What happens in the chair
Plaque that stays on the teeth hardens within days into tartar, a mineral crust that no toothbrush can remove. The hygienist scrapes it away above and just below the gumline, polishes the teeth, and measures the pockets between tooth and gum with a small probe. Depths of one to three millimeters are healthy, and readings of four or more are a warning. The dentist then checks each tooth, examines your tongue, cheeks and throat for signs of oral cancer, and reviews the X-rays. Bitewing X-rays are taken every one to three years according to your history of cavities.
The two diseases being headed off
A cavity caught early is a small filling and half an hour. Left alone, it reaches the nerve, and the repair becomes a root canal and a crown, at roughly ten times the price. Gingivitis, which shows as gums that bleed when you brush, reverses fully with cleaning and better habits. Untreated, it can progress to periodontitis, in which the bone that holds the teeth dissolves and does not return. The Centers for Disease Control and Prevention estimates that more than four in ten American adults over thirty have some degree of it, and most feel nothing until a tooth loosens.
The part you do at home
Brush twice a day for two full minutes with a soft brush and fluoride toothpaste, angled toward the gumline with light pressure. Clean between the teeth once a day with floss or small interdental brushes. Replace the brush or brush head every three to four months. Gums that bleed when you begin flossing need more flossing, and the bleeding normally stops within a week or two.
Paying for it
A typical dental plan pays in full for two exams and cleanings a year, about 80 percent of fillings and about 50 percent of crowns and other major work, up to an annual maximum that is often only one to two thousand dollars. Without coverage, ask for the cash price, ask whether the office sells a membership plan, and look into dental school clinics and community health centers, where supervised care costs far less. Ask for a written treatment plan with fees before major work, and seek a second opinion on anything costly.
Note A knocked-out adult tooth can often be saved. Hold it by the crown, rinse it briefly without scrubbing, push it back into the socket or carry it in milk, and reach a dentist within the hour. Facial swelling with fever or difficulty swallowing belongs in the emergency room.
