Fa­tal flaws in our jaws

The Jewish Chronicle - - JC SPECIAL - BY ANTHEA GER­RIE En­dodon­tics is the Cin­derella of den­tal prac­tice

IS YOUR mouth age­ing faster than you are? Teeth can be stealthy when it comes to wear and tear and the NHS is nowhere near as in­ter­ested in re­plac­ing our eat­ing tackle as it is in sort­ing out our worn-out hip and knee joints. Bel­size Park den­tist Dr Mervyn Druian of­fers an oral age as­sess­ment and was hor­ri­fied by my chipped teeth, one frac­tured (prob­a­bly by stress-in­duced clench­ing). As­sured, pre-mid­dle age, that I had “good” teeth, it never oc­curred to me I could lose any, or that frac­tured teeth breed in­fec­tion and bone loss.

Is there any hope for grinders, clenchers and chom­pers? En­dodon­tist Dr Ju­lian Web­ber, founder of the Sav­ing Teeth Aware­ness Cam­paign, cites root canal treat­ment as a road to sal­va­tion. But my NHS den­tist told me I would never find any­one will­ing to do com­plex root canal work in the health ser­vice: “We’re not paid enough to do it and it re­quires spe­cial ex­per­tise”.

En­dodon­tics is the Cin­derella of den- tal prac­tice. More com­plex than gen­eral den­tistry, with none of the glam­our of cos­metic work, it re­quires so­phis­ti­cated and ex­pen­sive equip­ment and long ap­point­ments. At Dr Web­ber’s surgery, I sought a rem­edy for pre­vi­ous root canal treat­ment, im­per­fectly ex­e­cuted by the NHS. Dr Web­ber’s su­pe­rior x-ray equip­ment showed that a sec­ond tooth, alas, was fa­tally split and it took just £65 for this to be con­firmed at nearby premises via cone beam to­mog­ra­phy, an ef­fec­tive, af­ford­able tool in which the NHS chooses not to in­vest for den­tal di­ag­no­sis.

Dr Web­ber then pro­duced the den­tal equiv­a­lent of a magic wand to de­liver lo­cal anaes­thetic pain­lessly, while a gi­ant screen showed the third tooth be­ing treated, hugely en­larged through a mi­cro­scope more pow­er­ful than the loupes (mag­ni­fy­ing glasses) com­monly used by den­tists. The mi­cro­scope iden­ti­fied that this mo­lar, too, was be­yond re­pair. Never can two peo­ple have been so dis­ap­pointed not to go ahead with a root canal. I had al­ready had the in­jec­tion, with all the drilling (feel­ing noth­ing — at least I can con­firm root canal is pain­less).

The moral is that as well as look­ing af­ter teeth so that they never be­come in­fected, pa­tients should con­sider in­vest­ing in en­dodon­tists with the best equip­ment, as it saves money as well as teeth in the end. The high cost of a crown to seal root canal work is worth it only if it has been prop­erly ex­e­cuted and will stand the test of time. Oth­er­wise bac­te­ria will get back into the canals and per­pet­u­ate an in­fec­tion.

Den­tal is­sues of this type are a par­tic­u­lar con­cern for any­one pre­scribed bis­pho­s­pho­nates to treat os­teo­poro­sis or in a chemo cock­tail. This drug raises the risk of os­teonecro­sis (death) of the jaw — rare but se­ri­ous. I’d give any­thing to have reached the en­dodon­tist at the stage where my cracked teeth might still have been saved by his skill.

root­treat­men­tuk.com, sav­ing­teeth.co.uk

On this x-ray, no frac­tures can be seen but fur­ther in­ves­ti­ga­tion re­vealed an ir­repara­ble split

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