I am a dentist. Ask me whatever the hell you want.

Why wait till our mouths are full to start a conversation?

Yeah...sorry about that. I try to make small talk to lighten the mood and then oh right...you can't really answer. Sorry about that.

I hate this! I don't typically use novocaine, so I'm doing my best to zone out so I don't feel the pain, and you're trying to make me talk. :P

You're hardcore! My brother does that, he refuses to get numb for anything. I think he's insane.

I talk to people while I'm working, usually to explain what I'm doing. I'm not good enough at multitasking to carry on an actual conversation while drilling something to within fractions of a millimeter, upside down, covered in water.

Why does poking gums feel so good? And how do I quit it?

That...is something that I haven't heard before.

My habit is strange. It started when I flossed. I was flossing and hit a sweet spot. It was painful, but at the same time, it felt really good. Sooner or later, I started poking that same spot on my gum over and over and it became a habit. I know it will soon damage my gums, but I can't stop it at all. I tried quitting, but I kept coming back to poking it after a week max.

That is a strange habit. Try aversion therapy: Do something you really really hate when you're poking your gums, it may help to break the habit.

Does new jersey smell bad?

No. Fuck you. Next question.

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I don't hate you.

WRONG I live in NJ also and IT DOES SMELL. Especially right by exit 9 New Brunswick on the Turnpike. Some gnarly horse manure smell.

SO FUCK YOU

I live in Montclair and it smells like pine trees.

And yeah, Bayonne smells like a porta potty.

I'm officially doing this AMA from a bar now. Yay smartphones!

When I have to get a novocaine shot, my dentist shakes my mouth as the needle goes in. Is this actually a thing or is it just his way of messing with me?

It's an actual thing, it distracts you from the needle a little. Some people LOSE THEIR SHIT at the prospect of getting an injection.

I broke my front tooth, like in half. I'm overly terrified of the dentist so I've been putting it off and looking like a meth addict since Christmas. Is this fixable, or am I in for a world of pain?

Goddamn near everything is fixable. DON'T put it off too long, or it will end up being non-restorable. I can't tell without seeing it, but it either needs bonding (being built back up with the white, tooth-colored filling material) or a crown (which covers the whole tooth.) It may need a root canal. Don't worry! If it's not infected, if it doesn't hurt beforehand, then root canals aren't that bad. They're just really annoying and tedious.

Will insurance cover a decent amount of this, or is it going to cost me dearly?

Depends on your insurance. Usually they'll pay half of it. The sooner you go, the easier it will be to fix.

Can you let me use some nitrous oxide?

Yeah no...jail doesn't seem like it would be fun.

How often do people ask you if they can? Also, have you ever tried it, for recreational use?

Not very often, actually. I've only had it a couple times when I was in dental school, and I really didn't enjoy it.

Am I brushing my teeth right?

Maybe?

Why is dental work so expensive? I got a cavity filled and it was like $300 for 20 minutes of work. (serious question)

Dental school is insanely expensive. I pay upwards of 3k a month in loans alone.

Also, the dentist has to pay the assistant who's helping you. He also has to pay the office's rent, the power bill for the office, pay the receptionists, pay the water bill. Probably had to get a loan to install the chair so you're not using equipment from 1974. And then you have to pay for the actual filling material itself.

How much does the actual filling material cost? It is one of the white ones. I'm just curious what the markup is on materials. He billed my insurance company $120 for the amalgam.

The white comes in a little tube that's good for one, maybe two teeth, and costs upwards of $20. Amalgam is cheaper.

It's not so much markup of the material as it is a combination of a shitload of small costs that go into keeping the office running.

I just re-read your initial comment. $3K a month in student loans!?! That's insane. How much did it cost you to go to school, start to finish?

Also you said that you made $50K last year. I thought dentists were very highly paid? I know a guy that started working right out of school and his starting salary was $90K, and around here that is a HUGE salary.

I went to NYU, my loans total more than 250k. They ask me for donations and I laugh because I already bought them a Lamborghini.

Last year I worked in a different office, where I was paid a percentage of the work I did. This is a very common arrangement. However, it was a really small office, and I wasn't busy enough to actually make any money. Most dentists are well paid, I was just in a crappy situation.

Proof you're a dentist?

Verification is in op.

What's the most considerate thing a patient has done for you?

Somebody gave me a big gift card once. Another patient gave me ice cube trays that looked like dentures, those were pretty cool.

Have you ever had someone whose mouth was so nasty that you wanted to throw up in it while working on their teeth?

What is the most common bad thing people do that has a negative effect on their oral hygiene?

Do you ever get a whiff of bad breath while doing your work? How do you remain composed?

I haven't wanted to throw up...but yeah, some people are gross. Mostly people who smoke heavily. I swear, some people smoke an entire pack of cigarettes before coming in.

The most common thing? Probably drinking shitloads of soda/fruit juice/eating a ton of candy. I've seen a lot of teenagers with BIG cavities in every tooth because they're pounding Monster and Gatorade all day, on top of having crappy hygiene.

Sometimes, yeah. If someone's breath is REALLY bad, I breathe through my mouth. The mask helps but it doesn't always block everything.

Thanks for the replies, it has been an interesting AMA.

Can I make a suggestion? I used to go to a dentist that used a 'bite rest' while working on my teeth and it was awesome. Made the whole process easier because I didn't have to keep stretching my mouth out. My new dentist doesn't use it and I hate it. I'm actually switching back to my old dentist because of that one single thing.

You should use those, they make the whole procedure less uncomfortable.

Who knows how many people leave their dentists for dumb reasons like that and never just tell them (like me).

I use those sometimes, they indeed are awesome. Ask your dentist if he has it.

I don't use it routinely, because sometimes it's annoying to always be moving it in and out, but I'll use it if someone seems to be having trouble staying open. Most people say it's a huge help.

I keep asking you questions, I feel like I should send you my insurance info so you can bill them.

I drink a lot of soda. Probably the equivalent of 4 or 5 cans a day. I should stop, but it is my coffee.

I brush twice a day and floss every night. Anything else I can do (other than stop drinking it) to cut down on tooth decay?

Yeah...just stop drinking soda. At least switch to diet.

One can of non-diet soda has around 10 tablespoons of sugar. On top of that, the soda itself is ridiculously acidic.

I used to be the same way, I'd drink soda instead of coffee, but eventually I just manned up and started drinking coffee. Now I drink it practically black.

How come regular dental work is barely covered by insurance but getting teeth pulled is considered surgery and covered under medical plans.

Insurance companies are dicks. And, a lot of employers have been cutting their benefits because they don't want to pay for it. Some plans are awesome and pay for everything, but most employers don't want to shell out for it. Even though, if they did, it would save money in the long run because more people would get preventative care.

1. What's the annual pay?

2. Did Finding Nemo inspire this job?

3. How many years of school did you have?

4. How many hours a day do you work?

1.Last year I made around 50k. However I had a particularly shitty year and actually left the office I was working at because I wasn't busy enough to make any money.

1. No, although that guy is funny as hell.

2. 4 years college, 4 years dental school, 1 year residency (which for a dentist is optional)

3. Today I worked from 12 noon to 8-ish PM. Usually I work 8 hours and a half-day on Saturdays.

What's a rough estimate of your income per 8hrs?

$75 an hour before tax.

Seriously? What's the best tooth paste? Sensodyne?

As long as it has fluoride it's good. Sensodyne has added ingredients to help with sensitivity. I personally use Sensodyne Pronamel (because it was on sale) and Arm and Hammer Sensitive (because they sent me a huge crate of like 300 mini tubes)

Also try to look for toothpaste that says it has ACP. It's a protein made from milk that has been shown to prevent cavities.

Can you die from bad oral hygiene?

Some people theorize that Nefertiti died from a periodontal abscess which sent into her sinuses and from there, into her brain.

So yes.

Mgghmmugh aagghmach aaaamunnghee?

I DID see Mad Men this week! Holy shit, I used to really like Harry.

You should have come to switzerland buddy. Dentists over here make about 11'000 USD a month and the education is (nearly) free.

And the landscape is mind-bogglingly beautiful!

so... I had a reeeeeally bad habit of not brushing my teeth when I was depressed. It was a huge chore, and I didn't bother. I really regret it now that I'm feeling better. My teeth are yellow, and they look very stale. What are the ways to whiten teeth? Is mixing Nitrogen Peroxide and Baking Soda together, then dipping toothpaste on toothbrush in it, and brushing for 10 minutes, doing that twice a week help? I got that tip from this video: youtube.com/#/watch?v=IjqXyvPC5pI

I'm desperately trying to whiten my teeth now, but I don't want to pay for whitening sessions on my dental clinic, as that costs a loooot of money.

That mixture seems pretty harsh. I'd say to try over the counter whitening strips first. They're not as strong as the in-office or the take-home-from-the-office ones, but they are a lot cheaper. Also get your teeth checked out, to make sure the staining isn't caused by decay, which has to get fixed.

Why are dentist that work only on adults so much more "I dont give a damn about that pain, but i will continue to rip the tooth out with pliers"?

I dont expect to be treated like im a kid but damn sometimes you guys are ruthless.

Some dentists are assholes. If I'm working on someone and it hurts, I don't hesitate to give them more anesthetic. I'd rather someone be numb as shit than in pain.

brush teeth, good?

Brush teeth, good. Floss teeth, better. Sugar bad.

Receding gums--brushing too hard or just the inevitability of aging? (I also read that collagen has been used to restore receded gums--have you seen this developed commercially?)

Brushing really hard can definitely cause recession, you can actually wear the gums away from the tooth. It's common but not necessarily inevatable, if you're able to stay away from periodontal disease, you can have minimal recession.

Gum grafts are done using connective tissue (which is basically collagen) from the roof of the mouth. It can't be done in all situations though, if there's a lot of recession, you'll end up with a big, flappy, loose piece of gum that traps food and just makes the situation worse.

Cleaning every 3 months. Your thoughts?

Some people do build up a whole ton of calculus and do need it.

I used to be a dentist myself. But then I built up a ton of calculus in my teeth and I am now a math teacher

Ha

Genetically, can you inherit teeth that are not susceptible to cavities and etc? Also what should I look for in picking a dentist office

You can, some people do a crappy job brushing but never have cavities, other people keep their teeth super-clean but still get problems.

I would say that the biggest thing to look for is that you feel comfortable with the doctor and everyone, and that they explain WHY they're doing what they're doing, not just "you need this, this, and this."

is flossing really THAT important?

Yeah. When you brush some crap still gets stuck between the teeth.

Did you always have clean teeth as a kid? Also when did you get interested in the field and why?

When I was a kid I probably had averagely-clean teeth. I never had any cavities until I was about 20, though.

When I was in high school I knew I either wanted to be an MD or a dentist, I always liked going to the dentist (Probably because I didn't have any cavities) and learned more about it and thought it was a really interesting field.

If my wisdom tooth isn't causing pain, but I still want it removed, would it most likely be considered elective and not covered by insurance? I'm sorry if this is worded poorly. Its a weird question, but I think you get the basic idea of what I mean.

It probably would be covered, but you may want to call your insurance just to make sure. An extraction is an extraction and most plans pay for it regardless, especially if it's a wisdom tooth.

HOWEVER if it's a surgical extraction, those cost more because they're harder to do, and the insurance would want proof that it's impacted or otherwise going to cause a problem.

What is your protocol if a kid just bites down on your finger as hard as they can, and there's no parent nearby?

OOOOOOWWWWWWWWWWWWWWWWWWWWWWWWWW WHAT THE HELL IS WRONG WITH YOU

Actually that's never happened. Thank God, I'd probably want to punch him in the face.

Two questions: (1)Is there any real difference between the different brands of toothpaste?(2) I read on another thread on Reddit that you shouldn't rinse out your mouth after brushing ?True or old Reddit wives tale?

1) Not really. As long as it has fluoride, it's good. The sensitive toothpastes also have extra ingredients to help with sensitivity.

2) It doesn't really matter, but if you're using the extra-fluoride prescription toothpaste, then you won't want to rinse afterwards so the fluoride gets a change to stick to the teeth a little more.

How medically Needed are braces? or are they all just aesthetics?

Depends on the individual case. For some people it's just a little bit of tweaking, but for a lot of patients they're necessary. Some people have teeth so crooked that they can't keep them clean because food gets all stuck in there, or they have teeth that get stuck partway erupted that will causes down the line.

What's the weirdest infection/thing you've found in someone's mouth?

Someone tried to floss with a rubber band for some reason. It broke, and she came in all freaked out that her teeth were ruined. She was fine, and I put in her chart "advised patient to not floss with a rubber band." Good times were had.

Why are metal fillings and crowns covered by insurance but not the ceramic/white ones? It seems like the ceramic/white ones are easier and look better.

Again, insurance companies are cheapskate dicks. White fillings usually have a higher fee than amalgam ones, and some insurance plans only pay for amalgam. If you want a white filling (Also a lot of offices only do white fillings nowadays) they make you pay the difference.

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Yeah, my brother says that all the time. Funny story, when I saw that in theaters, I was still in school, and about 1/4 of the room was full of other dental students. We all laughed our asses off at every dentist joke.

I remember reading that the conventional way of treating root canal problems is wrong: drill it out and then close down the tooth. The problem with that is that a perfect sterilization of the root canal is impossible because it is living tissue so some bacteria remain and can lead to infections down the road. They can also spread through the blood and cause heart problems, etc...

The suggested alternative I've read is as follows: drill down to the root and let it open, exposed to saliva and air. The root is living tissue so it will naturally create a layer of secondary dentin that will close up the root. After that you can fill the tooth again.

Comments?

EDIT: added a bit of info to clarify.

It is always possible that some bacteria can remain. As technology and techniques improve, root canals can become more and more predictable.

I've never heard of this technique before, but there are some problems with this technique just from thinking about it: First, secondary dentin forms slowly, and human saliva is full of bacteria. Leaving the pulp exposed would quickly get infected and make things worse. Also, leaving the pulp exposed would hurt like a son-of-a-bitch.

Usually you're doing a root canal because the pulp tissue has become necrotic, or is on the way to becoming necrotic, and wouldn't be forming any secondary dentin, anyway.

I had a small fracture in my tooth and it didn't hurt at all. My dentist did a filling and within days it hurt like hell and I had to get a root canal. What could have gone wrong and should I just leave a tooth cracked if that happens again?

It probably would have started to hurt after a while even if you had left it alone. When a filling is done, particularly if it is a big filling, it's always possible that the pulp (the soft, chewy center of the tooth where the blood vessels and nerves are) can get inflammed and need to be removed.

If you have a tooth crack, always get it, at the very least, looked at. It's possible that if it's just left alone for too long, it could get infected and abscess, which sucks.

What do you think of fluoride?

It's awesome. Yes it's possible to overdo it, but that's actually really hard to do. You'd need to drink so much fluoridated water that the water itself would harm you before the fluoride would.

Do you work on children? Have you ever had to take out everyone tooth out of a patient due to cavities?

Yes, and yes. Most kids are fine, the ones who totally flip out and don't cooperate at all get referred to a pediatric dentist.

I've only had to completely remove someone's teeth a couple of times. Mostly it's been because of gum disease rather than cavities, though. Periodontal disease is an infection within the gums which, when left untreated for a long time, destroys the bone around the teeth and can causes them to get loose. some patients have had teeth that just fell out on their own.

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Some people do. Usually though, people who keep baby teeth forever were missing the adult tooth that would replace it, so the baby one just stays. As long as it doesn't get a really bad cavity or anything, it works just as well as a permanent tooth.

HOWEVER. Baby teeth that DO have a corresponding adult tooth, that get stuck, can cause damage to the permanent tooth. So yeah, if there were baby teeth that decided to be jerks and stick around, it was good to get them removed.

Why on earth would you become something like that?

I always knew I wanted to go into a medical field, and over time I realized that nowadays being a physician kind of sucks. I always liked going to the dentist when I was a kid (I'll be honest, I didn't have any cavities until my 20s so the visits were pretty easy) and I thought it was really interesting.

Why does physician suck?

Being on call insane hours, insurance companies are jerks, doing residency for 3+ years after school, incredible stress, fun stuff like that.

Also I don't think I could ever tell someone they were going to die. I already don't like telling someone their tooth has to come out.

I am starting dental school in the Fall (University of Nebraska). Any advice?

It's going to be hard, don't get discouraged. Don't forget to relax sometimes.

If you feel like you're in over your head, don't worry, everyone feels that way.

I have two or three wisdom teeth that, as best I can tell, are erupted and mesially impacting their neighbors. I can feel sharp edges on the wisdom teeth with my tongue, etc. it seems like the wisdom teeth are losing the fight, as they seem to be breaking down, and I'm pretty sure little pieces of them have broken off (they looked toothy, and smelled like FUCK). They don't cause me pain, except every sixth months or so, when FUCK, they hurt like they're jamming everything together, but topical anesthetic and Goody's make it manageable.

How fucked am I, and can you possibly tell me what I want to hear, which is 'you're fine motherfucker, definitely don't need to go to the dentist.'

Yeah, you definitely have to go to the dentist. It sounds like you're on the way to a pretty nasty infection.

Why are crowns considered "cosmetic" but root canals are not, yet ot is mandatory to get a crown put on after a root canal?

Some insurance plans don't like to pay for anything. On a posterior tooth (premolar or molar) yes, a crown is nearly always needed because the chewing forces are higher back there. A tooth that's had a root canal is more likely to break when chewing if it doesn't get a crown.

Front teeth aren't so critical to get a crown, as they don't encounter as much force when you eat. As long as the cavity isn't very wide, and most of the natural tooth structure is remaining, a front tooth can be okay without a crown. It may get discolored, though.

I only brush my teeth at night, and sometimes at morning to get a better breath, is it really necessary to brush it at least 3 times a day and always after eating? I think in the teeth as a rock, if you brush it too much, everyday, won't it will get weaker due the constant friction everyday? As you brush it, you will "waste" a very small part of your teeth everyday, and they don't regenerate right?

If you brush really gently, you won't wear them away. If you're not brushing, though, you'll have bacteria constantly producing acid which will eat away at the teeth much faster than the friction from brushing.

Teeth are very hard, you can wear the gums away and then expose the root, which is softer, to wear. Just don't jam the brush up against the teeth super hard and you'll be good.

When you give us those glasses to protect from that light and other flying objects, can you see through them? Sometimes I stare at my dentists face

Yeah, but I'm usually so focused on the teeth that I don't notice patients' eyes while I'm working.

Mad respect for answering every question here, great AMA!

Thanks!

I've heard of military k9's having titanium implants. Is this true and is it really made of titanium? Do humans get that done?

I've heard of that too, but as far as army dogs, I think it's just a rumor that sounds really bad ass.

They do titanium implants for humans. My brother actually has one for one of his two front teeth. The whole thing isn't titanium, though. There's a titanium implant that goes into the bone like the root of the tooth. Then the actual crown part, the part you see and chew with, is made out of porcelain.

They're used to replace teeth that are already missing, they're not done as an enhancement.

Also, what's a good way to get a kid to take himself to the dentist for a checkup? Do you know of any successful strategies? People can play on their daughter's vanity, but for boys it's sometimes a little harder to find a motivator.

Look up pictures of cavities. Try to scare the crap out of him.

Honestly though, teenagers are the worst patients. They don't want to be there so they give you a hard time, which just means they have to be there longer because they won't open and I can't goddamn see what I'm doing. Sometimes I see kids who barely brush at all, and actually hope they have a cavity so maybe, just maybe, they'll actually try to keep them clean in the future.

As I mentioned in a comment, I don't typically get novocaine or any kind of painkiller/numbing. People always think I am crazy for voluntarily being able to feel my teeth being drilled. Is this really that uncommon? I can't be the only one.

When you get a cavity fixed without anesthesia, does it hurt? Some people have a really high tolerance for pain, some people just hate being numb. It's not very common but I've had a few people ask for it. I'm usually extra-double-super-gentle then because I don't want to hurt them.

And I thought we were supposed to be asking the questions. :P

For me, its a combination of both of those. While I do have a high pain tolerance, it still does hurt if I get distracted or focus on it. But I hate being numb because I usually do something dumb like chew on my cheek or tongue, which hurts when I can feel it again.

The biggest thing is telling yourself pain is not real. It is just an electronic signal sent from a nerve to be interpreted by your brain as what we perceive as pain. It is literally all in your mind. With this, you can overpower it. Basically, I mentally block the pain through what I can best describe as meditation. I am completely zoned out when the dentist gets to me. I'm on a beach in Mexico sipping on a Corona and watching beautiful women. The less the dentist talks to me, the more I can focus on not being in pain. When I do this, I feel maybe half of the actual pain. Probably less. To me, this is much more preferrable than being numb.

If you can just mentally block it, that's bad ass. Whatever works for you. Some patients have a panic attack and cry at the thought of getting a needle...and then don't even realize that I already gave them it.

Other patients get numb as hell, and then still freak out because they EXPECT it to hurt, even though they're not actually feeling anything.

I'm a dental hygiene student and although I'm happy with my decision to go into this instead of dental assisting, it still is a bit discouraging to see so many more D.A. job postings on craigslist versus D.H. jobs. What are your thoughts on assistants versus hygienists? Have you phased out the number of hygienists you have employed and replaced them with assistants? Any other advice you have for me? Thanks!

The two offices I work in both have multiple hygenists, and one of them just actually hired a couple more. Hygienists are great, we haven't phased out the position at all.

Stick with it, it's great that you enjoy it. There's always a market for DH jobs, ask your faculty if they know of any job openings, I don't know if I would trust craigslist.

What do you think about that guy that had a guava seed in his cavity? Gross? Or seen gross-er?

OH MAN I FORGOT ABOUT THAT GUY!

That's pretty gross, I've seen some gross shit though. One lady had a cavity and as I'm cleaning it out, the tooth is almost liquidy inside. Normally tooth decay feels almost like you're poking the sole of a shoe. This was cream of wheat. Bugh.

2 questions: 1: I have shit genes for teeth and already have sensitive spots on a few of my back teeth, how annoying is it when patients ask you not to scrape certain teeth because of sensitive spots? is detrimental to the patient to avoid those spots?

2: do you ever feel bad when you have a patient who is obviously uncomfortable? I'm a fucking pussy at the dentist (my first experience was freakishly bad. like emergency surgery and 14 needles split between my palette and right about my 2 front teeth). I feel guilty about hating going so much cause my dentist is a great guy and honest, but I spend the whole time blatantly fighting the want to squirm. do you hate those patients?

If you skip a few spots during cleaning, then you're not getting the plaque and stuff out, and those areas can become cavities. I know it sucks but try to bear with it.

I hate it when people are obviously in pain. I try to make people comfortable but I also know that sometimes, it's impossible. The injections in the palate and around the front teeth ALWAYS suck, it's almost impossible to do those without squirming. I know that some people are just really skittish so I try to work around it, and as long as they're trying to not actively get in the way it's fine.

one more question, sorry, there's no way a tooth can cave in, right? it's an irrational fear of mine, that when they do that stabbing/shake tool violently in molar, or they scrape the soft spots, then my tooth will fall in and pain will attack my face. (yes I am the most annoying patient ever, I panic breathed in a whole new tank of laughing gas when i got teeth pulled for braces and still didn't chill until he was like "okay it's all done". I'm sure I have ridiculous notes in my file)

The only way a tooth would break during a cleaning is if there's already a giganto-cavity in it beforehand. And you'd probably have a screaming toothache before you came in, so no worries.

What the hell's up with cankers? I have like three of them right now and I have no idea why/how to rid myself of them. (I realize this may not be in your wheelhouse but I always hear dentists know a bit about 'em).

It's one of those things that sucks and nobody's sure exactly where they come from. Sometimes it's stress, sometimes you bit your lip a little, sometimes your skin just wants to be mean. You can try rinsing out with warm salty water to keep it clean and basically you just have to wait.

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Personally I would go with invisalign or something similar over veneers for a really minor movement. Veneers require drilling (not much, but still) and I would rather not drill a perfectly good tooth.

What are your thoughts on the use of mouth tobacco? (Chew/dip not cigarettes)

Stay the hell away, it's even worse than cigarettes are. And cigarettes are terrible, too.

Hope its not too late. I recently started flossing every night to fight off my bad plaque forming habit. I was wondering if too much flossing can damage the gums? Can flossing replace brushing? And whats the worst case of plaque youve ever seen? I get it pretty bad some days, so i avoid dairy when i can.

Flossing too hard can hurt the gums just like brushing too hard. Don't go back and forth in like a sawing motion, just go up and down and wiggle a little. Flossing won'e replace brushing, the best is to do both.

The worst plaque I've seen is in some people who I think brush their teeth on a yearly basis. It looked like their teeth were covered in pancake batter.

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That really sucks, I'm sorry that happened to you. It's rare, but nerve damage is always a possibility. I was told to leave one of my wisdom teeth alone because the roots are right up against the nerve on that side. Luckily it hasn't even started to erupt yet, and I'm 28.

I'm not familiar with your case entirely, but unfortunately there are times where it's nearly impossible to not damage the nerve when extracting a 3rd molar, but it has to come out anyway (due to decay, or gum disease, or another reason.) It's possible to have no idea that the nerve was damaged until after the damage has been done.

I try to avoid doing impacted 3rd molars.

What does a dentist do to unwind at the weekend??

Scotch, PC gaming, and netflix.

How do dentist's recognize smoking? Besides the yellow teeth. At my last checkup my dentist point blank asked me if i smoked marijuana. I told him yes, he told me that smoke was not good for my teeth or gums. While I appreciated the information it was impressive how he knew that I used marijuana and not tobacco.

Probably by the smell. You can smell a cigarette smoker as soon as they walk into the room. And most people know what the ganja smells like.

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Sometimes things look OK, because the hygenist already cleaned all the crap out. There's been times where I say someone looks good, and then the hygienist says "yeah, not so much"

I went to one dentist, told me I needed a crown and a bunch of other dental work done. Being poor, I didn't do it.

6 months later, new insurance, new dentist. Got a new exam, he said I had 2 small cavities, and he filled them both. Said no crown was needed.

Was the first guy probably scamming me, or was the second just incompetent?

I didn't have any toothaches, and from the xrays the second doc showed me, the grey areas were really small, and in between my teeth.

The first guy may have been a little aggressive in looking for treatment, it's probably good that you went away, and it's REALLY good that the second dentist showed you what was going on.

I've always pitied people that had to have all their teeth removed and have dentures because of the false appearance and those incidents where they fall out uncontrollably. Have there been any advancements in dentures or is there a newer alternative?

I always think about that while I'm in the chair, but I never remember to ask...

Nowadays there are implants which can give you something that replaces all the teeth, and doesn't have to come in and out.

However they're expensive as hell. Like $30k. The best thing is still to not need to replace anything in the first place.

What pet peeves do you have with patients?

When people sit down and immediately say I HATE THE DENTIST!!! and then barely open, close constantly, push their chin down towards their chest making it hard to see, things like that.

I know it's not the most pleasant thing in the world, but if you just cooperate, you'll be in and out in half the time.

Also people who obviously don't take care of their teeth. Anything I do is going to fail, and then they're looking to blame me when all their fillings have to be redone because they're surrounded by decay again.

Do you take hits of nitrous oxide when no one is looking?

No. It makes me feel drunk, not a pleasant feeling at 8 AM. And I don't want to ruin anyone's shit.

I'm about so-so sure that I need my wisdom teeth removed. half of them are actually straight and half of them really aren't. I'm 26 and they haven't created pain. I would just get it done, but my insurance covers only 750 dollars annually and America, fuck yeah.

So is it something I should just bite the incredibly expensive bullet and get it done or can I get away with leaving them in? Is it something that will take an Xray to determine?

It's really hard to tell without actually examining you and having an x-ray. At the very least, if two of them are impacted and two of them are ok, take out the impacted ones. They can eventually cause damage to the teeth directly in front of them.

I had braces on to close a gap in my front teeth for a year. Got them off a year ago and now I wear a retainer to bed every night. (It's the clear kind, but still looks so gross after a year..) My dentist said he doesn't want to give me the permanent retainer because then I won't floss properly. What do you think would be better?

The permanently bonded ones work well, and don't have to come out, BUT they're a pain in the ass to keep clean. And it becomes really hard to get floss in there because the teeth are now stuck together. I know some orthodontists who almost never do the bonded retainers for that reason.

I have permanent retainers on the back of my front teeth and I concur, flossing is shit.

I've had some patients ask to have them taken out and replaced with removable ones for that reason.

Do you all really expect me to floss all the time? I understand on occasion, but they always nag me about it.

Personally I don't expect it, but it sure would be nice if everyone did.

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I don't know the whole story there, but if they really took out 21 teeth when they only told him they were extracting 3, then they should lose their license. That's really, really screwed up.