As a dentist, I hear certain things so often that I thought I should write a blog about it for a couple of reasons. One is to help our patients, and our community to understand just how important it is to know the truth behind common myths or common misconceptions when it comes to dental health. And the other reason is that I think, sometimes, people make these comments and want to believe them (even if they don’t) simply to brush away the real truth so they don’t have to take action. But avoiding needed dental work because you want to believe a myth is just going to result in much bigger issues down the line. So here are my top five most common things people say to me… that are absolutely not true.

NOT True # 1: “But it doesn’t hurt so why do you say I need a….”
So many people think that if nothing in their mouth hurts, then they must be fine. High cholesterol doesn’t hurt, either, but it’s a big problem. Same with high blood pressure. Yet those things can land you in the hospital emergency room and result in massive life changes, surgery, or worse. We have to stop relying on pain as the signal for action. Pain is the result of a longterm issue being left without action. By the time your tooth hurts, it likely needs a root canal or extraction. By the time your gums hurt, it is likely that you can have a massive infection or severe loss of jaw bone. And by the time your jaw joint hurts, it is likely that’s it’s been an ongoing slow degeneration that could have been prevented years ago with a simple
night-guard, but now you need much more invasive procedures to restore it. Don’t wait for pain. Let your dentist help you prevent big problems with action way before you feel pain.

NOT True #2: “My insurance only covers cleanings every 6 months so that’s all I need”
Seeing your dentist or hygienist for dental cleanings every 6 months only applies to very healthy mouths with no bone loss, very healthy gums, and pristine teeth, as well as exceptional home care. Every six months is not enough if you are not the ideal case and waiting this length of time between professional periodontal therapy (aka a cleaning) often leads to irreversible issues later on. Gum disease in its early stages has no symptoms. We, as dentists and hygienists, can catch it and treat it very early on, but if you wait for symptoms, you will experience bad breath (and not related to food but the kind that makes people step away from you when you speak), food impaction (food gets stuck between teeth easily and even if you think you got it out, you didn’t), and the kind of bone loss that leads to tooth loss. Periodontal therapy (dental cleanings) at intervals recommended by your hygienist or dentist are key to not only keeping your teeth and gums healthy, but having people want to be near you when you are talking with them. Don’t be the one people talk about when it comes to stinky breath.

NOT True #3: “Mouthwash is way cheaper than what you are telling me to do to treat
my bad breath so I will just buy some of that” Brushing, flossing and using a mouthwash is not enough if you have the type of bacteria that causes mouth odour. Bad breath, known as halitosis, is a result of the bacteria in your mouth that produce volatile sulfur compounds, and this can have a nasty smell associated with it. The problem is that mouthwash won’t help get rid of this bacteria and you can be masking a bigger problem, which is bone loss due to periodontal disease, if left untreated. The other “breath” problem that mouthwash can’t help you with – Diabetic Ketoacidosis(DKA). DKA is a dangerous condition, where ketones rise to unsafe levels and often cause bad breath. DKA is a dangerous condition, mostly limited to people with type 1 diabetes whose blood sugars are uncontrolled. If you have these symptoms, seek medical help immediately.

NOT True #4: “It’s just a baby tooth”
I often see kids with cavities on their baby teeth and a very common comment I get when I discuss treatment options is: “it’s just a baby tooth so let’s leave it”. Baby teeth that develop cavities have bacteria in them that is destroying the tooth inside, which is often difficult to see until it’s too late. That bacteria, as it eats away at the tooth, continues to travel deeper and deeper, through the root of the baby tooth and into the bone where the new developing adult tooth is sitting. If left untreated, that bacteria will continue to destroy the developing adult tooth as well as the bone around, and can lead to dangerous infections if left untreated. Restoring baby teeth is critical to overall health and should not be dismissed even if the teeth are meant to fall out in the near future. The other issue with baby teeth that are decayed is that if they are so broken down that they need to be extracted, that will leave a space after extraction. However, if the adult tooth is not yet ready to erupt, the other surrounding teeth will tip in and close up the space where the baby tooth was extracted, causing future problems for the adult tooth. Not only will there not be space enough for the adult tooth to come in properly, this can also lead to other issues with proper jaw growth and arch development, but also poor tooth alignment. Maintaining the space after a baby tooth has been extracted is important in order to help the future teeth to erupt properly and reduce complications when it comes to future orthodontic treatment.

NOT True #5: “You are too expensive. I can get it much cheaper in my home country”
Every now and then I hear a patient say that to me and it breaks my heart. I agree that the cost of dentistry is high, and running a dental office with its constantly rising overhead is a challenge for any dentist. Many of the fees set out in the fee guide don’t even come close to what we spend to deliver certain services so yes, from the outside, it can see like dentistry in Canada is so very expensive. But one thing I can say, seeing other dentists’ dental work in our new patients that come through the door, is that dentistry taught in our Canadian Schools (and that includes the US as well) is exceptional. We train our dental students to be excellent clinicians, with detail-oriented precision and hand coordination, and most of the work I see coming from other dentists around me is outstanding. That is not the case with many many other countries. That’s not to say that some countries or some dentists outside of Canada and the US don’t do great dentistry. But what I have seen more often than not, is more than scary. Being an immigrant myself, I do connect with patients when they say they want to do it “back home”. There is not only a savings when it comes to cost of dentistry, there is also that nostalgia and attachment and trust, when it comes to going back. But what many people don’t realize, and it’s so hard to explain to a patient who is already so emotionally connected to their home country, is that there is so much that goes wrong when key things are not followed. What you can’t see can hurt you, and the most common issue I see over and over again in the dentistry that was done in some parts of the world, is poor marginal integrity (which is something you can’t see but it’s critical for longterm success) which often leads to massive leakage and tooth loss after a few years, and you won’t know it till it’s too late. The other common issue is biologic width invasion (again, a term you probably don’t recognize and may not see) which leads to severe inflammation and bone loss over time, and the need for surgery. Though it’s not always the case, and there are many places and many dentists in all countries that deliver precise and well fitting dental restorations, my general advice, especially when the “price is too good to be true” is go “back home” for a visit and a vacation, but get your dental work done here, in your new home.