Archives for December 2012

Dental MythBuster #3 – Root Canals Hurt!

One very common dental myth that I encounter frequently in private practice in Orange, CT is the notion that root canals hurt.  If you even mention the word “root canal” to someone they will often shudder with fear.  This is one dental myth that does not seem to die, and as a dentist, it really strikes a nerve with me (pun intended).  To see the degree to which this root canal myth is propagated, watch this video:

President Obama’s reference to a root canal is at the 38 second mark.  This dental myth transcends politics.  It doesn’t matter if you are a Republican, Democrat, Independent, Whig, Libertartian, or other party affiliation.  If the President of the United States maligns root canals, you are inclined to believe that root canals are undesirable and are to be avoided at all costs!

Why Teeth Need Root Canals

Root Canal Picture

Root Canal Picture. Courtesy of the American Association of Endodontists.

In my personal experience as a dentist in Orange, CT, over 90% of the time a patient needs a root canal it is due to dental decay (a.k.a. cavities).  In these cases, the bacteria from the decay enter the nerve of the tooth, resulting in pain for the patient.  This should be very intuitive: you have live nerve tissue that is normally sequestered from the outside environment which is now suddenly exposed to nasty bacteria.  Of course it is going to hurt! The other teeth needing root canals are primarily due to other factors such as trauma, cracking, and resorption.

Why Patients Associate Pain with Root Canals

Woman with a toothache needs a root canal

A woman in pain needing a root canal. She will associate this pain with the actual root canal procedure.

This scenario plays out fairly frequently.  A patient calls our office with extreme tooth pain.  The pain is often described as “unbearable” or “the worst pain I’ve ever had” or sometimes even “worse than childbirth.”  An x-ray is taken and I perform a limited exam. I observe dental decay into the nerve of their tooth.  I discuss the findings with the patient and recommend a root canal. The patient consents.

I place topical anesthetic over the injection site and assure the patient that the pain will soon be gone. I then administer the local anesthetic with the patient feeling little to no sensation of the needle.  Within just a few minutes, they are profoundly numb, and their pain is gone!  I then perform the root canal procedure, removing the bacteria in the tooth, and then filling the roots of the tooth.  The procedure now done, the patient goes home, the numbing wears off, and the pain is still gone.  And it is gone for good and they still have their tooth!

Years later, the patient will then recount his/her experience, and say:

Yeah, I had a root canal at the dentist. It was the worst pain I have ever experienced!

This happens all too often. The patient confuses the pain that caused him to need the root canal with the pain (or lack therof) of the procedure.  And every person who listens to this story then thinks that root canals hurt.  And thus, the myth lives on!

So remember:

  • Root canals do not cause pain, they relieve it.
  • Root canals allow you to keep a very compromised tooth.
  • There are no substitutes for your own natural teeth.

If you’re still scared after all this, you can always be sedated for the procedure. But we hope we’ve busted this myth and eliminated this fear.

“Insincere” Dental Blogs: We are not that naive!

Why I Blog about Dentistry and Dental Topics

As a full time practicing dentist and a part-time blogger, I write about dentistry because I enjoy doing so.  With years of clinical experience under my belt, I feel privileged to be able to share my observations online and to help readers and potential patients understand the many facets of private practice dental care.  When it comes to my posts, I always try to personalize the information so that readers know that there is a real dentist behind this blog and not some for-hire marketing professional.

I also blog because it helps to increase my online visibility.  Patients not only look for information about dentistry online but they also search for and evaluate dentists.  If you are a dentist without a visible web presence, it is unlikely you will get new patients who searched for a dentist online.  When I blog about common dental topics (fillings, root canals, dental implants, etc.), patients searching for information online are likely to come across my blog. Assuming the patient is in the same geographic region as Orange, CT and that they believe I am a good clinician, they may actually pick up the phone and make an appointment.

Why Other Dentists Blog

The fact that a blog about dentistry can help a dentist gain visibility online is in no way a secret.  This is well known by many dentists and the numerous enterprises that help dentists with their websites.  As a result, many other dentists have started blogs, a fact which I pointed out in my inaugural post. However, the majority of dentists do not blog because they like writing and conveying dental information; they blog solely to “juice” up their online presence.

Most dentists have neither the time nor desire to blog about dental topics. So they hire marketing firms to blog for them. The following is an example:

Insincere Dental Blog post canned content not written by dentist

The above is a screenshot of a “blog” from a dentist in a part of the country far away from my office in Orange, CT.   Some key observations here:

  • The topic is Kathy Ireland and her need for dental implants.  Kathy, as a well-known celebrity, lives in the Los Angeles area.  This dentist resides approximately 2500 miles from Los Angeles and does not market himself as a “Dentist for the Stars.” Do readers actually believe that he provided the dental treatment to Kathy Ireland?
  • Near the top, there are white brush strokes where I blanked out the dentist’s name to preserve his anonymity.  But it used to read: “By: Dr. ZZZ YYYYYY DDS” implying that Dr. YYYYYY DDS actually wrote the article.  Does the reader actually believe this dentist wrote this?
  • The post is written in the third person, with no reference to that dentist’s experience and training, his geographic location, his interests, or anything else relating the post to that particular dentist.

If you go ahead and cut and paste two sentences from this blog post into Google, this is what you will see:

Google Results showing insincere and recycled dental blog posts

You end up seeing the same exact content on multiple different dental blogs!

I used a red pen to cross out information that might allow readers to quickly identify the exact dental blogs.  Basically, these dentists have all contracted with one marketing firm to allow them to package and publish content under their own names. On just this one page of Google search results, we see dentists from Michigan, Georgia, and Illinois all “writing” the same information about Kathy Ireland’s dental implants!

On the surface, this may seem like great marketing for the dentist. After all, if the dentist is writing about Kathy Ireland’s dental implants, then he/she must be a great clinician!  But if you analyze it more, you reach several conclusions:

  • Readers are not naive enough to actually believe that a dentist in Georgia is intimately familiar with Kathy Ireland’s dental implants, let alone restoring them!
  • Any reader who actually spends more than 30 seconds perusing the article will see no references to that particular dentist at all, leading the reader to question who wrote this boring article.
  • Readers will then realize the dentist didn’t write the article, despite it saying on the blog that the dentist wrote it. From there, they will wonder what else the dentist is not being truthful about and start thinking about going to a different dentist…

Please keep in mind that I am in no way bashing my fellow dentists as incompetent clinicians. I am sure that each one of these dentists treats his/her patients with respect, provides good treatment, and has an excellent clinical team supporting them. I am simply  questioning their judgment in attaching their name and reputation to such an insincere endeavor.

There are many good dental blogs out there.  Dr. Chip Payet in Charlotte, NC blogs about digital dental photography here.  Dr. Alan Mead in Saginaw, MI writes about many dental topics at Mead Family Dental.  And there are many others.

So what is the secret behind a great dental blog? Original content written by the dentist himself or herself.  It’s that simple. And that is the point of Directions in Dentistry!


Dental MythBuster #2 – Diet Soda is Better for My Teeth?

Dental MythBuster #2 – Diet Soda is Better than Regular Soda for my Teeth.

Another common dental myth that I see nearly every day in practice in Orange, Connecticut is the notion that drinking diet soda is better for your teeth than non diet soda.  Frequently when I see a new patient with a lot of decay (a.k.a tooth cavities), both my dental hygienists and I discuss the dietary factors that influence decay.  While many people with cavities will admit to a sweet tooth or drinking lots of coffee with sugar, others will try to say “well I don’t understand why I have cavities because I only drink diet soda now.”  

The most accurate way to describe diet soda with respect to your oral health is as follows:

Diet soda is only marginally less destructive to your teeth than regular soda.  Frequent, daily consumption of either diet soda or regular soda will significantly increase the likelihood of dental cavities.

Soda vs. Regular Soda - both will cause tooth cavities for the dentist

In a previous blog post on Sports and Energy drinks, I wrote that dental decay was caused by sugary foods and acidic foods.  In the case of regular soda, you are ingesting sugar in an acidic liquid.  With diet sodas, there is no sugar, but the artificial sweetening is still being delivered in a very acidic mixture.  The acids in soda first weaken and then ultimately begin to wear away the tooth enamel.  Enamel is the hard outer layer of the tooth; without it, your teeth have little to no protection.

Differences between Diet Soda and Regular Soda on Teeth

As mentioned above, both acidic and sugary foods and drinks will cause dental decay.  We know that regular soda contains sugar.  I won’t bore you with the math, but on average, there are the equivalent of about 10 teaspoons of sugar in a typical 12 ounce can of soda.  Most sodas these days contain high fructose corn syrup but the distinction between high fructose corn syrup and sugar is not important for this blog post.  The key difference is that regular soda has large quantities of sugar while diet soda does not.  So when it comes to sugar content alone, diet soda is actually better for your teeth.

But what about acidity? There is lots of research on this topic.  In a widely cited 2007 study by the Academy of General Dentistry, the pH of Regular Coca Cola is 2.52.  Compare that to Diet Coke which has a pH of 3.28.  I won’t bore readers with chemistry here, but pH is a logarithmic measure of how acidic a liquid is.  A lower pH means greater acidity. Stomach acid has a pH of approximately 1.5 to 3.5.  Tap water has a pH of 7.  A key point to remember when you’re drinking diet soda then is:

Both diet and regular sodas are only slightly less acidic than stomach acid!

That’s very acidic!  If you’ve ever experience heartburn (GERD) you know the acidity of the stomach.  But what about the difference in acidity between Coke and Diet Coke? That can be best be summed up in the graph below:

Alt Text

Graph showing the percent weight loss of tooth structure by type of Soda.  From the Academy of General Dentistry, March/April 2007

I included this graph from the same Academy of General Dentistry showing the percent weight loss of teeth immersed in different sodas for 48 hours.  A tooth immersed in Regular Coke for 48 hours would have 6% of its mass dissolved away, while that same tooth immersed in Diet Coke would lose “only” 1.5% of its mass.  Note that for 7 Up, the percent weight loss does not vary significantly between regular versus diet.

So what does this all mean? It is worth repeating what was stated in bold earlier in this post, which is:

Diet soda is only marginally less destructive to your teeth than regular soda.

Frequent consumption of diet soda will place you at increased risk for dental decay, resulting in the need for dental fillings. And if the decay is not treated in a timely fashion, you could end up needing crowns, root canals, or even having the tooth or teeth extracted, requiring dental implants!  Keep that in mind next time you reach for that Diet Coke or Diet Pepsi.

Thanks for reading, and stay tuned for the next Dental MythBuster in a couple of weeks.