Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

August 28, 2017

Do I need fluoride treatment as an adult?


We thank our advertisers who help fund this site.

Hi Dr. Hall,
I am wondering if you can help me with a few dental exam questions? When I go to the dentist it seems they insist that I receive x-rays every six months. Is this necessary—what is the recommendation? Also, as an adult, do I need fluoride and if it is not needed will it have a negative effect if I get it?
– Kay from Arizona

Kay,
The general guidelines for routine checkups are to have bitewing x-rays (two or four x-rays taken while you bite on a tab that holds the film) once a year and a panographic x-ray or full series of x-rays (showing the roots of the teeth) once every five years or more.

There are variations from this that can depend on the individual. Some people with aggressive decay problems may need x-rays very 6 months, but that would be rare. In my practice of over a thousand patients, I maybe had a handful of patients for whom I would want x-rays that frequently. I did have some for whom I recommended x-rays less frequently.

As far as fluoride treatment, that is generally given to children and youths up to age 14—in some cases up to age 18. Once the permanent teeth are fully formed and the enamel has matured, the benefits of fluoride treatment are less. Adult fluoride treatment would similarly be justified in the case of some patients with aggressive decay problems.

There are no deleterious effects of fluoride treatment on natural teeth. But if you have any porcelain work, the most common type of fluoride can etch the porcelain, destroying the glaze and possibly removing some of the color. Most fluoride administered in dental offices is acidulated fluoride. The acid in the fluoride assists in its absorption by the teeth, but that same acid will etch porcelain, making the surface more rough which makes it attract stain. Also, the dental laboratory technician who fabricates the porcelain restoration will sometimes place tints in the surface in order to match the coloration of adjacent teeth, and those tints could be dissolved away by acidulated fluoride.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

October 16, 2010

Can you tell a cracked tooth from an x-ray?

Filed under: Fractured teeth — Tags: , , , — mesasmiles @ 9:58 pm

Is it easy for an x-ray to miss detecting a cracked tooth? I had full mouth x-rays-taken at two different dental offices within a month of each other. Neither set of x-rays detected a cracked tooth. But when I changed to another dental office and that dentist referred me to an Endodontist, from the x-rays the Endo took, he told me I had a cracked tooth that needed a root canal right away. I’m wondering why the other two dental offices missed seeing that cracked tooth in the x-rays, and am wondering if it is common for an x-ray and/or dentist to miss detecting a cracked tooth?
– Grace from California

Grace,
I would put the answer to your question this way – it is very difficult to detect a cracked tooth on an x-ray. Unless the x-ray is taken at the exact angle of the crack, it won’t show up.

I suspect that the endodontist didn’t actually see the crack, but saw some subtle evidence that suggested a crack.

I have four molars of my own that all ended up needing root canal treatments because of cracks developing in them. But none of the cracks have ever shown up on an x-ray.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

September 23, 2010

So many things wrong – where do I start? Find another dentist!

Filed under: Pain in teeth — Tags: , , , , , , — mesasmiles @ 5:11 pm

Dr. Hall,
I had a toothache.. Went to the dentist… He said that my filling in my 2nd to last molar is cracked… he also said the last molar needed to be fixed. So they did a deep cleaning… Drilled out the old fillings and capped both teeth with a single temporary cap… The next night I was in sooo much pain and my face swelled up… My throat and under my tongue was swollen… They put me on pain killers and antibiotics… After a week the told me that the tooth 2nd to last tooth died and it needed to be pulled… So they pulled it… this was all done on 9/18/10… But some friends told me that the dentist should have lanced my gums to let the infection drain… I’m still on pain killers and antibiotics.. There are still some swelling under and on my jaw on my throat and under my tongue… So what should I do???? I don’t want to be hospitalized for this or die after everything I have been reading… Can you please inform me of what to to????
– Joyce from California

Joyce,
Either I’m not getting the full story or there is something wrong with your dental care. I’ve got a lot of questions about what was done for you.

But first, pulling the infected tooth without lancing the gums is usually okay. The idea is to get the infection to drain, and with the tooth removed, the infection will usually drain just fine through the empty socket. But since you have swelling in your throat, hopefully you are still taking the antibiotics. If you’re not on antibiotics, I would find an excellent dentist and get another prescription.

But the way you’re telling about what happened in your dental care makes it sound like other parts of your treatment weren’t done right.

First, if you had a toothache and then putting the temporary cap or crown on made the tooth start to hurt as much as you’re saying, that means that this tooth was already infected before anything was done. I’m not sure why your dentist couldn’t tell that. It appears that the tooth was already abscessed, and that should have been visible on the x-ray that they hopefully took.

Second, I question doing the deep cleaning and fixing the teeth at the same time, as a treatment for your toothache. What was going on here? Couldn’t the dentist figure out what was the cause of the pain – is that why you got this scatter-gun-style treatment of trying everything? Was he or she hoping that one of the treatments would work? Usually when there is a toothache, you do a careful diagnosis and figure out the cause of the pain, and then get you out of pain. Deep cleaning is a great treatment for gum disease, but it carries a risk of causing an infection to flare up temporarily.

And I don’t understand why you were on antibiotics for a week before the dentist could tell that the tooth had died. That doesn’t make sense to me.

And you didn’t say anything about any suggestion the dentist made about saving this tooth. The tooth is dead so you have to extract it? Am I just being given a shortened version of this story? There are options that should have been mentioned to you.

If all of this was done and I’m just missing those parts of the story, then I would go back to this dentist and make sure that you are being given an antibiotic that is actually effective against this particular infection. If I am hearing this story right, then I wouldn’t have confidence that this dentist would give you the right prescription. I would recommend you find another dentist to get you the right prescription for the right antibiotic and get you healed.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

Powered by WordPress

Follow this blog

Get every new post delivered right to your inbox.


Categories