using it for years and I don't really notice the burn anymore and feel funny when it doesn't.

Dental insurance is pretty much a miss.  If your employer isn't paying for a substantial amount of the insurance it isn't generally going to be worth your money, for several reasons that I won't get into here as it will head us into politics for certain.  You might consider getting your hygiene done at the other place that the hygienist went to and then get your checkups and treatment with your other dentist.  If you're paying cash there's really no reason you couldn't do that. 

Yeah, the purple Listerine has fluoride and it doesn't taste quite as obnoxious. 

Question for you Ghost,
I had an extraction about 8 or 9 months ago and they keep telling me that i should get an implant. Of course that costs a fair bit (they were quoting around 3k) They told me that he jaw bone where the tooth was will recede a bit with no tooth there any more and of course the teeth on either site will start to crowd in.
Every time I talked to my dentist & hygienist about it, it felt like a sales pitch. if it stays as it is right now I would have no issues. So how important is an implant? (or a bridge for that matter)

It depends upon where the tooth is.  If it is in the front, you obviously have more motivation to get something done because you don't want to look like a hilllbilly.  If it is in the back, it becomes more problematic because of situations where people don't see the need for pumping a ton of dough into something that isn't cosmetic.  

If you don't get it restored with an implant, two things will happen:

1.  The bone will go away.  This is absolutely true.  How fast will it go away?  Who knows?  It varies from person to person.  If you wait longer than 9 months to a year to get the implant placed in the bone your chances of needing a graft go up significantly.  A graft in that area is problematic because it can increase the cost of the entire procedure significantly ($2-3000).  It also increases the chances of the implant failing.  Implants in the back of the mouth are generally highly successful, however (>95% over 10 years) and this should be considered a minor factor.  So my answer to whether or not it's a sales pitch is yes, it is, but it's still good information that she's giving you.  If you were related to me I would recommend that you at least get the bone portion of the implant done ASAP.  If you get that done and can't afford the rest for a bit they can "sleep" the implant, meaning do the surgery and leave it buried beneath the gumline so that you don't get an infection or have other trouble with it.  This is a nice option as it will keep the bone in place and possibly help prevent the need for the graft.

2.  The opposing tooth will overerupt and cause trouble.  This is a major issue that should not be ignored.  Teeth will erupt until they touch something, even if you are 50 years old.  So if you lose a lower tooth and the upper tooth isn't touching anything it will start to erupt again.  This is why if you get a wisdom tooth out you need to get both the top and bottom in most instances.  If you have a space and a tooth erupts into it to a significant amount you will be talking about getting a root canal and crown on that tooth just to make room to restore the implant, thus adding additional cost to the situation and additional risk as root canal treated teeth have a 7 year success rate of only about 70% when treated by a general dentist.  If you choose to do the "sleep" option that I mentioned above, I would recommend getting an Essix retainer (clear plastic and looks like Invisalign) made for your upper teeth or lower teeth (whichever does not have the missing tooth) so that you don't run into this problem.  

You may find a cheaper solution at the dental school if you have one nearby.  The treatment is generally going to be as good, if not better, than you'd find out in the community.  However, what you are gaining in cost you are paying for doubly with your time.  It takes  much, much longer to get anything done in the dental schools.  A nice middle ground is to go to the specialty residents, preferrably the Periodontist residents for an implant.  I highly recommend an implant over a bridge.  The success rate is going to be as good and you'll feel much better having a "tooth" in the spot.  Also, with an implant you are preserving the bone in the area, which is extremely important.  

Also, if you ever considered getting any form of orthodontic treatment you'd want to do it prior to getting an implant placed anywhere.  Teeth move, implants don't.  

Hope this helps.

This is great information ghost.  Just reading your replies to everyone's questions has convinced me to go back to my dentist after Christmas and let him put the cap on the tooth he just root canaled.
I'd told him to just slap a giant filling on it but after reading your stuff I understand why that's a generally bad idea.  If he'd just explained properly why I needed a cap I'd have scraped up the thousand bucks somehow and had the procedure done right away.

Most dentists (and clinicians in general) are remiss in educating patients.  This is unfortunate.

So in the interest of teeth, what does one do when they believe they have a cavity that is starting to affect their ability to eat food, but have no dental insurance coverage until January?  My girlfriend is pretty miserable most nights at dinner but her insurance doesn't kick in until January (but hey, for the first time in her life she has a job that actually provides insurance so that's a win).  Most dentists I can see it being a 4 figure bill without insurance (I know my doctor visits have been).

Go in and see if they can do a temporary filling.  It sounds a bit like a tooth that may need a root canal.  One tip that may let you know that it is heading that way is if the tooth is very sensitive to cold and/or hot for an extended period of time after exposure, i.e. you drink something cold and the tooth throbs for 45 seconds or more.  Also, if you have throbbing that tends to keep you up at night, that can be a sign of needing a root canal. 

Excellent.  Follow up to that question... how does one get in to see a dentist on such notice?  Most dentists won't see you for 3-4 months.

Walk in clinics usually work pretty fast, but the work is hit or miss. At least in my experience. Dental schools are another way around the wait and IIRC, cost. But if it is an emergency, they'll usually open up a spot - I got bumped from an appointment due to some guy coming in with 4 broken teeth from a kicked back chainsaw.

And I only throw my two cents in the ring as I have a sorted history with the evil dentists and being in that god awful chair. These days however, septocaine has changed my thinking.

3 or 4 months to see a dentist? That's crazy! Where are you guys from?

Land of the free and home of the brave. Now get in line and wait your turn like everyone else.

Yeah, most dental schools with have a walk in clinic that can get her out of pain.  Otherwise you'll just have to call around and keep telling people you are in pain and looking for a solution.  Somebody will help you out.

I always ask tons of questions, including 'what other questions should I be asking you?'

If a doctor won't answer them gladly (and satisfactorily), time for a new doctor. I  :heart: my specialists...GP different story.

It might be worth figuring out what dentists will be on her plan if she doesn't have one in mind.  That way if she can get in and does like them, she can be ready to pick them in January.

Since we're on the topic.  I had one of my back teeth break on me around 4 years ago.  There wasn't enough of it to salvage, so the dentist I went to just pulled the remainder of the tooth.  He never mentioned getting an implant, or anything like that.  I visited a different dentist in the not too distant past to get a small filling in the tooth behind the one that was removed.  He also did not mention anything about implants, or what have you.

Poking around in the spot where the tooth was, there's no indention, or anything that I can feel.  Should this be something I should be worried about?  My skull won't evaporate, or something equally distressing, will it?

It's already happened. People are just not mentioning it out of politeness.

It takes longer for the vertical bone loss.  Loss in width starts first and can make placing an implant very difficult.  It's hard to graft sometimes, too.  If it was one of your 12 year molars they may not have seen a need for it, and I wouldn't stay up at night worrying about it necessarily. 

Do you ever replace the 2nd or 3rd molars?  I know some endo's who said it was crazy doing root canals on 2nd and 3rds.  I'll clarify as the charting I'm used to, goes upper right 3rd molar (wisdom tooth) is counted as 1 and goes to 16, then drops down and goes 17 to 32.  I know there is like a million ways to chart teeth (or there used to be).  So if you had your wisdom teeth extracted (1, 16, 17, & 32), then lost #2--your 2nd molar, how bad would it before #31 since it doesn't occlude against anything now?

Not that I'm in that boat, instead I have the excessive build of tartar (calculi) which is causing some mild gum problems.  I love the hygenist at my office because she just blast the hell out of the teeth with the ultra-sonic cleaner, it feel so much better after that.  The other hygenist uses hand scaling which doesn't feel as clean.  It still doesn't hurt, she keeps asking if I'm doing okay, and I'm like hell ya, keep on blasting and get my mouth feeling better.  So far so good, haven't had to go to a periodontist yet.  Oh and I don't do the risk factors...don't smoke, drink moderately (like 1 a week at the most), don't chew or dip, don't drink sugary drinks.

3rd molars are rarely replaced.  Second molars are regularly, but in some instances they are not.  There's no loss of function without them.  It really is a bitch to do endodontics on a second molar.  You might not need to replace a second molar if the opposing tooth is occluding with another tooth, even just a little bit.

My personal thought is that 99% of all wisdom teeth need to be removed.  The partially erupted ones are the worst offenders-  you've probably seen bad dental infections in the ER.  Usually they are from lower wisdom teeth that have gotten out of control (but not always).  Fully erupted third molars are the next worst offenders.  People don't brush very well that far back (and sure as hell don't floss) and people inevitably have issues with them.  Often the issues will drag the second molars in as well, particularly if the problem is periodontal disease.  The fully impacted third molars cause trouble the least, however when they do cause trouble it's often the kind that causes  you to have to lose half of your jaw.  I just say fuck it and recommend to people to get them out.  It will save a lot of headaches (literally) in the long run for them. 

Why the hell do we even have all these Extra teeth mucking things up!

Dammit Evolution!  :why_so_serious:

So here's a question - what about cleaning/brushing the tongue?  I've been doing it for years now when I'm finished with my teeth, I take the brush and go over my tongue as well.  I think it helps with keeping bad breath away and gets rid of the whim scum layer.  Neither my dentist or hygienist have ever mentioned anything for or against tongue cleaning though. 

Do it.  You're spot on.

I am not a complete psycotic when it comes to hygiene, I mean I take my shower every morning - but I am almost OCD when it comes to bad breath. I been scrubbing my tongue after I brush and before the listerine for years and years now. Your tongue harbors a lot of bacteria and is the main cause of halitosis. That was enough for me to start scrubbing every time I brush.

I was told to only scrub the tongue in one direction. Is that true or doesn't it matter?

I also scrub out the roof and I dunno what you call-ems, the crevices at the top/bottom of gums where they meet the cheeks. A full wordhole cleaning.

Doesn't really matter which way you brush your tongue.

Never thought about scrubbing the roof of my mouth or the cheek pockets (? or whatever they're called) but maybe I'll try it.  I definitely agree with Numbers though about cleaning the tongue.  I can't stand it when I don't brush before going to bed and then in the morning my mouth feels so disgusting, especially the tongue.  It's just.. ugh.   

The area sky is talking about is called the "vestibule".  You really don't need to brush those other areas as much as there is natural cellular turnover with time.  The tongue is special because of the little rough areas  (called papillae) which will trap noxious substances and bacteria thus leading to bad breath.  Also, if you don't brush these areas the papillae can overgrow with time and get gross.

Any advice on an electric toothbrush?

My GF has just been told by her dentist that she should use one because she tends to brush too hard and is doing damage to her tooth enamel. Are there any that are generally held to be good brands by dentists?

Cheers.

My hygienist told me the same thing, though it's my gums suffering.  There's evidently brands/ models out there that shut-off if you brush too hard, but I didn't think to ask her what they were.  Google got me here:
http://www.amazon.com/dp/B000U08ZN4/?tag=centralbeekee-20

I would use a Sonicare.  I don't really like the rotating heads on the other ones.

I have a sonicare and it works pretty well.  Its not cheap though.   

So got my teeth cleaned today from my dentist of 15+ years.  His dental hygienist did something I have never had done before.  She pulled my tongue aside with a piece of gauze and checked my cheeks, gums, and tongue for oral cancer.  I wonder how prevalent this is? I don't smoke, chew etc so I am guessing I am fairly low risk but still it was interesting.

Oh and it helps she is hot and is super chatty :).

That has been standard practice for dentists for about 15 years.  If your dentist isn't doing it you should ask them to do an oral cancer screening when you go in, particularly if you are a smoker/drinker.  The combination of smoking and drinking is a significant combination for developing oral cancers.  Interestingly, using smokeless tobacco is not.  Most research that has been done shows that people that use smokeless tobacco are at barely any increased risk of oral cancers as compared to the general population.

Hot gases are more permeable would be my guess.  Plus whatever compounds are created by burning which aren't present in the raw form.

Well, people assume that it's the nicotine which is causing the cancer, which would be false.  It's the noxious chemicals, as you stated.  But part of the theory about smokeless tobacco was the irritation caused by the tobacco, thus leading to a high cell turnover rate in those areas and eventually the introduction of dysplastic cells.  It's just not the reality of the situation. 

I figured they checked when they were rooting around doing the cleaning but she actually took extra time and the gauze thing was new.  So I wasn't sure if they changed the practice or if there was extra emphasis on that now.

Personally not much of a drinker, don't smoke, drugs etc.

The sides of the tongue that are really far in the back are impossible to see unless you actually pull the tongue out and look.  It's the appropriate way of doing things.  I still think it's a good idea to do even if your patient isn't a smoker because it's painless, easy and takes 2 seconds. And you could save someone's life by doing it.

That smokeless tobacco thing is 100% counter to what I was taught in health class.   They even showed us a vid from a kid who had 2/3 of his jaw removed and blamed it on chew/ dip.  Which is ok with me because it's fucking disgusting.

It's just another good example of science being completely wrong.  A lot of things that are done in medicine are not based upon good science (or any science).  


Edit:  Here's a link (http://www.ncbi.nlm.nih.gov/pubmed/1569419) to the abstract of a good analysis.  Alcohol is the most important causative factor for mouth cancer, with smoking coming in second. 

So I am totally fine with going to the dentist, because I have delightful teeth and barely ever need anything done with them (when I stopped going for a couple of years due to lack of insurance, I did get a cavity though :heartbreak:). I am getting really, really tired of being harrassed to invisalign my bottom teeth, though. Our old dentist (and his lovely assistants) all had finally stopped pushing it my last visit. And to be fair, that dentist didn't seem to think it was a huge deal, even though my lower teeth crowding does mean more build up between the front two bottom teeth and my gums are mildly crabbier as a result, so most of the time it was "have we mentioned the crowding in your bottom tee- oh we did, okay." Basically, he put it on ME to take extra care with my lower teeth (mostly to make sure I flossed religiously, which I didn't do, because I am a terrible person) if I wasn't interested in straightening them.

But now we have a new dentist, and it's started up again. And Christ Almighty, the hygenist in particular was fucking relentless about it. What was especially annoying (to me) is one moment, she was basically saying my lower gums might explode in a shower of gore ANY SECOND because of my LESS THAN IDEAL BITE, and in the next talking about how actually my gums are nice and healthy for the most part (the gums around my front four lower teeth are indeed a little puffy ... but I also accidentally went a year between cleanings this time). And MY GOD THE PRESSURE ON YOUR BITE MUST BE TERRIBLE NO WONDER YOUR FRONT TWO TEETH ARE SENSITIVE (they are very, very mildly sensitive to the vibrating teeth cleaning thingy, because ONE OF THOSE TWO FRONT TEETH IS A VENEER according to Dentist Past). But then "hey I can tell you take really excellent care of your teeth, even those bottom teeth aren't too bad plaque-wise" (spoiler: I don't actually take excellent care of my teeth).

So to sum up: Now I am starting to HATE going to the dentist, because I am fucking sick of the invisalign pitches I have to endure every goddamn time.

I do have a question though! I had an appliance for years in my youth. The hygenist acted like my previous dentist committed some sort of war crime for not making me continue with a retainer for the rest of my life (not that he really could've personally, I DID move away from him 10 years ago!). I DID have a retainer for a couple of years after we finished the moving around shit, but I stopped wearing it when I was around 20, which the dentist seemed 100% fine with. Am I REALLY supposed to have had one of those stupid things FOREVER? I'm not doubting my teeth have decided to backslide some, but dang.


I AM RANTY

It used to be thought that there was a "sweet spot" that you get get the teeth into and there would be no movement of the teeth from this spot.  The theory was that if you got post-orthodontic crowding that the orthodontist didn't do their job correctly.  The problem with this theory is that all research that has been done on orthodontic stability strongly suggests that there is no anatomically correct position that will provide this sort of stability.  The current best evidence suggests that you will have to wear the retainer as long as you want to keep your teeth straight.  In most instances you can go to wearing the retainers only at night after the first 6-12 months and then can wear it only a couple of times per week at night after a few years.  If you stop wearing it the teeth will become malaligned again, usually to a much more minor degree than prior to orthodontic treatment.  That is why people went to the "permanent" bonded retainers, but these have their own problems including that people don't floss under them, get cavities on the teeth under them and they don't perfectly retain the teeth, i.e. your teeth will still move, sometimes to significant levels. 

As far as the Invisalign thing, just tell them to buzz off.  There is absolutely no scientific evidence that minor crowding will increase your risk for periodontal disease, gingivitis, cavities or any other problem (including TMJ disorders).  So if the dentist brings it up next time you are in the office politely tell her/him that if they bring it up again you will be finding a new practice to go to. 

Yeah I kinda assumed that AT THE TIME (~15 years ago) (waaah, I am getting old) that a retainer FOREVAR just wasn't a Thing. And he knew I didn't care too much about the cosmetic side of it, given I had asked when I could stop with the tightening hurty part when I was 17-ish, so we finished up the "make the bite worky" part after my wisdom teeth got pulled and went into "wear ur retainer" for a few years.

Really I mostly just regret having mentioned to the hygenist that my front two top teeth can be sensitive, because that seemed to be her major opening. But if I don't, without fail they run the vibrating tooth cleaning thing right up into the gum, I flinch slightly, and they go OMG WAT, when it really doesn't even hurt that much, I'm just never quite mentally prepared for it. :P

The denist said my molars "have a great bite" so it is seriously just my front lower teeth that have them all fussy, and I just ... I really don't think it's that big a deal. Maybe if my teeth weren't so hilariously awesome I'd be more concerned, but I'm really, really not.


(Also apparently my lone filling popped out sometime in the last year and I didn't even notice, my dentist seemed shocked that a) I didn't notice and b) this didn't somehow turn into a Tooth Catastrophe for me).

I'm actually surprised that it didn't turn into a tooth catastrophe for you.

And the dirty little secret of orthodontics is that it is almost 100% esthetic. 

It was a little bitty cavity and I am guessing the filling made a run for it really recently, since it didn't turn into A Thing.


EDIT: This is one of the reasons Ingmar calls me a bitch when dentist visits come up. :P

Is he infested with the cavity creeps?   :grin:

My mouth is more crown now than man, twisted and evil.

 :awesome_for_real:

I'm using this for my dental friends. 

You are such a dork, Ingmar.  :heart: :heart: :heart:

You guys make me laugh.   :awesome_for_real:

Cheers.

So is it best to floss before brushing? After? Doesn't matter? I can infer that it doesn't matter given the thread, but I am curious. I tend to floss, then brush, then listerine. If only I had done this religiously as a child... :oh_i_see:

Here is a link to the Quackwatch for dentistry (http://www.dentalwatch.org/) website.  There's a lot of good information here. 

Had one wisdom tooth taken out about 30 min ago. (In preperation for braces.) Was my first time so I didn't really know what to expect.

• Received a presciption for Parkemed 500 (500mg Mefenamic acid) and got told to take one 1 hour hour before the appointment.
• Dentist applied a local anthestic around the tooth area.
• The tearing out itself took about one minute or less: Dentist used a plier-like tool, grabbed the tooth and started to yank in 360° motions to loosen it. Then just pulled it out in one motion. There was a slight feeling, but not really pain.
• Then some stitches were sewn (I obviously didn't exactly see what was going on). A gauze pad was put there and got told to bite on in for half an hour.

After operation recommendations

• Not to not drink or eat anything for the next 2 hours and avoid anything hot all day.
• Apply cold pack on cheek to reduce swelling.
• Start brushing teeth again starting tommorrow.
• Told to take Parkemed if necesarry for next 2 days, up to 2 a day.
• Recommended to rinse mouth with sage tea.
• New appointment in 1 week to remove the stitches

So far mouth still pretty numb, so if there is any pain it will come later... :oh_i_see:

Ah yes wisdom teeth.  I got referred to the oral surgeon due to the bottom two being impacted and the roots wrapped around the nerves.  So on my birthday I went in to get them out.  The Surgeon assistant was out sick so it was just me and him.  He asked me if I wanted the gas or just a local.  I said the local was fine due to me not having insurance at that point in my life. So he numbed me up and got to work.  He made a total of 4 incisions (basically x marks the spot).  Then he got a chisel out because he had to break the tooth into pieces to get them out. This is where it got odd...  :why_so_serious: 

So then he tells me to separate my legs because he was putting his foot between them. Then he had me rest my chin on his knee (yea I know uh awkward) two quick smacks with the hammer on each side and he split the tooth into quarters.  Then he got the pliers out and slowly pulled out the pieces.  Once they were out he washed out the area did a couple quick stitches and he was done.  All said and done it took 30 min.  I had no complications and got the stitches out shortly afterwords. 

:ye_gods:

I'm not sure how I feel about a story where a dentist told you to spread 'em.

Aren't you glad you didn't go for the gas!

Losing teeth and innocence. A 2 for 1 deal! :why_so_serious:

Nobody has ever been taught that this is a good technique for tooth removal (chisels yes, knee on chest no). I'm not buying it. 

Shrug right or wrong it happened (small town surgeon and almost 20 years ago) and yes I thought it was odd and as time goes on it seems odder.  Seemed at the time to me really I just figured it was the weird angle he had to get into to get a nice shot at the tooth he tried a few different angles before that one with no luck.   I am guessing normally the normal process is his assistant would immobilizes your chin during the process.  He was extremelly concerned about the potential nerve damage from the root wrapped around the nerve.  It was pretty nasty and it looked like a corkscrew.



 

I am always amazed at how 'low-tech' a lot of dentistry actually is.


When I had some teeth pulled for my braces, the dentist basically froze up the area then pulled out a pair of pliers. Sure they were made out of surgical steel or whatever, but otherwise, they would not be out of place in my toolbox.

When I rotated through with Orthopedics it was very common for them to pull out the black and decker drill. 

When I had the pin removed from my broken toe, I'm pretty sure the channel locks were something found at Home Depot.  Of course that whole experience was strange, given my Ortho was my friend's dad, and I'd see him and his head nurse the following month at her wedding.

That sounds just like an orthopedist.   :awesome_for_real:

Just got back from getting my last three wisdom teeth extracted a bit ago.  The office used iv sedation, which was really nice.  I had a very viivid series of hallucinations when I was under the effect, everything was so damn colorful.  I remember seeing a brown arm coming towards me then it blasted into a million pieces, like little tiny Minecraft blocks. 

I think the first thing I said was 'I want to do that again', heh.  Now for the Percoset ride for a day or two.

I did a rotation w/ the oral surgery department, it was fascinating. The regular dental stuff is kinda neat but very predictable, not sure how general dentist don't go crazy. I remember the neat case where a lady had lower mandible bone cancer (lower jaw), and the general surgeon and dental oral surgeon, all got together and took a rib from her, then flipped her back over, removed the jawbone, and made a jawbone out of her rib.  Was really cool.  Of course I was pretty much a gopher (go get stuff, stay out of the sterile field--helped the circulating RN), but still could see some cool stuff as they were all really senior doc's who had done teaching stents.

There is a very high rate of suicide among dentists. 

I lost the filling in my back right wisdom tooth a little over an hour ago.  I was eating a peanut buster parfait from DQ and wondered what the hell was wrong with a particular peanut that was incredibly hard and bitter.  When I went to brush my teeth.. big hole!  Guess that wasn't a peanut!

I blame ghost.

So now I ponder.  There's no way of getting in to my dentist tomorrow because he's closed on Friday's now, how the hell do I deal with this over the weekend?

Brush well, rinse with a good mouth wash, slam some wax into the hole, and chew on the other side of your mouth. They sell temp fillings (wax) at most all box drug stores. But I am sure Ghost has a better option.

Duct tape!

Seconded. If it can fix shoes, bikes, doors, unruly passengers on planes, (http://www.cnn.com/2013/01/04/travel/iceland-disruptive-passenger) all the up to the fucking planes themselves then it can surely fix a little hole in your tooth.

Duct tape is notoriously poor in moist situations. 

I went with wax for now.

Wuss.

Duct tape is like the Force: it has a light side and a dark side and it binds the universe together

How's the wax working btw? Also, I'm surprised Ghost isn't in here already

Duct tape diapers say otherwise, sort of. Well, at first....ok not really

But the duct-taped plastic bottle raft does argue that


Random aside

Well, I learned a new word today. Was a little nervous about looking it up at work, but I need not have worried apparently.

That's probably your best option.  But don't go too long without getting into your dentist.  Fillings don't typically fall out unless there is something else going on, like decay under a part of the filling.  They can simply fail, particularly if it's an old silver filling, but when a patient tells me that their filling "just fell out" that gets my radar up for pathology of some sort. 

It's a wisdom tooth that needs to come out. It's been problematic due to location and not ever fully emerging anyway (small mouth, big teeth. hooray.)  The filling was done 5 years ago and at the time it was a judgment call left to me to have it extracted or filled. 

Given the cost I said we'd go for filling and see how it goes.  Whelp, now we know.

All I really need is to have it patched-in until it's extracted. The oral surgeon needed a month lead last time I went so leaving it empty that long isn't really an option.

Surely you can find an oral surgeon that will do it faster than that.  I'd hate to see you spend money on getting it temporized only to take it out. 

Possibly. Last time I just went with the one my Dentist recommended.  As far as paying, I didn't have to pay for the last one that fell out. (There *was* missed decay in that one.)

Theres a difference between missed decay and recurrent decay, meaning that there was decay that formed around the edge of the filling and eventually led to a catastrophic failure.  In reality, decay is left on quite a few fillings and the filling material will generally arrest the further development of the lesion, so it's usually not a problem.  Hell, just pick an oral surgeon and get the damned thing out.  It's going to save you time and money any way you look at it.  If you have too much trouble I can give you the names of some people down in Lexington that are trustable. 

I'm a giant pussy about anybody messing with my teeth.  I had a filing fall out over a year ago on one of the wisdoms and just left it go for so long that it ended up being pretty painful.

I was freaking out last week when I went in to have my wisdoms out, but the surgery ended up being easy as cake with iv sedation.  The two days after surgery weren't bad at all, but days 3-6 were super shitty with pain for me.  I'm rounding the corner on it, but one of the sockets was really damn sore.  Not too bad, but there was one of the days I couldn't even concentrate on work.

I'm so damn glad to have them out now, though.

I've actually only recently been going to a dentist again (as a kid and teen I had horrible experiences with dentists, to the extent of snapping an arm off chairs I was in, and punching the worst dentist of them all; I'm paranoid and a control freak and this dentist took 10+ attempts with the needle for freezing and skimped on the freezing and constantly fouling up for 20-25 minutes before I snapped and just hit him and walked out -- was the last dentist I saw for about twelve years). My teeth are/were in very bad condition due to lack of oral care, 1-2 litres of soda a day for ~16 years and many of them getting chipped or broken from fights. Lucked out and the current dentist I have is.. worlds better than any I'd ever had. Had several yanked with zero issues (other than nearly snapping an arm off the chair I was in on my first visit of actual work being done, just out of sheer stress). Had a root canal done.. never felt a thing. Worst was the four fillings put in two of my front teeth last visit, due to the discomfort involved, but easily manageable.

Its amazing what a good dentist does to the experience. She actually listened to my warning of needing ample freezing, has yet to fuck up with applying it and generally been excellent in the work she's done (and all for decent prices [probably around.. $6,000 for everything, excepting the wisdom tooth I'll need removed and the piece of denture/bridge/whatever to cover a gap in the top front; less than half of what someone I know spent to have similar work done] -- important given I have no dental insurance). Little nervous about an eventual trip to an oral surgeon for my one wisdom tooth that's a little badly angled and far back, but is apparently a low priority, for now, given its condition. Have about another 5-6 appointments left with this dentist and each one is easier than the previous.

Makes me wish I'd had better dentists when I was younger. Well, that and wishing I hadn't been a retard about oral care just because I'd expected to be dead long before pesky teeth problems could emerge.

I lurve my current dentist. He listens and pays attention to my discomfort levels. Ex: I had a bone chip in a socket after an extraction, and I went in to have it looked at. He poked around and couldn't find it, when I could feel it with my tongue. There was some kind of miscommunication because he was looking at the side of my gums, instead of in the socket. After we cleared that up, we was all "Ah! Yep. There it is." Yoink! Done.

It's amazing how much difference a good dentist makes.  I wish the ones I had growing up were like my current one.  I hated injections until I met her, because I'm hyper-sensitive to touch and I've only felt the needle once in the dozen or so times she's poked me.

Ghost... Question for you. How many visits does it take to remove tooth calculus? Now that I am almost up to date with my root canals (1 left and 2 crowns needed), I am going to have to get this stuff removed from the backside of my bottom front teeth. I would have ad all this done, but shit ain't cheap even with insurance, so I had to space it out. I have heard some take 3 visits to get it completely done, others have said one visit. Or does this just depend on my dentist office?

And why does this only affect my bottom front teeth on the backside? Top teeth have nothing.

My dentist told me that it was because the bottom teeth have gravity working against them so all debris falls by them and sticks around, whereas the top teeth tend to avoid the more serious problems for the same reason.

Actually, it really depends on your teeth and what condition they are in.  If you need a "deep cleaning", known as a scaling and root planing in the industry, that will be done in 2-4 appointments because they'll need to anesthetize and it takes more time. 

As for the calculus on the bottom teeth-  some people are more prone to develop calculus due to the makeup of the minerals in their saliva and other anatomical factors.  As Selby said, you typically have saliva pooled in the bottom of your mouth unless you are supine, so that's a logical place for it to develop.  You also have the exit point of two quite active salivary glands in that area (ever gleeked?), which contributes.  Lastly, hygiene habits play a big role.  How much you floss, how well you brush and your schedule for getting in for professional cleanings all contribute. 

Temp filling in place as of Tuesday.  The oral surgeons require a consult before the operation, so just patching it with wax wasn't an option. The soonest for a consult is next Tuesday. 

No charge, as expected, for the temp.

Definitely need the heavy treatment. Roughly how long a recovery for the gums to start coming back? I floss every night and brush twice daily. But that is only in the past 10 years... So I am playing catch up with the cleanings and exams, but needed the major stuff done first as to be able to eat without wincing. The majority of it is on the two center bottom teeth with little on the two adjacent ones on either side. More dental adventures coming for me...

I'm not sure I understand what you're asking by "how long a recovery for the gums to start coming back".  When you have severe recession on teeth that involves bone and gum and that never comes back. 

Oh no. Really?  Even with massive injections of fetal stem cells?  Seriously though, is this something they're doing research on or is it just flat-out impossible?

Oh, they've done research on it out the yazoo.  Let's just say that they've made some progress, to a limited extent, but there are major hurdles to overcome still before you can get any kind of reliable regeneration.  The sticking point is generally the area where the tooth attaches to the bone.  There are small collagen fibers that are the go between, forming a sort of ligament.  So you can get bone to pack in around the tooth and it will do okay for a while, but it will go away fairly rapidly without that attachment. 

Yeah I've had outbreaks of "yuck mouth" were the tartar (calculus is the actual name for it) is bad and I'm bleeding.  They fire up the ultra-sonic cleaner and blast away and it feels awesome!  Have no cavities, but have the other side where my mouth is full of calculus and gum disease if I don't stay on top of it.

Last year had to have 4 scale and root planings, now it looks so healthy that both the hygenist and the doc want to go back to 2 times a year on me.

Question on people getting shots, I don't like to numb before I give an injection.  Dentist routinely do, so do some of the pediatric centers and some of the infusion centers. One of the pediatric hospitals even claims "ouchless IV's", which makes me cringe. The problem is that good topical anesthetics are not that common or can cause more problems. Some of our CRNA's will numb even before a blood draw, some will not. We numb up for central lines and IO's too.

When I let the students start IV's on me I don't numb my arms or hands, but then again I'm a freak.

Bourbon.  Lots of bourbon.

No, my prescription for that case would have to be a series of sharp blows to the head with a heavy, blunt object. Repeat until you cannot.

In case you can't tell from the sarcasm, you're being told you need a root canal because the decay's made its way down in to the pulp & root.   I believe your only alternative to this would be pulling the tooth and having a bridge fitted instead, but I'm not the dentist here.

I really hope you guys aren't replying to the spambot, but I can never be sure.

Related to the topic - there is something wrong with a 5 year old needing to have a tooth pulled because it has an abscess.  That's just... it's a baby tooth!  That's probably one of the best cases for cutting out sugary drinks that I've ever seen/heard. 

No link, no sig, no spammy profile goofiness. Nothing that gave off the usual "spambot" warnings.

You never let us have any fun! I'm going to live with dad!

Username and email mismatch.  Plus firstnamelastnamenumber usernames are really common for spambot accounts.  Added to email addresses in the same format but different names/numbers and it's spammer all the way. 

And the only reason it came up is because I'd been cleaning up spam accounts on the manga forum before coming here, saw the account name and went right into spambot!cleaning mode, lol.

I assume you're all sophisticated spambots and I'm just amusing myself with my own comments.

This is, in fact, the case.

Yeah, this "new generation" of spambots likes to quote posts and insert the spam link into the quote (this spammer did that too). The actual reply to the quote doesn't have any links, so it isn't obvious if you look at the post, and since they like to make spam posts that end with a question, someone may quote them and thus unwittingly quote the spam link as well. I wonder how many people actually click those links, though...

Might be more SEO than outright spamming.  F13 has a remarkably high ranking for a forum with Google, so I'm surprised we don't see more of them.

--Dave

I just discovered that you can buy water jet flossers (a.k.a Water Picks or Oral Irrigators) for use at home. Does anyone have one of these or know anything about them? I'm tempted to pick one up to use as an alternative to flossing, which I find to be a fucking chore.

I had one back in the day when I had braces. Worked well, but use warm water. I used for once and almost died.

I think he meant he used cold once and almost died.  I agree that's TERRIBLE.   I also had one in the braces days and revived the practice more recently.  It's great for flushing out the gum pockets but the dentist says it is is not a replacement for flossing. It doesn't scrape the bacteria/ gunk off the spaces between teeth or aerate the anaerobic bacteria so they die.

Just floss.  Water piks don't do the job right.

Yeah, I've got pockets that have seriously nasty growths in the back of my throat that irrigation cleans up, but I wouldn't ever drop the flossing because so much comes out that only floss can get.  I used a Water Pik for quite a few years when I was growing up but it died and I haven't replaced it yet.  Flossing is a chore, but it takes less than a minute and I just suck it up and do it every day.  My dentist loves me for it.

This is the greatest invention in flossing ever. :  The Reach Access Flosser (http://www.amazon.com/Reach-Access-Flosser/dp/B0017TU2HE/ref=sr_1_1?s=hpc&ie=UTF8&qid=1388548969&sr=1-1&keywords=reach+access+flosser)

I've flossed regularly ever since getting one, and some of the terrible pockets I had (6-4-6) have gone down a whole rating in the last year.  I had the giant Y-shaped floss holder when I was a teen but it couldn't ever get the back of my mouth like this does.  It's fantastic.

I just had my back lower wisdom out. The tooth had impacted,  been pushed up my jaw and the lower parts of the tooth under the enamel were exposed, and naturally the entire length of the tooth under the enamel was decaying. It hurt like a bitch and I was keeping it damped down with clove oil and I was really scared it was going to or was abscessing. I went to one dentist who wouldn't touch it as he was afraid it would break if he tried to extract it, and said I needed to go to Hospital and get it out under general anesthetic. SO I went to another dentist recommended by my sister for a second opinion, and she said she would give it a try, as living with constant pain was a no no. Well I apparently have strong roots as she spent 20 minutes working the tooth slowly out, as she said she didn't want to use a pliers as the tooth was so weak it might crack. Well part of it still did, but she got it out in the end. It still hurt a bit coming out despite the 4 doses of local she put in, but it was tolerable.  Now the anesthetic has worn off and by God it hurts.

I have the sheet about care after the extraction, which basically says don't rinse your mouth for 24 hours after the extraction and after that use a salt water rinse for a few days, and avoid hot food and drink and eat soft food  but can you guys give some additional advice?

Lots of drugs?

That route sounds good.  :grin:

Don't swish too hard - I recommend just swirling the salt water around, no swishing. I have also done the wet tea bag thing for the first day or two to help the clotting. No straws and no suction or you could pull that clot out of the socket. Don't freak out if tiny bits of bone are pushed out of the gum, that happens. Other than that, pain killers for the throbbing and once that goes away, ibuprofen for the swelling.

I just had two root canals done last month and saw my dentist last week to get the core build-ups done and order the crowns. Surprisingly I did not feel a thing for either procedure until my dentist told me they'd have to use this electrosharp machine to cut away the gum a bit to get at the decay under the gumline. Very strange itchy, tickle-type pain. Odd since I just got done with an hour of drilling the teeth done to the core build-ups with nothing but the annoying sound to bother me, but once she started cutting...

Sleep.

The meds they gave me made me vomit everything back up, but I wasn't able to pin it down to them instead of the pain for three days.  All I could do was sleep because I couldn't even get a vicodin in me until then.

If you don't have that problem, drugs and sleep.

Nobody told me that and I did freak out.  THE TEETH!  THEY WON'T DIE!

Electrocautery.  They often don't numb for that.

Bigot! SirT can swish all he likes. Wait, what are we talking about?

If you're already used to the taste of clove oil then you're all prepared for dry socket, in my experience.   :grin:

(I can still taste that glop if I think about it)

How old are you?  I was 'of advanced age' (just under 40) and so it took longer to heal, had dry socket, etc, etc.  But nothing a constant stream of Percocet couldn't fix.  It seems really variable, with some of those whippersnappers up and bouncing around the next day.   Me, I didn't do any useful work for like a week and half.   

I'm 42. I'm making like an old person and sleeping.

Probably do some sleepswishing too.

I have dubbed it the demon machine. I am ok with what it does and it worked perfectly for me, I am not ok with the pain it causes. Holy god...

This was the worst part of the procedure for me.  I had to go back twice, months after they were extracted because the bone chips were lodged under the surface, causing an ulcer at that spot.  The irritation and pain those chips caused was second only to a kidney stone I passed.  The only upside was more percocets. 

I really wish I could get a script for one percocet on Thursday evening to go with a glass of wine. 

Yeah, very, very common for bone chips to work their way out even 6-9 months after having teeth out, particularly lower wisdom teeth. 

Orthodontist recommending a palatal expander and braces on the two front teeth. Kid apparently has giant teeth and a tiny mouth.  About to be 2 grand in and the kid isn't even 10!

Better to do it now. If you wait, the teeth will come in all jammed up and it'll cost more and take longer to fix.

At least, that was what my ortho said about my kid's teeth, lo those many years ago.

But yeah, ain't cheap. :)

Oh gods, the expander.  I hope they're less monstrous these days.  I hated that thing.

My kid said it wasn't that bad. I don't think they're quite as big -- it certainly wasn't noticeable unless you were looking for it.

Then again, he was thrilled to finally get rid of it.

Sounds better.  Mine was a solid block of plastic that had enough room to fit my tongue in my mouth.  Barely.

Current model is fancy and small, speech intelligible with a few days practice.  We are in the middle of eleven quarter-cranks, one quarter-crank every two days.

What comes next will be more than $2000.

I haven't been to the dentist for about two years. I got my wisdoms out in early 2013 and it used my entire insurance allowable for the year, so I got off track with bi-yearly visits. I also wasn't entirely fond of my general dentist, so I'm looking for a new one.

They're all different and honestly, I don't trust them. 10 years ago I went to a new dentist that told me I had to get 11 fillings across 2-3 sessions with him. It didn't seem right, because my previous visit everything was fine. I got a second opinion from another office and they said it would only be 2 fillings. That experience has really put me off, but it's time to figure it out.

How to get started? Outside of looking through Yelp reviews and matching them up to my in-network options, there's no way to get good information on a dentist. Does anyone have any advice? Can I go in and ask for a list of prices prior to the visit so I can compare how my insurance will pay out? I'm trying to balance my out-of-pocket expenses with quality of service.

Whatever happened to Ghost, anyway?

My experience with finding and switching dentists is you just have to find one whose staff you're comfortable with. More and more it seems like Dentists are pushing more off onto their hygienists while they just become middle-men and anesthesiologists.

I've been through 3 dentists in the last year, I can go into details but it seems pointless. I've gone through recommendations and they've not been useful to me because most folks hate them and just want it done with ASAP with little interaction. That's probably why there's so little information on them, not wanting to think about 'the scary mouth man.'

Prices for all 3 have been the same when in-network, so asking for a price list probably won't do anything. Switching providers or adding other things like fluoride treatment are the only times my prices changed.

I left my last dentist because his hygienist annoyed the shit out of me. She was nice, but just WOULD. NOT. SHUT. UP.  I do not want to have a conversation with a bunch of instruments in my mouth. I want to get out of there as fast as humanly possible.

That was 2 years ago now and I still haven't found a dentist. I haven't looked very hard either. I want someone with modern equipment/techniques, and young enough that they aren't going to retire soon (my old dentist was on his way out, another reason I left). I think I might look for a woman this time...I would imagine smaller hands would be a plus  :grin:

I think he was changing jobs or moving and he just quit posting. I see him on Steam all the time.

Last I heard he had a Honeycrisp accident.  Ruined his posting hand and most of his teeth.

True Story.

I have no idea if this is good advice because I never followed through.  :awesome_for_real:

I like my dentists to be perfectionists*.  The times I've switched, usually because of moving, I've talked to friends (and coworkers, and acquaintances, and business contacts like bankers or insurance agents or realtors or cashiers or anyone willing to talk about their dentist) and told them that is what I was looking for and listened to see if their dentist matched that description. Once somebody described their dentist as matching that description, I gave them a go. It's worked out well every time but once. That once was when I found out my other requirement was that the hygienist was not allowed to be the type who thought it was her duty to punish me or teach me a lesson for not taking care of my teeth as well as I should!


* I had a REALLY bad experience with a dentist when I was 15. I had a cavity that got out of control while on the other side of the continent from home one summer, and by the time I got home it had abscessed and I needed a root canal.  Our dentist was a family friend, in the same religious circles, so my parents trusted him implicitly. (There are no words to describe how much my eyes are rolling as I type that.) He's finally retired and they've gotten a new, real, dentist and have finally learned what I was so upset about, to the tune of several thousand dollars each to fix the mess he left of their mouths! Anywhoo, I was his first root canal. I was in that damn seat for a couple of hours and had nightmares about his hands in my mouth for 20 years after. The bastard broke the tooth in the process, made a mold for a crown in the horribly abused and swollen crater, slapped the ill-fitting thing on a couple weeks later, and in the process left a cotton swab underneath it which was discovered by a REAL dentist 15 years later when he redid the crown to make it right.  All three of us in the room at the time of the refitting (dentist, aide, and me) barely managed not to throw up when he pulled the old crown off that putrefying mess!  So, I highly value and will gladly pay for someone who has the skill and takes the time to do it right! Sadly, I'm about the same age as my current dentist (who is absolutely fantastic) so she is likely to retire before I die leaving me to look for another again. :(

p.s. Small hands/thin fingers are definitely a plus for a dentist. Also for prostate checks, fwiw.

Let's hope she washes her hands in between.

 :awesome_for_real: or at least changes gloves!  :why_so_serious:

Way, if you're willing to go downtown to the Municipal tower at 5th and Columbia, my dentist, Dr. Kim, is pretty rockin'. Korean-american, young, fast, and very precise. My regular hygienist is also great. She is quite shy and doesn't gab, and is a goddamned machine. The oral surgeon isn't bad either; he's Chinese, like PRC chinese, so there's a bit of a language barrier but he's good as well.

I have a feeling dental hygienists attract a large portion of sadists. Finding one that isn't is very nice.

My wife and kids and I all use the same husband-wife dentist team.  I use the husband and they all use the wife. I have never been happier with my dentist for one reason: neither uses a hygenist. They do all the work themselves. If you can find a dentist who isn't 70+ years old and does the work with their own hands, I recommend that.