The Tribune

BY DR SPARKMAN

FERGUSON

Registrar-Bahamas Dental Council

IF SOMEONE told you that having regular dental exams might cause you to keep all your natural teeth would you do those exams? I would, and hope that you would, too.

Permanent teeth (as the name suggests) were never intended to be removed from the mouth. This fact comes as a major surprise to most people. The prevailing thought among many is that if a tooth offends you, you should have it plucked out. This is a very careless, callus and uninformed approach to mouth health. Closely coupled to this is the notion that dentures (false teeth) are available and capable of replacing natural teeth.

How much neglect do I need before loosing a permanent tooth? Answer: 12-36 months for rotting teeth, and various times between 12-60 months for advanced gum disease.

There is a huge difference, however, between ‘dental extractions of neglect’, and ‘dental extractions of intervention’. Extractions of intervention include removal of baby teeth to create space for permanent teeth, removal of permanent teeth to create space during braces treatment, the removal of ‘extra teeth’ in the mouth (more than 32), and the removal of wisdom teeth.

Extractions of neglect are teeth that have to be removed because the patient was unaware of harbouring a diseased-tooth. Also in this category are patients who were aware of their diseased tooth, but did not pursue treatment in a timely fashion. The net result is that excruciating pain arises in the mouth and a tooth needs to be removed because of pain caused by cavity disease, or gum disease.

What to do? First of all, there is no substitute for awareness and being proactive about oral health.

A lot can be solved when we become aware of a mouth concern and then act upon our discovery by seeking professional treatment. That being said, it is better for these discoveries to take place in the dental chair.

Knowledge is very significant in dealing with dental health matters.

With knowledge of the predominant causes of tooth loss, we can take steps to avoid those situations. We must not allow our teeth to rot, and if they begin to rot, we need to seek other dental treatment immediately in order to prevent tooth extraction.

To conclude this article, I would like to mention the practical aspects of the dental extraction.

The average person does not appreciate that all dental extractions fall under the heading of surgery.

Regular extractions are considered minor oral surgery, and wisdom extractions (which are usually unavoidable) are major oral surgery.

With any consideration of surgery, the pain threshold of the patient is an issue (although an arsenal of pain medicines are available). This is precisely the reason why dentists try to steer people away from extractions by promoting early intervention with other painless treatments. Most people don’t think of an extraction as surgery, and therefore miss its potential complication of post- operative pain.

In the final analysis, we then have to ask ourselves if the neglect is worth the toothache, loss of time, inconveniences, and the pain.

Finally, people need to understand that dental extractions of neglect can easily be avoided. This is easily accomplished by being proactive, vigilant, and staying aware.