If you ignore your teeth, they’ll go away.

Working in an emergency department is interesting for many different reasons. One thing in particular I’ve noticed over the years is how oblivious some people are to their smiles—especially their teeth. We see it all: loose teeth, missing teeth, broken teeth, infected teeth, sensitive teeth, erupted wisdom teeth, gingivitis, bad breath, dental infections (especially abscesses), things stuck in the teeth, mouth cancer, yeast infections, rashes inside the mouth and other conditions. The mouth is the gateway to the body. Through it, you introduce many substances that can infect or otherwise damage you. Clinically, the appearance of your mouth, gums and teeth are often a direct statement about how well you care for the rest of your body.
You would think dental hygiene is an especially difficult proposition, but it’s actually quite simple. According to the American Dental Association (ADA), all you really need to commit to good dental hygiene is less than five minutes at a time, at least twice a day. Surely that’s not too much to ask of yourself for yourself, is it?
Let’s identify three sets of conditions you should be prepared to address with your activities. Each measure contains simple tips and habits you should employ to keep your smile making the right kind of introduction.
1. Prevention and self-maintenance

Brushing and flossing keep your gums and teeth healthy by removing plaque and food particles that can serve as a source for infection and tooth decay. Here are your essentials.

• Brush for two minutes at a time.
• Brush at least twice a day and preferably after each meal.
• Flossing is important. There are particles that collect under the gums and between the teeth that your toothbrush can’t reach.

Avoid the stainers. Tobacco products (e.g., cigarettes, chewing tobacco and cigars), excessive red wine and coffee contain a high quantity of very strong chemicals that stain and damage your teeth. Cranberry and grape juices also may stain teeth if consumed in excess. Besides cosmetic considerations, the staining isn’t the problem as much as fact that the chemicals causing the staining are also damaging your teeth and gums.
2. Prevention and professional maintenance

Do you have a dentist?

• Regular dental checkups are very important for the ongoing maintenance of your teeth and the early identification of dental problems—before excessively expensive and painful options are needed.
• Dental exams provide an opportunity for identification of several medical conditions and diseases whose symptoms can appear in the oral cavity (mouth).

3. Recognizing possible dental emergencies

It is simultaneously understandable and befuddling that patients go without dental care as long as they do. By the time they come to the ER, invariably, some of these symptoms have been present and were ignored. If you’re experiencing the following symptoms, you’d do well to see the dentist early, before you end up in the ER.

• Your teeth have become sensitive to hot or cold stimuli.
• Your gums are swollen and/or they bleed with brushing, flossing or eating.
• You have continually bad breath or bad taste in your mouth.
• You have difficulty chewing or swallowing.
• You have pain or swelling in your mouth, face or neck.
• You have spots or a sore that doesn’t look or feel right in your mouth and it isn’t going away.
• Your jaw sometimes pops or is painful when opening and closing, chewing or when you first wake up.
• You have an uneven bite.
• Your mouth is becoming unexplainably drier than normal.
• You have a medical condition such as diabetes, cardiovascular disease, eating disorder or are HIV positive with new dental problems.
• You are undergoing medical treatment such as radiation, chemotherapy or hormone replacement therapy with new dental problems.

Upcoming Straight, No Chaser posts will evaluate individual dental emergencies.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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