I’ll take the dental crown without formaldehyde please

OK. I will admit it. I chose this provocative title to get your attention.

formaldehyde is a toxic chemical and carcinogen

Formaldehyde has not been found in dental crowns but many other toxic chemicals have.

Nearly everyone has heard the news surrounding Lumber Liquidators and the flooring containing elevated levels of the chemical formaldehyde. Formaldehyde, a known carcinogen, was found in flooring manufactured in China and sold by Lumber Liquidators.

Understandably, people do not want to live in a home where there might be elevated levels of formaldehyde. But did you know that tens of thousands of Americans are walking around with crowns and dentures in their mouth that were made in China with possible toxic chemicals?

Toxic Chemicals in Dental Crowns from China

Let’s look at incidents from across the world where toxic chemicals were detected in dental crowns and bridges from China and other Asian countries:

dental crown that contains no lead

Does this crown have lead or cadmium?

  • In Ohio, a woman’s dental bridge that came from a lab in China was tested and found to contain high levels of lead. Additional crowns were then ordered from Chinese labs and some were found to contain lead at a concentration of 490 ppm – nearly five times above the 100 ppm for children’s toys set by the CPSC. Based on this article, the dentistry was performed by Aspen Dental.
  • In this news report out of Australia, they found lead, cadmium and beryllium in many all-ceramic cosmetic dental crowns originating from several Asian countries.
  • This report from the UK talks about the surge of Chinese crowns being brought into Britain and the lack of oversight over the materials used.

This is not just restricted to wood flooring and dental crowns. Remember the lead paint made in China that was used on Mattel toys?

In the United States, the FDA has the authority to inspect and investigate any dental lab. And there are strict laws governing the contents of dental materials. Do you think China has similar safeguards?

You Get What You Pay For

As a dentist in Connecticut, I only use United States based dental labs, and I know my lab fees. From the advertisements I receive from Chinese labs, I could get prosthetics at one fifth the price. So that means if I have to pay a Connecticut based lab $250 for a crown, I could probably have it done in China for around $50 or even less.

dental bridge made in Connecticut

This bridge was made by a Connecticut lab for a patient from Milford, CT

At my office, we will periodically get phone calls from patients asking about our fees for crowns. Since we only do high quality dentistry, our fees are higher than many other offices. How do you think dental offices are able to offer $400 crowns? You guessed it – they’re most likely made in China. In fact, if you believe this post, one large corporate dental chain uses labs in China for their crowns. The use of Chinese labs by this corporate chain owned by a Wall Street Private Equity Form was also noted in this article.

So, if you shop around thinking “all crowns are the same” you will likely end up with an inferior or substandard crown. Remember this famous saying: the bitterness of poor quality is remembered long after the sweetness of low price has faded from memory.

Your Rights as Dental Patients

made in the USA slogan for dental crowns

My office, as well as many other dentists, will only use USA based dental labs.

In the wake of these findings, legislation was introduced in several states regarding dental materials. Laws can and will change. In general:

  • You have the right to ask your dentist where your crown and/or denture was fabricated.
  • You have the right to ask your dentist about the materials used in any dental prosthesis.

In general, if your dental office doesn’t want to give you this information, you should be suspect. As a dentist in private practice, I welcome inquiries from my patients, since I only use dental labs based in my home state.

And lastly, there are no known cases of crowns containing formaldehyde. I only included this given the news surrounding Lumber Liquidators and the Chinese laminate flooring.

Legal disclaimer: the information presented in this article about two large corporations was derived from news reports. Those sources are referenced and linked to. This blog post does not purport to verify the accuracy of those news stories. As always, conduct your own research prior to making conclusions and deciding from whom to receive dental care.

Root Canals Get No Lovin’

Root Canal awareness week banner

Root Canal Awareness Week 2014. Logo courtesy AAE.

As we get ready to kick off the 8th annual Root Canal Awareness Week on Sunday March 30, it is remarkable to see that root canals are still perceived to be horribly painful and worse than torture. I outlined this myth in one of my Dental MythBuster posts called Dental MythBuster #3 – Root Canals Hurt!

Needless to say, despite that post getting over 12,000 views, the myth lives on in the popular media. Let’s see where:

  • The New York Times, February 7, 2014. “…taxes you pay on your investments has as much appeal as a root canal.”
  • The Los Angeles Times, June 14, 2009. “For the average American, modern air travel has all the appeal of a root canal.”
  • Northwest Indiana News, February 20, 2014. “… the topic of life insurance has about as much appeal as a root canal.”
  • The Los Angeles Times, March 29, 2011. “I had a root canal, and that was fun” (this was done in a sarcastic manner).
  • Washington’s Blog, August 26, 2013. “the American people would much rather get a root canal or a colonoscopy than bomb Syria.”

At least in the last example, the procedure is considered more desirable than a regional war and on on the same level as a colonoscopy!

And lastly, we have the President of the United States publicly maligning the procedure in his State of the Union Speech seen here:

So clearly, the procedure is believed to be unpleasant. But shouldn’t we all just stop worrying and appreciate root canals for what they do?

How I Learned to Stop Worrying and Love Root Canals

Dr. Strangelove who would not have worried about a root canal

Dr. Strangelove would have loved what a root canal could do (image courtesy wikipedia.org)

While there are different view on this borrowed line from Dr. Strangelove, there is no ambiguity when applied to the root canal procedure. This procedure helps to save teeth and prevents premature tooth loss.

Once you are adequately numb, you feel no pain during the procedure.

So let’s get this straight. You have a broken down tooth, one that you are at risk of losing. A procedure is available, one that does not hurt, that will allow you to save the tooth and not go around toothless!

And despite all the inherent benefits, the procedure is maligned by nearly everyone, including President Obama.

For this Root Canal Awareness week, let’s try to appreciate them. Or, to take inspiration from Stanley Kubrick’s film, let’s stop worrying and love root canals!

 

Pulling Your Own Tooth?

Basketball star Reggie Evans photo loose tooth that he pulls

Basketball Star Reggie Evans after he pulled his own tooth.

As a dentist, I’ve heard lots of stories from patients. And I’ve seen lots of YouTube videos where people perform dentistry on themselves. And I have, on occasion, had to treat a patient in pain in my practice in Orange, CT after they attempted dentistry on themselves. So this incident piqued my interest when one of my patients told me about it.

On April 6, 2013, Brooklyn Nets player Reggie Evans was setting up for a rebound and was headbutted by an opponent. The headbutt significantly loosened one of his front teeth. Then several seconds later, he pulled his own tooth, and placed it on the coaches table. The photo above shows Reggie shortly after he pulled the tooth when he began to bleed from the extraction site.

Within one minute of the incident, he fists bumps another player, and then jumps back in the game. Below is the YouTube video from the incident:

 

Athletes Behaving Badly?

No one can dispute that Reggie was demonstrating a 100% commitment to his team and to his sport (at least in this instance). But does he set a precedent that pulling a tooth or doing dentistry on yourself is “cool” given the way many look up to and emulate professional athletes?

vice grips used to pull teeth if you do it yourself

Unsterilized vice grips from my basement.

As I mentioned before, on multiple occasions, I have treated patients who thought it would be either “funny” or “cool” to pull their own teeth or do other dental procedures. They’ve told me about the vice grips or pliers they used.

In all of those instances, the patients ended up in severe pain and suffered significant complications. One patient even pushed a piece of his tooth into his sinus and required invasive sinus surgery to have it removed!

Reggie most likely sought professional dental care after this incident. We’ll never know what complications he suffered. So, in spite of the fact that Reggie looked cool pulling his own tooth, it is not recommended!

What will Reggie do next? He will most likely need a dental implant at some point to replace his missing tooth. But we also recommend that he not “behave badly” and set a dangerous example for NBA fans.

Dentistry and Art: Mickey’s Toothache

I recently posted about the depiction of dentistry in Baroque art. Let’s fast forward approximately 400 years to something more recent, although this “art” is still from 1938!

The archivists at Disney just released a 1938 sketch of Mickey Mouse experiencing what can only be described as a dental adventure.  The artist Ferdinand Horvath completed the piece for Disney in April 1938.  The sketch was apparently found in a folder with other material in the Disney Archives in California.  As a bit of history, Mickey made his debut in 1928 and had already been featured in comic strips and several movies by the time this sketch was being illustrated.  Fantasia, with its psychedelic influences, was due to be released in 1940, with Mickey Mouse playing a role in The Sorcerer’s Apprentice.

1938 sketch of Mickey being chased by the dental chair and a dentist

Newly released sketch from Disney called Mickey’s Toothache featuring Mickey Mouse, a dental chair, and a dentist wielding pliers. Image is courtesy of Disney Archives.

The sketch, titled “Mickey’s Toothache”, shows a younger looking Mickey Mouse.  He has a towel wrapped around his head to suggest he has a toothache and his cheeks appear swollen. He is running away from a dental chair whose “arms” have a firm grasp on him. An unidentified character playing the role of the dentist is in hot pursuit despite having what looks like a wooden leg. The “dentist” has both a pair of pliers and a saw.

If you look closely at the sketch, specifically at the back of the chair, you can see where the chair had initially been drawn in and then subsequently erased. It makes you wonder what the sketch initially looked like.

I could probably write much more analyzing all the nuances of this sketch and how it portrayed dentistry back in 1938.  But one generalization can be made:

Steve Martin as the sadistic dentist holding a dental drill

Steve Martin with a drill, 1986.

Up until the development of the air powered dental handpiece (a.k.a dental drill), the most dreaded instrument of the dentist was the forceps (a.k.a. pliers).  With the introduction of the drill and its characteristic noise, the forceps have been replaced by the drill as the “most dreaded dental instrument” that is depicted in the mainstream media.

So the real question is this: if Disney were to make a short cartoon called Mickey’s Toothache 2013, would it involve a drill? A large needle? Forceps? I suspect it would involve a drill.