Fatal flaws in our jaws
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.
On this x-ray, no fractures can be seen but further investigation revealed an irreparable split