14 Jan My top 5 myths of dentistry
Myth 1: Root canal treatment is really painful
Almost every time I tell a patient they need a root canal filling they look at me with trepidation and ask “isn’t root canal treatment really painful?”. I am always happy to put their mind at ease on this one. The vast majority of root canal treatments are completely painless. In fact I have had many patients doze off during root canal work. As long as they doze with their mouth open that’s fine by me! The reason this myth exists that a very small proportion of times when a patient comes for root canal treatment they have what we call a ‘hot pulp’. This is when the dying nerve is very inflamed and extremely sensitive. In such cases it can be difficult to get the tooth fully numb with local anaesthetic. In such a case the dentist may find the patient experiences pain when they try to open up the nerve chamber. If this happens a dentist would usually open the nerve chamber as much as the patient can tolerate, and then place a paste containing steroid and antibiotics on or into the nerve chamber, with a temporary filling on top. A week later the tooth can usually be treated painlessly. Luckily this doesn’t happen very often, and if it does a caring dentist will get the dressing in place with the minimum possible discomfort to the patient and continue a week or so later.
Myth 2: All wisdom teeth extractions are difficult and painful
Luckily this is untrue. This myth relates to the fact that removal of impacted wisdom teeth can be difficult. The procedure itself should not be painful with adequate anaesthetic. However there can be some swelling, bruising and pain afterwards. But all wisdom teeth are not impacted wisdom teeth. If a tooth is impacted it means it hasn’t had space to erupt and is buried or partially buried. Therefore in order to remove the tooth if is often necessary to remove some bone around it. It is nearly always lower wisdom teeth that are impacted and rarely upper wisdom teeth. Nearly all upper wisdom tooth extractions and many lower wisdom tooth extractions are of fully erupted teeth and therefore removing them is the same as for any other tooth.
Myth 3: You can’t eat before a dental appointment
This myth stems from a confusion between local anaesthetic and general anaesthetic. It is true that you cannot eat before having a general anaesthetic, which is where you are put to sleep in hospital. However, there is no need to avoid eating before having local anaesthetic for dental treatment. In fact it is better to make sure you have eaten. Especially if you are a little nervous, avoiding sugar will mean you end up with low blood sugar and are more likely to feel faint.
Myth 4: Honey isn’t bad for your teeth
Children of affluent well educated parents tend to have good teeth. So one day I was surprised when a family of such children came in showing widespread decay. Their mother was being careful to ensure they didn’t have sugary drinks or snacks and generally their diet was very healthy. But then it transpired that they were eating a lot of ‘grandpa’s honey’ as their grandfather was a beekeeper. Their mother had no idea that honey is extremely tooth-decay-causing. So watch out for those products and recipes that tell you something is healthy because it has no sugar in, but its been sweetened with lots of honey.
Myth 5: Interdental brushing isn’t as important as normal brushing
Very nearly everyone brushes their teeth with a normal electric or manual toothbrush every day. But how many people are as good at brushing with interdental brushes every day? Unfortunately a lot less. Much as you might want them to there is no way those toothbrush bristles are getting all the way between your back teeth. This means plaque that forms here can be left for days and weeks undisturbed if you aren’t using interdental brushes or floss. So it is no surprise that most of the gum disease and tooth decay I treat on a day to day basis occurs between the teeth. So stock up on those interdental brushes and make it part of your daily routine.