DENTAL CARE

Jeffrey Gross, DDS, FAGD

Q: A:You Are Fortunate To Be Over The Age of 50 There are many reasons for the word fortunate to fit with a 50-year-old. First and foremost, we are alive. Nothing is as precious as life itself. We often need reminders of this, but if we take a moment to think about it and not focus on what is wrong, a smile should appear, and an appreciation for hitting that landmark and above will be evident. Often our children are grown, and the blessing of grandchildren comes to us. We can slow our lives a little bit, and financial pressures may ease up. I could go on as I am sure many of you could also add your thoughts. I want to share with you the context of the opening statement.

A lady came in for a routine cleaning and checkup. Upon examining her x-rays, a large cavity was present in her lower right tooth. The hole from the cavity extended down below the gum and deep into the tooth. I needed to act quickly before the tooth became so damaged that the only fix would be removal.

In my discussion with this person, I told her that the possibility of needing a root canal was high. The extent of the decay was very close to the center of the tooth where the nerve and other living tissue reside. If the decay reaches this tissue, then a root canal procedure comes into play. Anytime decay or fractures reach the center of the tooth, an infection will occur. A root canal procedure stops the infection and allows the tooth to remain in the mouth.

What does all of this have to do with the age of my patient? I will explain to you why age played a role in her treatment. When we first develop teeth as babies or children, the teeth form from a mass of living tissue. The cells in this tissue have one job. They lay down layers of hard material which form the final tooth as we see it. The layers of tooth develop much like a tree trunk thickens as it grows. Each area of the mouth grows the tooth that is appropriate for that spot. Chewing teeth form in the back of the mouth, and cutting teeth form in the front of the mouth.

After the final tooth forms, the living tissue, which is now in the center of the tooth, serves no further purpose for growth and development. Over time it shrinks and even disappears entirely. On a young person, the tissue is substantial. As we get older, sometimes we can’t find the tissue. On a young person, root canal procedures that deal with this living area of the tooth are easy to perform. On an older person, a root canal procedure may become an impossibility.

My patient had a large area of decay. If she had been younger, that degree of decay would necessitate a root canal procedure. That level of decomposition would have reached the nerve of the tooth. She did not need that procedure because the nerve and blood vessels in the center of the tooth shrunk away. The decay never reached them as shrinkage occurred.

A root canal procedure, despite its bad press, is not horrible. Most of my patients tell me that they could not believe how easy the process went. I often say that the best dentistry many times is the least dentistry. Her age allowed me to do less treatment to save her tooth. In this regard, she was fortunate. Our need for meticulous dental care does not go away as the decades pass by—the type of care changes. If you are overdue for your routine exam, call us to schedule that essential visit. You can reach us at 440.951.7856. I look forward to seeing you. Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine. The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com