Top Five Questions and Answers About Your Dental Health
The dental debate: How often should I visit my dentist? Does sugar cause cavities? Are X-rays really necessary? We've got answers to five common questions about your dental health
Illustrations by Chris Reed
While not definitive, several studies do suggest a link between the two. According to the American Academy of Periodontology, people with periodontal disease, which involves the gums and underlying bone, are almost twice as likely to also suffer from cardiovascular disease as those who don’t.
Some experts argue that a direct connection between the two diseases has yet to be found, although it’s thought that inflammation triggered by periodontal disease may contribute to both maladies.
One Columbia University study also reported a possible link between oral bacteria and a higher risk of stroke: One group of people with higher levels of certain disease-causing bacteria in the mouth was also more likely to have clogged arteries in the neck, which in turn can lead to stroke.
This apparent relationship between unhealthy gums and heart disease makes regular dental care more important than ever, says Dr. Robert Chorney of Stony Point Dental in Stony Point. “Seeing the dentist is not just a matter of oral health — it’s a matter of general health.”
“Although I believe the origin of the six-month dental checkup was actually the brainchild of some toothpaste ad,” quips Dr. Chorney of Stony Point Dental. “It actually turns out to be sound advice.”
He adds: “For the general, healthy population, six months is a good period of time for a routine exam and dental cleaning. I’ve seen enough cavities and gum problems develop in six months that I’d be concerned about extending that interval.” Some patients are advised to head to the dentist’s chair more often — especially if puffy, bleeding gums are the culprit. “Individuals with gum disease should see their dentist or hygienist more frequently, sometimes every three months,” says Dr. Chorney.
While most dental fillings do their job well for many years, chances are they’ll eventually need an overhaul. “Whether it is a cemented crown or cap, or directly placed filling material, it will at some point break down,” says prosthodonist Dr. Mary Anne Salcetti of Wappingers Falls. “The seam of the restoration to the tooth may eventually open and begin to ‘leak,’ causing sensitivity in the early stages, and decay as time progresses,” she notes.
Teeth endure frequent daily stress from chewing — and tooth clenching or grinding puts added force on tooth enamel and fillings. All of this can help cause a filling to gradually chip, crack, wear down, or fall out, according to the American Dental Association. Bacteria can also creep in around the edges of a filling, doing invisible damage; eventually, it may reach the nerve, resulting in pain and the need to replace the filling — or, sometimes, perform a root canal or even extract the tooth entirely.
Some dental-health experts have a saying about the link between sugary drinks and tooth problems: “Sip all day and get decay.” Meaning it’s the amount of sugar your teeth are exposed to that really determines the risk.
Strictly speaking, sugar itself doesn’t cause cavities. It’s the interaction between plaque — a bacteria that develops in the mouth, which “gobbles up” sugar for nourishment — and the chemical balance in the mouth known as the pH, or acidity level. The longer sugar remains on teeth, the more the balance goes haywire (as the acid levels rise) and the more prone you are to developing cavities.
And not just sweet snacks are to blame. All types of carbohydrates — including bread, potatoes, rice, even fruits and vegetables — trigger a bacteria-stimulated chemical shift in the mouth.
Although kids who consume lots of sugar are prime candidates for decay, some older adults — even seniors — are seeing a spike in dental cavities. This isn’t necessarily linked to a sweet tooth, but to the use of certain medicines. Diuretics, for example, can cut the production of saliva, which helps irrigate the mouth and keep it more germ-free.
Most experts agree that standard dental X-ray exams are safe, since they emit very low levels of radiation exposure. (Some studies report that a person is more exposed to more radiation flying coast to coast in a jet, than in a dentist’s chair getting a full set of X-rays.)
“To put X-rays in perspective,” says Seth Horn, D.M.D., of Aesthetic Family Dentistry in Port Jervis, “bitewing X-rays that are commonly used in dental checkups tend to be less than one-tenth of one percent of the annual radiation exposure the average person gets just in everyday life.”
X-rays are a key diagnostic tool to use in conjunction with a standard oral exam, Dr. Horn adds. “They help spot problems early.”
How often to get X-rays depends on various factors. For instance, kids may need them more frequently than adults because their teeth are still developing; the condition of a patient’s gums and teeth and overall health history are also considerations. The American Dental Association recommends that dentists provide leaded protective aprons and thyroid collars for all patients during X-rays; protecting the thyroid gland, which is particularly vulnerable to radiation, is essential. The ADA also suggests that dentists use the fastest film speeds available — or opt for digital X–rays, which utilize even lower levels of radiation.