Things I’d never do as a dentist (and why)
I’m Ilon, a dentist in Miami. Here’s my reason for each one, and what I do instead
Jump to a number
Replace a filling just because it’s old
Every redo drills out a little more tooth, so each new filling is bigger than the last. Enough rounds of that and the tooth ends up needing a crown
Instead
Leave it alone and keep an eye on it. If it isn’t cracked, leaking or decaying underneath, it’s doing its job
Use a strong antiseptic mouthwash every morning
The strong ones (chlorhexidine, or CPC, which is in a lot of drugstore rinses) knock out the mouth bacteria that help you make nitric oxide, which your blood vessels use to relax. In one study, a week of it cut the nitrite those bacteria make by 90%
Instead
Skip the daily rinse. If it’s for your breath, find the cause, usually the coating on your tongue or a dry mouth. And eat your greens and beets. They’re full of nitrate, and those bacteria are what turn it into nitric oxide
Brush harder to get rid of yellow
Yellow is often the layer under your enamel showing through. Scrubbing can’t remove it, and teeth wear fastest when you scrub right after something acidic
Instead
Protect the enamel you’ve got. Acidic drinks go with meals, not sipped all day. If you want a lighter shade, that’s a whitening job, not a scrubbing job
Numb sensitive teeth and never ask why
Sensitivity means the inside of the tooth is exposed. Acid wear, gums pulling back, grinding, a crack or a cavity. The paste quiets the signal, not the cause
Instead
Find out which one it is. A crack or a cavity needs fixing. Acid wear and grinding usually start upstream, with what you sip all day, how you sleep and how stressed you are
Ignore my vitamin D
In old trials, kids given vitamin D had about half the cavities
Instead
Know your number, it’s a cheap blood test. Sun helps, so do oily fish and eggs from hens that actually get outside. If you’re low, fix it
Pull wisdom teeth that never bothered me
Wisdom teeth with no problems don’t need to come out just in case. UK guidelines told dentists to stop doing it routinely back in 2000
Instead
If they’re healthy and you can keep them clean, they stay. They come out when there’s pain, infection, decay or damage to the tooth next door
Pick a toothpaste because the box says whitening
Most whitening pastes just scrub off surface stain with grit. They can’t change the actual color of your teeth
Instead
Pick one for your enamel, not for the word on the box (lower grit is easier on it). Want a different shade? That’s a whitening treatment, not a toothpaste
Eat anything after my night brush
Your spit nearly shuts off while you sleep. Whatever you eat after brushing sits on your teeth all night with almost nothing to clear it
Instead
Make the night brush the last thing. Water after that is fine. And if you wake up with a dry mouth, find out whether you’re breathing through it at night
Skip a cavity because it’s just a baby tooth
Back baby teeth stay until about 10 to 12. A cavity there can still hurt, get infected and mess with the adult tooth growing underneath
Instead
Get it treated, then look at why it happened. Kids’ cavities follow how often sugar shows up (juice in a sippy cup, snacks all day), and fixing that now protects the adult teeth coming in
That’s all 9.
There’s more where this came from on Instagram, @theNOBSdentist
Sources
No. 2: Kapil V, et al. Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radical Biology and Medicine. 2013;55:93-100. Read it
No. 5: Hujoel PP. Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. Nutrition Reviews. 2013;71(2):88-97. Read it
No. 6: National Institute for Clinical Excellence. Guidance on the extraction of wisdom teeth (TA1). March 2000. Read it
General information, not personal advice.