Mead Family Dental

The boring dental patient

Are you one of those people?

You know the ones.  They've never had a cavity in their life.  They have beautiful straight teeth but have never been further than the dental hygienist's chair.  They've never experienced the drooly feeling of a numb lip or been subjected to their dentist's cheesy jokes (yeah, it's not just me.)

If you are one of those people, then good for you!  No one aspires to be an "interesting case" for their dentist.  Rest assured that this Saginaw dentist loves all kinds of patients...interesting or boring.

So what's the difference between a "boring" patient and an "interesting" patient?  Can patients that have had a lot of dental needs learn something from those that haven't?  Probably.  Let's look a little closer.

"No offense, but I hate dentists."

I hear this line at least once a week.  Really.  "No offense, but I hate dentists."  How could I take offense at that?  

My usual reply: "Perfect!  I hate patients, too.  Open wide."

I know, I'm making light of the way a lot of people feel about the dentist office.  Perhaps I shouldn't, but I've found that approaching patients with a sense of humor is usually helpful.  

So why would a patient "hate the dentist?"  Some associate the dentist with pain.  If you've ever had an abscessed tooth, who could blame you?  Others may have had a bad experience in the dental office that has been hard to forget.  Some people really don't like the way that anesthetic makes them feel.

Finally, dental care is expensive.  Anything that costs money that you would rather spend in some other way is expensive. Have you ever had someone trying to sell you a new roof or a dry basement try to explain to you how inexpensive their product is?  Dentistry is kind of the same way.  If you came into my office and said, "doc, I've got a bunch of money in my pocket that I don't know what to do with so I thought I'd have a root canal" you'd be the first patient that ever said that to me.

Any of these concerns is 100% legitimate.  So my job is to try to make you hate us less.  I have a few suggestions that might make coming to the dentist a little easier:

• Don't wait until something is broken or something hurts.  By the time it breaks or hurts it's going to cost more to fix (if it can be fixed) and has more potential to hurt.  Regular visits for checkups when you're not having troubles make it a lot easier to catch small problems before they become big problems.
• Dentistry has come a long way!  The way it used to be and the way it is now is a LOT different.  The needles are smaller, our numbing agents are better and our understanding of pain control is much improved!  If you haven't had work done for awhile I think you'll be pleasantly surprised.  I can't guarantee that there will be absolutely no discomfort but we're able to keep pain down to an absolute minimum.
• Tell us!  If you had a previous bad dental experience that information is really important.  If you tell us what happened to you before, we'll make sure we don't do it again.  For instance, I've had a patient tell me that her biggest problem with dentistry in the past was a feeling of claustrophobia because she was leaned back too far.  This is an easy problem to fix but we don't know if you don't tell us!
• Mead's rule.  There is never a time when we're working on you that we can't stop. In my office, the patient is in charge.  If you need me to stop, for any reason, I will.  Just raise your hand or let me know in some way.  Even if it's just to rest your jaw or take a deep breath.  There's nothing so important during dental work that we can't give you a break.  Even if you aren't in control of anything else in your life...you're in control when you're here!

 The goal of this Saginaw dentist is to turn "haters" into "regulars."  We do it by treating you like we'd want to be treated.  We'll greet you with a smile.  You can pick whatever TV channel you might want to watch.  Maybe you'd prefer to surf on your laptop or iPad.  We'll explain what we're going to do before we do it and we'll tell you how much it's going to cost before we start anything.  You're in charge and what you say goes.  I don't know if we can change "I hate dentists" into "I love visiting my dentist" but we're going to try!

Questions or comments about this blog?  Would you like to make an appointment?  Call the office at (989) 799-9133 or email me at alan@meadfamilydental.com.  I always answer my own email!

The dentist and the apple

One of my top 10 favorite foods is an apple.  I'm partial to Jazz or Honeycrisp.  In fact, you don't want to be standing between me and a Jazz apple.

Why should you care?  This is the blog of a Saginaw dentist, not a fruit market, right?  Well let me tell you a little story.

I got up this morning early.  I mean really early.  Like 4:30am.  It snowed like crazy last night.  Schools were cancelled and the roads were terrible.  My routine is to get up in the morning and feed the horses.  At the moment we have 12 horses and a miniature donkey that I feed a couple times each day.  Also two dogs.  So it takes a while. And with snow, it takes even longer. 

So I knew I was going to be trudging through the snow as well as shovelling, so I needed a breakfast on the go.  And since I'm such a huge fan of apples, it made perfect sense.  I grabbed my apple and hopped in the truck. This is when the trouble started.

When I bit into this beautiful, shiny apple I didn't have any idea the problem I was about to experience. On the very first bite I felt a heavy pressure and sharp pain by my lower left canine. WOW! It lit up my morning like fireworks!  This is the part where you revel in the irony of a dentist explaining his toothache, so enjoy it!

What had happened to me has probably happened to anyone who's ever eaten a really crispy apple.  I had jammed a little bit of the skin of that apple right between two of my teeth.  And it really stuck!  It was a ton of pressure on that one little spot and wow did it hurt!  

So what was I to do?  It just so happens that I keep a small spool of floss, just like the ones that we give to our patients at their cleaning appointments, in my truck.  I reached into the center console, grabbed my floss and I was as good as new in 2 seconds flat.  

So I had a happy ending to my story.  I tell you this tale because I can offer you a happy ending if you were to ever have such a tragedy.  Come get your teeth cleaned here at the office.  Not only will we treat you really nicely but we'll look over your teeth and make sure everything is O.K.  If there are problems, we'll offer you solutions.  We'll tell you how much it will cost to fix them.  If you've got insurance, we'll help you sort out how much they'll kick in for your treatment.  If you don't have insurance, we can help you find ways to save some money on dental care costs.  

And most importantly...we'll give you some floss that you can carry with you.  You know, to help out with those tragic apple accidents.

Give us a call at (989) 799-9133 or email me at alan@meadfamilydental.com.  We'll give you a dental office experience that you'll want to tell your friends about!

What's the diagnosis?

Here's how it's supposed to work.  The patient comes in with a problem.  The dentist (that's me) looks at the patient, evaluates the x-ray, examines the tooth or teeth in question and tells the patient in no uncertain terms "you need a filling," "you need a root canal," or "this tooth can't be saved."  The doctor knows and tells the patient what they should do, right?

Here's the problem.  Each of those treatment recommendations kind of jumps a step.  I shouldn't recommend treatment without first explaining the diagnosis.

Merriam-Webster gives us a few different definitions for the term diagnosis. First is: "the art or act of identifying a disease from its signs and symptoms."  This is probably the most typical way people think of diagnosis.  This is how we can tell a cavity from gum disease.  They present with different signs and symptoms.  A sign is an objective measure of condition in the mouth.  Examples of "signs" are periodontal (gum) measurements or x-rays.  These are collected by the doctor in order to form a diagnosis.  Symptoms are subjective experiences of the patient. Common symptoms of dental problems are pain, "discomfort" and pressure.  They aren't measurable in the same way that signs are but that doesn't make them any less real.  Symptoms are described by the patient and interpreted by the doctor in relation to the objective signs collected.  

Another defintion of diagnosis is: "investigation or analysis of the cause or nature of a condition, situation, or problem."  I prefer this definition because it describes an active search to get to the bottom of the problem presented.

Some dental diagnoses (plural of diagnosis) are very straightforward.  A cavity found on the x-ray and verified with magnification and lighting and recorded with an intraoral photo is dentistry's version of the slam dunk.  This is a very common finding and the likelyhood of a dentist getting it wrong is very low.  

Other conditions require us to be a bit like a detective.  Sometimes we find ourselves settling on a differential diagnosis.  The differential diagnosis is a list of the most likely things that could be causing our problem.  For instance, "the tooth needs a root canal" isn't a diagnosis.  That's a recommended treatment.  A differential diagnosis might be "the nerve of the tooth is inflamed from a deep cavity.  It may be able to heal from this trauma (reversible pulpitis) or it might be on it's way to dying (irreversible pulpitis).  There are some signs and symptoms that help us determine which way it's heading.  And sometimes, we just don't know!

Next time you're visiting your dentist or your doctor, ask them to talk about the diagnosis.  One thing I can promise, they'll be surpised that you asked.  You'll be letting them know that you're an interested patient who wants to take an active part in their care.  I promise that you won't regret asking!

Are you interested in working with a Saginaw dentist who explains the diagnosis?  Then I'm interested in having you as my patient!  Drop me an email at alan@meadfamilydental.com (I always answer my own email!) or call the office at (989) 799-9133.  We'll get you in right away and you won't believe a dental office can treat you so well!  

Saginaw dentist reads minds! Amazing psychic powers???

So I had a patient in the chair earlier today.  I got a look at his teeth and said, "you have heartburn, don't you?  You suffer pain in your chest and throat after eating Italian food."

He got this look on his face.  It was kind of scared but also kind of amazed.  It was as if Sylvia Browne had told him about a relative of his from beyond the grave!

The difference is, Sylvia Browne uses cheap parlor tricks and I'm for real!

What's my secret?  Was I born with this amazing power?  Have I trained under experienced psychics? 

Nope.  I've just seen a ton of gastric reflux patients.  They have telltale acid erosion spots. They show up most often on lower molars. Once you realize they aren't necessarily from bruxism (a.k.a."night time tooth grinding") I see them a lot.  The amazing thing is that 25% or more of patients with gastric reflux don't have any symptoms!  No heartburn, no itchy throat, no noticeable bad breath. On top of that...these erosion area on the teeth usually don't hurt. They're often only detectable by a dental exam. This is particularly scary because untreated gastric reflux is a leading cause of esophageal cancer, and esophageal cancer is particularly bad!  

This Saginaw dentist is trying to impress you with his amazing powers.  But have no fear...there's nothing supernatural here!

Do you have questions about your teeth?  Would you like more information about gastric reflux or other topics I've talked about?  Feel free to email me at alan@meadfamilydental.com (I answer my own email) or call the office at (989) 799-9133.  I'd like to be your Saginaw dentist!

 

"Do you have ESPN?"

The March Madness brackets came out on Sunday.  Shelly handed the remote to a patient and he asked, "do you have ESPN?"

Wait a second...this guy is at the dentist office!  And there are TV's?  And he can watch what he wants?  

Yup.  We have ESPN.  And a whole bunch of other channels, too.  

Shelly's pick: game show network...ideally Lingo or Chain Reaction

Doc's pick: How it's Made, Mythbusters or Spongebob Squarepants.  

But it's not about us.  It's about you.  What do you want to watch?  Let us know ahead of time and we'll have the channel on for you.  

Hey, if you've got to have some dental work done, you might as well watch what you want!

Should we set a channel for you?  Email me at alan@meadfamilydental.com or call us for an appointment at (989) 799-9133.  I would love to be your Saginaw dentist!

pH, your body and your mouth

I recently bought a bottle of water at Walgreen.  The brand was "Iceland Pure Spring Water" and it featured "pH 8.88" prominently on the label.  I read a little further to find:

"...it has one of the naturally lowest mineral contents of any water and a high pH of 8.88.  Icelanders live longer than any other nationality; we believe their secret to long life is their water."

This is an interesting claim.  My research (if you want to call finding a cool chart Wikipedia chart research) shows Iceland coming in 3rd to Japan and Hong Kong.  FYI...the U.S. comes in tied for 36th place with Cuba and Denmark.  So the claim that Icelanders live the longest is in dispute, but what about the pH of their amazing spring water?  Could it account for longevity?  Should I be worried about my pH?

pH is a measurement of acidiy or alkalinity in an aqueous (water based) solution.  A solution that is high in acidity has a low pH and a solution that is more alkaline has a higher pH.  pH is measured on a 14 point scale with 0 being the lowest pH (most acidic) and 14 being the highest pH (most basic or alkaline).  A pH of 7 is considered neutral, neither majority acid or alkaline. This 14 point scale is logarithmic, which means that each number on the scale is 10 times higher or lower than number above it or below it.  For instance, a substance with a pH of 3 is 10 times more acidic than a substance with a pH of 4 and 100 times more acidic than something with a pH of 5.

The pH of the human body is variable depending on the part of the body you're talking about.  The stomach has a pH of about 1...very acidic.  This is useful in breaking down the food into smaller, more digestible pieces.  Lysosomes, the small bags of chemicals found inside cells are used to break down damaged cell parts.  They can have a pH of 4-4.5.  Our blood is at a relatively steady pH of 7.34-7.45. The body keeps the pH of our tissues relatively constant completely separate from our diet.  

Our mouths are a bit of an exception.  The pH can range quite significantly in our mouths due to the presence of acid producing bacteria.  Some of the bacteria in our mouths can turn the carbohydrates that we eat into acid.  I've talked quite a bit about this in previous posts.  This acid can dissolve the surface of the tooth if it reaches a critical pH.  The critical pH, or the pH at which tooth structure begins to dissolve is 6.7 on the root surface of the tooth and 5.2 on the enamel.  Diet, habits and saliva flow have a lot to do with how well an individual defends against pH drops in the mouth.  But these localized oral pH fluctuations are not the same as pH change of the body.  

 You often hear claims that the pH of your body being off or unbalanced are the cause of disease.  Whether these claims are indirect like my water bottle or more direct as in some blogs or books, they need to be looked at critically.  Most of these claims have no basis in science or actual physiology.  Beware of diets or claims that talk about "changing your body pH."  Often they direct you to test your saliva to evaluate your body's pH.  That would be akin to checking the inside of your furnace to evaluate what the temperature of your house is!  Your body has very specific control mechanisms for regulating your pH through the lungs and kidneys.  Your diet makes no difference with regard to your body's pH, except in your mouth!

Some disease states can result in pH changes.  Diabetics can experience diabetic ketoacidosis, which can lower the pH of the blood.  This is a consequence of their inability to use sugar in their bodies. However, in healthy individuals this is not a concern.

So, do I think my Iceland Pure Spring Water at a pH of 8.88 will prolong my life?  Not really.  However, it was cold and delicious and made it so I wasn't so thirsty.   So it did what I was hoping it would!

Do you have comments or questions about this or any of my other posts?  Do you like what you see on my blog?  Leave a comment here on the blog or feel free to email me at alan@meadfamilydental.com.  This Saginaw dentist writes all the posts and answers his own email.  Thanks for taking the time to read!

"Saginaw dentist sells out!'

No, it's not what you think!  

Both morning and afternoon sessions have sold out.  I can hardly wait!

Sinusitis II...The Return of Inflammation (a sequel to yesterday's post...now with 100% more video!)

I couldn't have said it better myself.  

Sinusitis and toothaches

"My sinuses are really bothering me.  Man it sure is that time of year."

I hear this from patients a lot.  Actually, I hear it all year round!  I'm not exactly sure what time of year is prime time for sinusitis, but since our seasons are constantly changing here in Michigan, this Saginaw dentist thinks that it's typical 365 days a year.  

What are your sinuses?

The sinuses are multiple air filled cavities that are connected to the inside of your nose.  They are lined with mucous membranes.  

What is sinusitis?

Sinusitis is inflammation of the sinuses due to infection, allergies or some autoimmune problems.  The most typical symptoms of sinusitis are headache, drainage and occasionally toothaches.  Since these sinuses are "dead end" air spaces the inflammatory process allows pressure to build up.  If the sinuses aren't able to drain this can cause serious pain.

Why do my teeth hurt when I have sinusitis or a sinus infection?

Your upper teeth, particularly the upper molars, are sitting right next to your sinuses.  It's quite common for someone to present with a toothache when they're having sinus troubles, even when it isn't a tooth problem.  Often the toothache will be difficult to localize to one tooth.  The dentist needs to perform tests to determine the cause of the toothache.  When in doubt, I often treat the patient for an acute sinusitis and check back with them in a couple of days.  If it's really a tooth problem, the sinusitis remedy won't have helped very much. 

 

 

It's interesting to note that if you lose an upper tooth the sinuses can actually "grow into" the spot where your tooth used to be.  This process is called "pneumatization."  In cases where we want to try to place an implant to replace an upper tooth the surgeon has to push the membrane of the sinus up and replace it with bone.  This is called a sinus lift.  

How do you treat sinusitis?

• nasal irrigation with saline solution can be helpful
• nasal spray decongestants can be used for short periods of time.  Using these more than a short amount of time can lead to rebound sinusitis
• oral decongestants like Sudafed or others can be very helpful to reduce sinus pressure and NSAID's like Ibuprofen can reduce inflammation to help with pain
• occasionally antibiotics are indicated in chronic sinusitis due to bacterial infection

What doesn't work?

Root canals.  Treating a tooth that's actually referred pain from sinusitis with a root canal won't help.  And worse, you get a root canal that you don't need.  Get the right diagnosis!  Sinusitis has never been helped by a dental drill!

Sinusitis is common.  It is also miserable.  It's important to get the right diagnosis, so ask your dentist or doctor good questions.  Better safe than sorry!

Do you have any good sinus stories?  Leave them in the comments section below.  I'd love to hear them. Do you have questions or comments about this website?  Feel free to email me at alan@meadfamilydental.com.  I answer my own email!