Dentists from across the country tell us what they're really thinking as they peer at our teeth.
Do you floss about as often as you flip your mattress? Do you spend more time putting toothpaste on your brush than actually cleaning your teeth? Dentists notice these things. And that's not all. They also know when you're asking for a procedure that's going to disappoint you and when insurance companies are stinting on the care your smile needs. We asked 22 dentists from across the country to tell us what they're really thinking as they peer at our teeth. What came out of their mouths will change the way you treat yours.
You Don't Get It
Some truly educated people think that if nothing in their mouth hurts, they're fine. High cholesterol doesn't hurt, either, but it's a big problem. I honestly think that the general population doesn't understand that their mouth is part of their body.
-- Danine Fresch Gray, DDS, general dentist, Arlington, Virginia
If your hands bled when you washed them, you'd run to the doctor. But in the public's mind, bleeding gums are okay. Unless you're really whaling away with your brush, if your gums bleed even a little, that's periodontal disease, period.
-- Ron Schefdore, DMD, general dentist, Chicago, Illinois
The advice to see your dentist twice a year applies only if you have healthy gums. Most people don't.
-- Chris Kammer, DDS, cosmetic dentist, Middleton, Wisconsin
Many of my patients have periodontal disease affecting their back teeth, but their front teeth are fine. Evidently, they brush only what others see.
-- Joel Slaven, DDS, general dentist, Valencia, California
Dentists often tell patients with advanced gum disease to floss more often. But flossing is useless at that point. Imagine trying to clean out the bottom of a shirt pocket with a piece of string tied to your fingers.
-- Reid Winick, DDS, holistic dentist, New York, New York
People come to me with a mouthful of tooth decay and say, "I got my grandfather's soft teeth." I don't even know what soft teeth are.
-- Bryan Tervo, DDS, general dentist, Trenton, Ohio
When someone meets you for the first time, the first thing they notice is eyes. Second is teeth, and third is hair. But people spend way more money on their hair than their teeth.
-- Damian Dachowski, DMD, general dentist, Horsham, Pennsylvania
Proper oral hygiene requires ten minutes of brushing and flossing every day. The average adult spends two or three minutes total, and kids do even worse.
-- Joel Slaven, DDS
Our Noses Still Work
People who smoke try to cover it up with mints or mouthwash, but that stench is steeped into their gum tissue and the tissues in their mouth.
-- Jennifer Jablow, DDS, cosmetic dentist, New York, New York
Brushing doesn't go deep enough into the gums to reach the plaque that causes bad breath. You need to floss every day and get a cleaning every few months. If you do all that and still have bad breath, I start looking into diet and checking for health problems.
-- Ned Windmiller, DDS, general dentist, Stillwater, Minnesota
A mouthwash with alcohol dries out your mouth -- you'll smell nice and minty for a half hour, but then the bad breath comes back worse than ever.
-- Gary Herskovits, DDS
If your breath is bad, we won't tell you unless you ask.
-- Gary Herskovits, DDS, family dentist, Brooklyn, New York
"New and Improved"? Yeah, Right
There's no reason to sanitize a toothbrush unless you're sharing it with other people. Those UV devices and other germ zappers are totally unnecessary.
-- Joel Slaven, DDS
There's a limit to what toothpaste can do. New whitening formula? It can get rid of surface stains, but it can't whiten like a bleach.
-- Careen Young, DDS, prosthodontist, Beverly Hills, California
The electric toothbrush is one of the best things to ever happen to dentistry. The newer ones replicate professional cleaning -- they won't reach much below the gum line, but they're far superior to regular toothbrushes. The cheap ones are okay for kids, but you'll have to pay more than $75 for a really good brush with a warranty and replacement heads.
-- Danine Fresch Gray, DDS
I wish people still used the Waterpik [a water-shooting device that was popular in the 1970s]. Each tooth is surrounded by a putrid, germy moat of saliva. If you replace that moat every day, you'll go a long way toward keeping your mouth clean and your gums healthy.
-- Chris Kammer, DDS
We Blame You When Baby Teeth Go Bad
It's not unusual for me to see a beautiful little child dressed to the nines with teeth rotted down to the gums. And I'll see teenagers from affluent homes with nine cavities.
It's just a total breakdown in parental supervision.
-- Joel Slaven, DDS
For the past 20 years, we've been telling parents about baby bottle tooth decay and not to let a child go to sleep with a bottle. But I haven't seen much of a change.
-- Winifred J. Booker, DDS, pediatric dentist, Owings Mills, Maryland
The bacteria that cause cavities can be spread from mother to baby through saliva. If you have poor dental health and you taste your baby's food and then pop the same spoon into his mouth, you're putting him at risk.
-- Mark Helpin, DMD, pediatric dentist, Philadelphia, Pennsylvania
Kids with dental problems often struggle in school. They're distracted and easily agitated. Teachers will say they have behavior problems, but they really have toothaches.
-- Winifred J. Booker, DDS
I have to extract a lot of baby teeth that are abscessed or heavily decayed. Parents think there's no reason to pay attention to baby teeth because they fall out. But when a tooth comes out prematurely, other teeth crowd in to fill up the space. Without the right treatment, it turns into a mess.
-- Paul Hettinger, DMD,general dentist, Orlando, Florida
I call soda pop the liquid chain saw. It cuts through teeth. And it's not just the sugar -- it's the acid.
-- Chris Kammer, DDS
Free Advice
If you want to reduce the bad bacteria in your mouth, you should be all over xylitol [a sugar substitute found in chewing gum]. It changes the chemistry of your mouth. Six or seven pieces of xylitol gum every day will help keep cavities away.
-- Chris Kammer, DDS
Some people give up on tooth whitening because the gel irritates their teeth and gums. Just use a fluoride rinse or gel before and after—it'll make your teeth much less sensitive.
-- Ned Windmiller, DDS
With any kind of mouth piercing, there's a huge risk of infection if it's not done in a really sterile environment. I've seen cases where we've had to cut out pieces of the tongue because the infection was so rampant. Even when things go well, virtually everyone I see with a tongue piercing has chipped front teeth. Don't pierce your tongue.
-- Jay Grossman, DDS, cosmetic dentist, Brentwood, California
Quit Worrying
Amalgam [silver] fillings do release a small amount of mercury through wear and tear in the mouth. But you'd have to have about 300 fillings for the mercury level to get high enough to pose even the smallest risk.
-- Edmond Hewlett, DDS, prosthodontist, Los Angeles, California
Taking metal fillings out can release more mercury than leaving them in.
-- Brody Hildebrand, DDS, orthodontist, Dallas, Texas
Composite [tooth-colored] fillings are popular, but a metal filling is going to be more durable, especially for bigger jobs.
-- Brody Hildebrand, DDS
I have amalgam fillings in my own mouth. There's no proof that they do any harm. Convincing patients to remove their fillings for health reasons is quackery.
-- Michael Alkon, DMD, general dentist, Holmdel, New Jersey
A lot of patients are worried that dental X-rays can cause cancer, but if you're outside for an hour, you're exposed to more radiation than you'd get from a full set of dental X-rays. What I worry about is that if I don't take an X-ray, I might miss something serious.
-- Bryan Tervo, DDS
We Hate Insurers Too
A few decades ago, most insurance plans would cover up to $1,000 or $1,500 in dental bills every year. Today, a single crown can cost that much, but most policies still have the same limit. People are getting teeth pulled that could be fixed because they can't afford to pay for the work.
-- Bryan Tervo, DDS
Patients seem receptive to everything I say until I tell them how much it costs. I feel really good when patients accept 40 percent of what I recommend.
-- Joel Slaven, DDS
If you're missing teeth, chances are that your insurance company won't cover implants—only one out 22 insurance companies I deal with covers them, even though they're better than dentures in every way.
-- Joel Slaven, DDS
Your Teeth Can Alert Us to Disease
Misaligned teeth can cause migraine headaches. If we can align the teeth and fix the bite, the pain often goes away.
-- Mai-Ly Ramirez, DDS, general dentist, San Francisco, California
One of the first signs of diabetes is bleeding gums. I started taking blood samples from all my patients with bleeding gums and bone loss around the teeth and discovered that many of them were diabetic or prediabetic.
-- Ron Schefdore, DMD
We're Not Miracle Workers
Patients come in with pictures of celebrities and say, "I want to look just like her." I'm sitting there thinking, You can't have a smile that looks like Angelina Jolie's, because you don't have a face that fits those teeth. It's like when you get your hair color done -- you can't just put the same highlights or lowlights in everybody's hair.
-- Jay Grossman, DDS
Teeth get whiter when they dry out. Some dentists promise that their office procedures will make your teeth four shades whiter. But if you leave your mouth open for an hour, you could easily be two shades whiter just from dehydration.
-- Careen Young, DDS
If you bleach your teeth too often, it can thin the enamel. Your teeth can end up almost translucent.
-- Jennifer Jablow, DDS
We Feel Your Pain
People say something difficult is like pulling teeth. But pulling teeth is really fast and easy.
-- Mark Mutschler, DDS, pediatric dentist, Oregon City, Oregon
Everyone should be able to get basic dental care. At our public health clinic in the Shenandoah Valley, we see a lot of people who don't have money, and some of them need to have every tooth in their head taken out. It's like a Third World country.
-- Lori Wilson, DDS, general dentist, Petersburg, Virginia
I tell nervous patients that we can give them the sedative triazolam an hour or so before their appointment—they just need to have someone else drive. It works so well that sometimes they don't remember the appointment.
-- Chris Kammer, DDS
A study showed that tooth implants increase libido, probably because people feel much more confident without missing teeth or dentures sliding all over the place.
-- Jim Janakievski, DDS, periodontist, Tacoma, Washington
Many people without insurance don't go to a dentist until they're in a tragic situation. They could wind up needing $20,000 worth of work.
-- Paul Hettinger, DMD
We Choose Our Own Dentists Carefully
Cosmetic dentistry works only on a healthy mouth -- you can't build a house on a swamp. But if you look around, you can find a dentist who will do cosmetic work without treating your gum disease first. There are a lot of incompetents and outright charlatans in my profession.
-- Joel Slaven, DDS
I put in veneers for a living, but they're really overused. At some offices, patients come in for a simple cleaning and are sold on the idea of getting veneers too. Veneers are excellent for making teeth longer, but if what you want is to get your teeth whiter, use a bleach. If they're too crowded, get them straightened.
-- Careen Young, DDS
Some dentists will say you need a deep cleaning because they can charge your insurance company more for that than for a standard cleaning. But unless an exam shows you have a lot of tartar on your roots or other specific signs of disease, you probably don't need it.
-- Careen Young, DDS
People assume that the more a dentist charges, the better the dentist is. But I see no correlation. Ask coworkers or friends and family for a recommendation, but make sure they've been going to their dentist for at least five years. It takes that long to know if crowns and fillings are any good.
-- Paul Hettinger, DMD
When choosing a dentist, Check if the magazines in the waiting room are current. That shows attention to detail.
-- Michael Alkon, DMD
We Wish You'd Think Ahead
People come in for an appointment without knowing what their insurance covers. They think we have a crystal ball that tells us everyone's insurance information. We don't. And we need to find out what's covered before we can do anything.
-- Damian Dachowski, DMD
Don't eat a heavy garlic lunch before coming to see us -- we'd appreciate that.
-- Jennifer Jablow, DDS
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