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When I go to one of those drive-thru oil change places, I always feel like the mechanics are trying to sell me a bunch of stuff that I don't really need. They sound very convincing, but don't really have a lot of evidence to back up why I should charge an additional $50 on my credit card, other than; "It will prolong the life of your engine, blah,blah, blah".

Fortunately, when a patient asks me why I am recommending that they have a filling done, especially if they aren't experiencing any symptoms (these are usually the people with a pain threshold of barefoot fire walkers), I have an x-ray to back me up.

A Picture is Worth a Thousand Words

alice in wonderland history lesson scene"I'm sorry, but how can one possibly pay attention to a book with no pictures in it?"
-Alice, Alice in Wonderland

Sometimes all of the explanations and science lessons in the world aren't enough to help a non-dentist understand what exactly is going on in your mouth. Humans are naturally visual creatures, so it makes sense that we process abstract concepts better when there are supporting images.

It seems perfectly reasonable to question whether you need to go ahead with treatment when there is no pain - and I wont get offended if you ask! I'll do my best to 'show' you why a filling might be in your best interest, and I'll use pictures to help illustrate my recommendation.

intra oral camera photo of tooth decayHere's an intra oral camera picture of a tooth with a mushy, gooey hole in it - a hole that goes down to the pulp of the tooth. You can click on the picture to enlarge it.

That's actually a photo of a child's tooth, so feel free to also use it as a visual aid to help explain the importance of oral hygiene when your child is being particularly stubborn about brushing.

dental xrays showing tooth decayAnd here's an x-ray showing that same tooth. See that shadow of decay? Again, you can click on the picture to enlarge it if you want, but it probably won't 'scare' your child into better brushing.

It does, however, illustrate just how extensive the decay on this particular tooth is.

The Thing About Tooth Decay...

Think of it like this; if you were to sprain your ankle or have the flu, you'd experience symptoms severe enough to prompt you to harass the front desk person at your PCP's office to get you in. Stat!

However, tooth decay is not the food poisoning of the medical world, it's more like those health conditions you may not feel or see, at least not acutely. For example, high blood pressure, anemia or diabetes may be present, but you often don't experience the symptoms until later.

Decay may be actively eating away at your tooth, but it won't actually cause pain until it reaches the pulp or nerve. And while I do not have empirical evidence to back this up, it usually happens right before you are going away on a week long cruise of the Caribbean. Or when I'm still away on my week long cruise of the Caribbean. Actually, I'm totally joking about the cruise, after being in the Navy the prospect of taking any kind of vacation on a ship makes me physically nauseous.

Seriously, here's the thing with tooth pain: decay does not actually cause the zingers that keep you up at night until it reaches the pulp or nerve of a tooth. By the time a decayed tooth hurts to that degree, it's a recipe for disaster and you're likely looking at a root canal.

In modern dentistry, we have the ability to catch tooth decay early, drill it out, and put in a simple filling. Seems a bit of a no-brainer to me: no pain, less expense, small filling versus toothache of the century, burning a big hole in your credit card, root canal.

So, even though nothing hurts right now, those fillings might keep you from being in a world of pain right around the corner.

peter's signature

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