I really hate going to the dentist, even if it's just for a cleaning. I hate it so much, in fact, that I put a reminder on my calendar a few days before an appointment as a reminder to cancel in case I wimp out. I'm embarrassed, but it's that bad.
Due to my hate for invasive dental work, I'm big on a healthy diet loaded with vitamins and minerals (in food-based form) to help prevent cavities.
In recent years, there have been a lot of articles going around that say food can not only prevent cavities, but it can heal them as well. The skeptic in me wanted an opinion from a trusted holistically-oriented dentist to help sort out fact from fiction. This brings me to today's post from Dr. Paul Rubin, one of Seattle's pioneers in “mercury-free” dentistry. Dr. Rubin has been practicing Mercury-Safe, "biological" Dentistry for over 32 years.
I hope you enjoy Dr. Rubin's responses to some common dental myths!
Myth #1: "Nothing hurts so I must be OK"
Pain is not a reliable indicator of dental problems. Sometimes pain can be a useful, early warning of trouble, but many dental problems can develop with no pain symptoms. A cavity can develop, sometimes getting quite advanced, with no symptoms at all. A deep cavity can develop over time into an abscessed tooth, and even this can happen with no symptoms! Periodontal disease can be there with no symptoms. The point is, regular checkups are your best way of early detection of problems, as well as preventive help. I will repeat: Pain is not a reliable indicator of dental problems.
Myth #2: "I've heard you can heal cavities with [fill in the blank]"
One example here is the Weston A. Price diet. I believe it is a very healthy and health-building way of eating. You can get information from the Weston A. Price Foundation. It may be one of the best diets for preventing cavities and periodontal disease. But some have been claiming it can heal and reverse cavities. What does that really mean? I know that very beginning cavities, that have just started to break down the enamel surface, can be stopped and re-mineralized. But I have not yet seen any reliable evidence that a cavity, once it's beyond the very superficial stage, can be "healed." The tooth just isn't capable of rebuilding the lost tooth structure. The mechanism isn't there.
I have seen some misleading articles and blogs and even photos, claiming to heal cavities. The claims don't hold up to scrutiny. The criteria for being "healed" often include "It doesn't hurt anymore." (see the above Myth #1 about pain). Or, it's claimed that "I can see that the cavity has disappeared." I looked carefully at one blog about this that included before and after photos. I've been a dentist for over forty years, so I'm pretty sure I understand what I'm looking at. The photos showed surface stain (not decay)! The stain visibly reduced or disappeared in the "after" photos. The person thought it was a cavity that disappeared and wrote to tell everybody about it.
If I could see one good example of a real cavity that was documented by a dentist, and evidence from a dental exam and/or X-rays that this cavity "healed" or disappeared, I'd be jumping at the chance to find out what was done and how to advise my patients to duplicate this. Please, if anybody has such evidence, let me know!
Myth #3: "An abscessed tooth can be healed"
Can an infected tooth, where the "nerve" or pulp of the tooth is infected or necrotic (dead) be revived? Alas, the answer is again: No. Why do some people think that it can? Usually it comes down to Myth #1 - lack of pain. A patient uses an antibiotic, or maybe a homeopathic remedy, and the pain fades and disappears. Or, the swelling fades away. The symptoms have stopped, but that doesn't mean the tooth has healed. There is still a chronic, asymptomatic infection going on, and it is still dangerous.
Because of the internal anatomy of a tooth, the live pulp tissue doesn't have the same healing capacity of tissues elsewhere in the body. The pulp tissue may be affected by deep decay and bacterial invasion. It gets inflamed. If caught early enough and treated, this inflammation may be reversible. But there comes a "point of no return" where an inflamed pulp progresses to "irreversible pulpitis" or actual infection or tissue death. At this point, it is not reversible. It cannot regenerate. It is a dead tooth and must be treated.
Unfortunately the only treatment options here are a root canal treatment or extracting the whole tooth. I'm not going to get into the various pros and cons of these treatments in this article. I just want to emphasize that an infected, abscessed tooth cannot heal and become a healthy tooth again.
Note that a gum abscess (which sometimes has a similar appearance to a dental abscess), definitely can be treated and healed. This may confuse some, and may be partly responsible for why I hear stories like "I didn't need to do a root canal after all. I healed my tooth."
Myth #4: "You don't need to take X-rays on me today unless you see a problem."
The point of taking X-rays is that they show things we cannot see visually. They have a tremendous value in early detection. Some X-rays are needed to clearly diagnose the source of a perceived problem. But if you understand my busting of Myth #1, then you see that not all dental problems are obvious or create symptoms. For example, one of the most common areas for decay to start is between the teeth where adjacent teeth contact each other. These will show up on "bitewing" X-rays many months before they are actually visible in the mouth.
The earlier a cavity is detected, the simpler and more conservative is the filling to repair it. If a cavity between the teeth goes undetected until it's visible and obvious, then restoring the tooth may be a more extensive and expensive procedure than it needed to be.
So, we take X-rays periodically. We take them much more conservatively than many dentists. And we take them with a digital system, which is 70-90% less radiation exposure than the traditional dental film X-rays. We are not cavalier about exposing our patients to even this small amount of radiation, but the benefits are definitely worth it.
What do you think? Do you agree or disagree?