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Is it really necessary to get teeth cleanings and dental checkups?
February 26, 2011 5:46 PM   Subscribe

Is it really necessary to get teeth cleanings and dental checkups?

I used to go for a dental checkup and teeth cleaning by a dental hygienist about every year. Then I stopped for a few years because I didn't get around to it. I've noticed that I still have all my teeth.

I'm wondering if this yearly time-consuming and unpleasant ordeal is really necessary. Also, I'm wondering if getting irradiated in the head once a year is actually a great idea.

Because the alternate strategy is just to brush and floss every day and if your teeth start to hurt go to the dentist. Could that be a perfectly reasonable approach? Or would I be risking some serious problem by doing that?
posted by eeby to Health & Fitness (40 answers total) 7 users marked this as a favorite
 
Plaque can build up, regardless of how good your home care is. It gets in the margins between the teeth and gums and causes inflammation, which can effect your whole system.

So, yes, while not necessary, it is highly desirable, just as keeping your teeth into your 5th or 6th decade is arguably desirable.
posted by Danf at 5:51 PM on February 26, 2011


Congrats on having all your teeth now. How old are you? Do you want to have all of them when you're 50? How about 60? Will you get dentures then? Or do you have many thousands of dollars available for implants?

In my experience, when you wait until it hurts you get socked with a root canal or crown and end up paying big bucks. If you go regularly, get cleanings and fluoride treatments, and treat any problems as they emerge and before they're enormous, you stay in win territory.
posted by BlahLaLa at 5:54 PM on February 26, 2011 [5 favorites]


Some tooth problems aren't noticeable until they're a big problem. For example, I went several years without visiting a dentist until I got some very bad pain. By that time I had a bad infection (which can be potentially fatal) and needed a root canal. If I'd gotten regular checkups and the initial problem was noticed, all I would've needed was a filling. Not all cavities hurt.
posted by Emanuel at 5:56 PM on February 26, 2011


Yes. Abso-fuckin-lutely. Do not neglect your teeth cleaning. Furthermore, do a deep cleaning (root planing) every once in a while. Otherwise, even though you have teeth today, you won't have them by the time you hit your 50's and 60's. Also, a lot of periodontal damage is not visible or felt initially, but has horrible consequences for your overall health (particularly cardiovascular). Frankly, depending on your mouth chemistry (how fast you tend to form plaque), you should go anywhere between 2-4 times a year. AND, go to a good hygienist - otherwise you may be only "cleaning" your teeth, rather than actually having them cleaned. I'd advise - my younger self, too late for me - to visit a periodontist pronto and listen to what s/he has to say. And no, you don't need yearly X-rays. You'll have the initial X-rays done, then you don't need for a few years, unless you develop problems. It's a lot cheaper to pay $500 a year now, then to pay tens and tens of thousands later for root canals, perio gum surgery, crowns, extractions, bridges, dentures and implants. Do not neglect your oral health. You can't feel the damage - by the time you do, by the time your gums bleed when you brush your teeth, by the time your gums are receding, it's ten times worse than your wildest imagination.
posted by VikingSword at 6:10 PM on February 26, 2011


Much of regular dental visits are about preventative care. I got right with the Dentist about 4 years ago. I had a little bit of pain. I went in, he took xrays and it turned out that I had 12 cavities. 12! And a developing abscess. After all of the fillings and the eventual root canal, I made damn sure to go for my twice yearly visits.

My dad never went to the dentist until it was too late: he eventually lost them all in his late 40s. Dentures by 50 is not a way to live if you can help it.
posted by Cat Pie Hurts at 6:11 PM on February 26, 2011 [3 favorites]


Stay ahead of the biofilm and you're golden
posted by Cuspidx at 6:19 PM on February 26, 2011


I didn't go to the dentist or get my teeth cleaned for 8 years, due to dental phobia. When I finally worked myself up to going, I didn't really have any tooth pain.

I did, however, have the need for 11 fillings, 2 partial crowns, and one full crown. Most of which was done in the space of a month. It was a tough month.

One of the teeth that was partially crowned later died, which was painful, and required a root canal.

That was 10 years ago, and since then I have compulsively visited the dentist every 6 months for a cleaning, and have required very few new fillings.
posted by Squeak Attack at 6:31 PM on February 26, 2011 [1 favorite]


Please, please, please, with whipped cream and a cherry on top, go get your teeth cleaned.

If you have any interest at all in making with the kissy-kissy or something more, your partner will thank you from the bottom of their hearts.

Trust me on this.
posted by LN at 6:53 PM on February 26, 2011 [1 favorite]


It's a high-stakes gamble. I was very lucky - I went to the dentist at age 28 for the first time since 6th grade, and they refused to believe it had been so long. My only cavity was in a wisdom tooth slated for removal. HOWEVER, my teeth are quite gappy, and half my mouth tissue is actually hypertrophied due to my birthmark (so gum loss would be somewhat helpful - less for the surgeons to take out with a knife,) and my family is apparently blessed with anti-cavity spit in general.

The sensible, life-preserving, "I am a grown-up and take care of myself" thing to do is, at a minimum, get your teeth professionally cleaned twice a year.
posted by SMPA at 6:56 PM on February 26, 2011


For some people it's a necessity, for some, not so much.

I once went 11 years without visiting a dentist. I just brushed my teeth twice a day. I didn't have any ill effects. No cavities,my teeth were still very white, no gum problems, I just didn't see the need.

When I finally did go back, they did scrape away at my teeth for a while, and they told me I should floss more, which was obvious since I didn't floss at all.

Most people have teeth that need to be attended to. Some people don't. I guess I fall into the latter category. I have taken up daily flossing though, might as well...
posted by sanka at 7:02 PM on February 26, 2011


I'm a layman as far as dental science goes, but I believe there has been some research that correlates general dental health with other physical health, especially heart disease.

I have also been told (and again, just a layman speaking) that there are two different kinds of plaque; a "soft" plaque that is easily removed by brushing and a "hard" plaque that essentially needs to be cracked off with stronger tools, i.e. dentists' picks and pneumatic brushes.

And like other people have said, preventive care is generally much, much cheaper than reactive care. A small hole in a tooth is much easier to fix than a big hole and a root canal.
posted by backseatpilot at 7:08 PM on February 26, 2011 [1 favorite]


Time consuming? Unpleasant?

I don't see the word "expensive" in there.

I take it you are not paying for the full cost of your dental care. If there's any possibility that you may be in the future, you should be aware that it's not at all difficult to end up with tens of thousands of dollars of word that needs to be done by the time it starts to hurt.

You don't know unpleasant until you've paid a few thousand for a root canal. That was the most unpleasant part of the whole thing.
posted by yohko at 7:12 PM on February 26, 2011


I didn't go to the dentist for 8 years due to lack of money and just life being all in upheaval. The bill that they put down for me was 30,000+ dollars to fix all what was wrong with my mouth or dentures that would be covered by medical. In the end I chose dentures so I'm toothless in my 30s.

Odds are you won't end up as bad as me but don't let yourself get to that point. Where unless you have a well paying job you actually consider removing all your teeth. A simple cleaning and check up once a year would've kept me on top of all those things and I wouldn't have had to let poverty make my decision for me.

That said dentures do rock over having your teeth crumble in your mouth every time you eat anything harder than cheese.
posted by kanata at 7:20 PM on February 26, 2011


Yes, if you skip having your teeth cleaned, you will be risking some very serious problems, including major pain in the head and wallet. If you think that having your teeth cleaned is time-consuming and unpleasant, try root canals, extractions and gum disease. It's way more pleasant to see a dental hygienist than an endodontist, periodontist or oral surgeon.

Also, if you get your teeth cleaned regularly (2x year), it will become easier and less unpleasant as time goes on. If you don't do it, the day will come when you will wish that you had. Guaranteed.
posted by Corvid at 7:25 PM on February 26, 2011


I think some people really luck out on this. I went about a decade without seeing a dentist with no issues. The hygienist didn't believe me at first. Brushing twice a day (usually) but no flossing. The dentist said acidic saliva and my sugar-free gum habit could account for it. She warned that the next decade will likely not be so kind, so I should really get in there again.
posted by the christopher hundreds at 7:35 PM on February 26, 2011


Some people are lucky with their teeth. I'm 35 and have never had a cavity or a tooth extracted and there was a period of time where I didn't go to the dentist. Genetics may play a part.
posted by dfriedman at 7:38 PM on February 26, 2011


I'm in my early 40s. I didn't go to the dentist for (I'm embarrassed to say) 28 years.

Aside from needing two visits for the initial cleaning, I had no issues. My parents did NOT have great teeth. I have always cared for my teeth. I generally don't drink/eat sugary things. I floss. I've used a Sonicare for a long time. I chew on toothpicks.

Maybe I was just lucky. I don't know.

I suspect most people who avoid the dentist also neglect their teeth, and so it follows that when they go in all sorts of problems have come up and they end up with a horror story. But that is only a guess.

But I will tell you one thing: just in case it was dumb luck, I am never, ever missing an appointment again.
posted by quarterframer at 7:45 PM on February 26, 2011 [1 favorite]


Not sure if this is funded by ADA or equivalent marketing vehicle for dentistry, but may help give you some idea for why regular checkups are helpful:

http://www.mayoclinic.com/health/dental/DE00001

Endocarditis - Gum disease and dental procedures that cut your gums may allow bacteria to enter your bloodstream. If you have a weak immune system or a damaged heart valve, this can cause infection in other parts of the body — such as an infection of the inner lining of the heart (endocarditis).

Cardiovascular disease - Some research suggests that heart disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation from periodontitis — a severe form of gum disease.

Pregnancy and birth - Gum disease has been linked to premature birth and low birth weight.

Diabetes - Diabetes reduces the body's resistance to infection — putting the gums at risk. In addition, people who have inadequate blood sugar control may develop more-frequent and severe infections of the gums and the bone that holds teeth in place, and they may lose more teeth than do people who have good blood sugar control.

HIV/AIDS - Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.

Osteoporosis — which causes bones to become weak and brittle — may be associated with periodontal bone loss and tooth loss.

Alzheimer's disease - Tooth loss before age 35 may be a risk factor for Alzheimer's disease.
Other conditions. Other conditions that may be linked to oral health include Sjogren's syndrome — an immune system disorder — and eating disorders.


Anecdotally, someone I know had forgone the dentist for over a year and suffered from an infection that spread to his face, partially paralyzing it and swelling his glands. He had to come back for a very painful emergency root canal. I know my dentist checks to see if my jaw alignment may be off as a result of stress and teeth grinding. It's a good signal to me if I need to take things easier.
posted by hampanda at 7:56 PM on February 26, 2011


Like others commenting, due to lack of insurance and whatnot I didn't go near a dentist for maybe 10 years. When I finally went in, both the hygenist/whatever you call her as well as the dentist simply wouldn't believe that it had been that long. They both said separately that they thought it "might have been a little more than 6 months."

When I told them I never eat/drink sugar or sweets and am a vegetarian, and they basically said "oh, that explains it," and one told me explicitly that not eating meat helps, however the original dentist was surprised to learn that I avoid dairy products, generally, and never drink milk. I've since heard versions of this from 2 other dentists as well.

I rarely floss unless I've been eating popcorn or something of that ilk, brush twice a day, generally. I go through spurts with a fluoride rinse, and have no cavities. My parents and sister all have/had terrible teeth. YMMV
posted by nevercalm at 7:58 PM on February 26, 2011


Just chiming in to say that I think genetics plays a big part in this. I haven't had a cavity in my whole life (32 now). I haven't been to the dentist in several years but whenever I have gone there have been few if any problems (and I don't floss and just do the usual brush-twice-a-day routine) However, I know some people are not as lucky.

ALso, I live in a country where people rarely if ever go to see the dentist, because there simply aren't many dentists (China). I'm not saying that's good, but there are plenty of people here living to a ripe old age so I am just not sure it is necessary for everyone.
posted by bearette at 8:01 PM on February 26, 2011


I went over ten years without a dental visit die to dental phobia. I cleaned my teeth twice a day, but did not floss. I eventually thought I should get a check up (no pain, just thought it was time to grow up). 2 wisdom teeth extractions, 4 crowns and I've forgotten how many fillings. I continue to visit regularly but do not floss. Eventually I need gum surgery, and root canals.

A cleaning from a competent, gentle hygienist is nothing painful. Look for a new hygienist if you find cleanings painful. I will tell you that root canals and gum surgery make a cleaning feel like a short, pleasant walk in the park.
posted by Joh at 8:23 PM on February 26, 2011


For some people it's a necessity, for some, not so much.

It's genetic, whether or not you get the bad bacteria. If you do and don't care for your teeth, you will eventually lose the. Without the bad bacteria, you will have some problems but can get away with a lot. (I have the bad bacteria)
posted by Obscure Reference at 8:28 PM on February 26, 2011


Some people are prone to carries, some are not. I went around 15 years without going to the dentist, and after all this time, when I did go it was because I bit on a really hard bone on a steak, chipped a tooth and gashed my gums. The dental hygienist only had to spend around 10 minutes on my teeth because I had no plaque. DH, who goes regularly, spent almost an hour getting his cleaned.

It's genetics, diet, and how well you care for your teeth. My family never visit the dentist, and all have good teeth. However, we are all crazy brushers who spend 10 minutes just brushing. I also don't drink (uh, much - low tolerance) smoke or have a sweet tooth - those things also run in the family.

Why not ask your dentist next time and see what s/he thinks? Mine was honest with me and said that given my history (and lack of problems + diet) regular checkups and cleanings are not necessary.
posted by Sallysings at 10:12 PM on February 26, 2011


I think it really depends on where you are and what a dentist's checkup involves in your region. (And if it varies, then it depends what dentist you go to.)

For the first 20 years of my life, I went to the dentist for an annual "checkup" which involved a quick look in my mouth, and a brush with an electric toothbrush. I never needed a filling or any other work (besides removal of some baby teeth that didn't have second teeth underneath). Every year for 5 minutes work, they charged my parents, and later me, $100. Obviously this came to seem like unnecessary expense.

For the next four years, I continued to go once a year, but to a different dentist, who only charged $50, and did an x-ray as well as the 5-minute clean. At least the x-ray reassured me that there weren't any lurking cavities, but it still seemed like this whole process might be unnecessary.

For the next six years I didn't go at all. I finally went back recently (now in a different country), and oh my god I got the world's most invasive cleaning. There were picks and vibrational things, and the worst pain I have ever felt in my mouth, and it lasted nearly an hour. Possibly the six years of no five-minute cleanings meant this hell-cleaning was now necessary, in which case I'll go back to annual cleanings, thank you. Or possibly it's just a difference between what different dentists in different countries do.
posted by lollusc at 10:41 PM on February 26, 2011


yes. especially since you can catch cavities while they're small (and relatively cheap to address). if you wait till you get an abscess or need a root canal, you'll be out a thousand or two, easily. and the avoidance of horrific pain is also a nice bonus.
posted by thinkingwoman at 10:43 PM on February 26, 2011


I have not had my teeth cleaned in 10 years. My teeth are FUCKED UP something major. My dental insurance kicks in year after next. Trying to convince myself that it's worth going before then.
posted by mollymayhem at 10:46 PM on February 26, 2011


I used to manage a dental office. My vote is: Yes. Go to the dentist. Not only for all of the sensible reasons people above have listed.

More importantly, go because the dentist's exam include an oral cancer screening.

Yes. You heard me. ORAL CANCER.

We had a guy come in after years and years without seeing a dental chair. His cancer had progressed so far that his options at that point were only palliative.

On the other hand, the dentist I worked for sent folks to the oral surgeon for biopsies, and several did turn out to have cancer.

Count this advice for triple if you have ever (EVER!) been a cigarette smoker.
posted by bilabial at 4:46 AM on February 27, 2011


You definitely should see a dentist, at the very least, once a year. All kinds of crap can go wrong in there, even for the most diligent and fastidious of people.

That said, I haven't been to a dentist in several years, because I simply haven't been able to afford it. No dental insurance. I'm sure there's work that needs to be done, but...

We've scraped-together the cash to get our kids to the dentist from time-to-time, but neither my wife or I have been able to go. Our son needs to get his wisdom teeth extracted, but there's just no spare cash for that kind of oral surgery.
posted by Thorzdad at 6:31 AM on February 27, 2011


Yes.
posted by jchaw at 6:59 AM on February 27, 2011


i seem to recall from when i was pregnant that not getting your teeth cleaned can somehow increase the risk of pre-term labor. meaning having your baby early.
posted by wurly at 8:34 AM on February 27, 2011


My thought is, we didn't have dentists until pretty recently and our ancestors seemed to manage. At the same time, we didn't live much beyond 30 back then, so... depends on how much faith/aversion you have regarding dental implants/dentures, I guess.
posted by Menthol at 8:39 AM on February 27, 2011


My thought is, we didn't have dentists until pretty recently and our ancestors seemed to manage.
Our ancestors also had a very different diet, with no refined carbs or processed sugars, both of which impact dental health.
posted by Joh at 10:01 AM on February 27, 2011


My thought is, we didn't have dentists until pretty recently and our ancestors seemed to manage.

Our ancestors also didn't have refined sugars added to every. single. thing. they ingest. Guess what plaque feeds off of?
posted by Civil_Disobedient at 11:13 AM on February 27, 2011


Er... what Joh said.
posted by Civil_Disobedient at 11:14 AM on February 27, 2011


It's important. Annual dental visits are not just a scam to fatten the wallets of whichever company makes those little pots of flavored tooth grit the hygienist uses to clean tartar off your teeth.

Dental problems are cumulative. You'll always hear a lot of anecdotal stories from people who say "I haven't been to the dentist in 10 years and at my last check-up, my teeth were fine!" Ask these people to check back with you when they're 50 or 60.
posted by ErikaB at 11:15 AM on February 27, 2011


I think a concept that could be useful here is "cheap insurance".

Maybe you won the genetic lottery and are going to have rock-solid teeth until you're 105. But maybe you lost the lottery and in five years you're going to be looking at a full set of dentures.

Odds are you're somewhere in the middle. But since you use your teeth every day, several times a day, you rilly rilly want them to be healthy, pain-free, useful, because it's gotta suck--BAD--when they're not.

Cheap insurance. Avoid those problems if you can. Brush, floss, see the dentist.
posted by Sublimity at 12:14 PM on February 27, 2011


I think a concept that could be useful here is "cheap insurance".
Cheap insurance usually doesn't cover dental care. Hell, expensive insurance usually doesn't automatically include dental care. That's an add-on. A very expensive add-on.
posted by Thorzdad at 1:52 PM on February 27, 2011


I don't know why you'r getting an X-Ray every time, that seems like bill padding to me. However, the radiation exposure you'll receive is up to 0.15 millisievert. The amount you'd get just from living in Denver is 0.5 mSv, the natural source radiation you'll be exposed to each year is about 3 mSv, so in that context, please relax and don't worry.
posted by wilful at 4:02 PM on February 27, 2011


Thorzdad, that's true.

But the concept I was trying to convey was that, compared to the hassle and pain and expense of real problems with one's teeth, the hassle and pain and expense of preventative care is pretty small potatoes. Since it can't reasonably be foretold who's going to luck out and be spared those problems and who's going to have them in spades, it makes sense to do your diligence and put in the cost and effort to prevent those problems.

Absolutely, insurance in the sense of payors and coverage is relevant too. It sucks to pay for preventative care out of pocket, absolutely. But if you're totally uninsured for dental care, it's probably even more important to do your diligence about prevention, to keep little problems from developing into big, super-expensive, painful problems.
posted by Sublimity at 7:27 AM on February 28, 2011 [1 favorite]


I stopped going to the dentist for a few years in my mid-twenties because I was poor and uninsured. Like you, I noticed that my teeth seemed to be doing fine and didn't hurt.

So then I got a job that included dental insurance, but didn't go to the dentist for another ten years, since I had fallen out of the habit, and my teeth seemed to be doing fine and didn't hurt, so the dental cleaning/checkup seemed unnecessary.

Until one day I chipped a tooth. Or so I thought, from the way it felt when I ran my tongue over it. Okay, I thought, I'd better bite the bullet (metaphorically) and go see a dentist.

Once I saw the X-rays, it was obvious the tooth was more "broken" than "chippped." About a third of it was missing. The dentist was astonished that I hadn't felt any pain until it actually broke, but I hadn't. So over the course of several visits—at a total cost greater than what my dental insurance would cover in one year, I should note—the dentist fixed that, plus several other defects he found. A root canal, some fillings, and some crowns. To be honest, I've lost count of the total number of fillings and crowns I have now.

And now I'm religious about my regular dental cleanings/checkups. Go figure.
posted by DevilsAdvocate at 9:22 AM on February 28, 2011


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