I'm male, 38, and very lucky to have good teeth. To be honest, I generally only get around to having a dental checkup every few years or so. Now, I know all the dental professionals here will be itching to tell me how important it is to have regular checkups, but I'm going to need some convincing... Every time I see a dentist they compliment me on my teeth, say they are very clean, but that I have a very large amount of tartar, which they then proceed to scrape off with various sharp implements. I have never had a filling in my life nor been told that I needed one. The last time I saw a dentist, though (about 4 years ago) he managed in his scraping frenzy to remove a small bit of enamel from one of my molars, which was quite sensitive for about a year or two afterwards. It's fine now (presumably with a nice healthy coating of tartar) and I don't have any problems with my teeth at all. This dentist also tried (fairly forcefully but unsuccessfully) to persuade me to have cosmetic dentistry (which I didn't need or want) for a "peg" incisor I have. So, I'm wondering - what do I actually gain from visiting (and paying) the dentist? Does this tartar (which is entirely invisible to me) actually do any harm, or might it even protect my teeth? I guess my main worry (and my usual incentive for checkups) is that I have heard that tartar buildup causes gum disease. I don't (or at least very rarely) get sore or bleeding gums, however. I have had another experience that has put me off dentistry. In my mid 20s, I was booked in by my dentist to have my wisdom teeth removed, which were causing me a bit of trouble at the time. I was all ready to have the operation when I learned that there was a small risk of nerve damage associated with it. Largely through irrational neurosis I decided not to go ahead, and in fact my wisdom teeth entirely sorted themselves out within a year or two. I'm so glad I didn't take my dentist's (strong) advice to have them out! So - yet again I now find myself thinking that it's been a long time since I saw a dentist, but with a competely trouble-free set of teeth that I am very reluctant to have someone meddle around with... (on the principle that if it ain't broke....) Persuade me otherwise??

Well, sounds like you have healthy gums and teeth but, what will it hurt to pay $200 (or less) once a year to get a full mouth x-ray and a full mouth cleaning? My friend was in the same mindset as you, perfect teeth, gums, no cavities etc... One day he goes in after 5 years of not going to a dentist and BAM, 2 cavities..

With that said, even though you may not have been to a dentist in 4 years and FEEL as if your teeth are trouble-free, they may not be.

Yeah, that's been my attitude before (i.e. why not get them cleaned / checked anyway) but then as I say, last time it actually seemed to do more harm than good... what if I asked the dentist to leave the tartar on the molar that caused trouble last time?

Well, I am no expert by any means but if the tartar is on the tooth and you leave it, I believe it may eat away at the enamel as well as go under your gums. That may be the reason part of the enamel came off.

Don't let the tarter accumulate, regardless if it is a little or a lot, I did that for a long time and now I am missing 3 molars, just fixed 1 cracked tooth and am in need of a root canal. I thought, as you did that I had good teeth as well so I never went to the dentist and next thing you know, BAM.

Anyways, what happened to your during your last cleaning is not a normal thing and I HIGHLY doubt it will happen again. I am envious of you for having such nice teeth but would never want you to be in the situation I am in now.. SOOO, with that said, cleaning and x-rays at least 1 time a year..:D Don't worry about the enamel coming off, worry when you need a $2500 root canal or a tooth extraction like me.:p

EDIT: When they scraped the tartar and the enamel came off, didn't you ask yourself why that happened? Because if your teeth are truly healthy, it should not have happened unless the dentist tried to chisel the tartar off.

Okay smoo, i am here to convince you. I, unlike you, went to the dentist every six months and had my teeth cleaned. My teeth were wonderful. I had fillings as a child (I am older than you so had no flouride growing up) but never had any more fillings as an adult. My teeth were straight and strong, or so i thought. I had the same dentist for 20 years who told me my teeth were great but I did accumulate more tartar than others so he had to scrape a lot away every 6 months.
Well, my dentist retired and the same week as he retired I got a pain in one tooth (I never had any tooth pain in my life before, no bleeding gums, nothing). Went to the new dentist and he told me i had advanced periodontal disease...he wanted to pull all my wisdom teeth to start right then and there. Well i did not let him but now 9 months and many dental consults later I have had multiple xrays, each showing much bone loss, have had 6 teeth pulled (4 of them wisdom) and may still need more pulled if they end up not being saved. My husband also discovered he has slight periodontal disease. He will not lose any teeth but did need a deep cleaning and may need some other work.
Bottom line, you cannot see what is going on below the gum line. Your teeth may be fine. Mine probably were at 38. I will never know how long it took for my bone loss under the gums to progress this much. And periodontal disease is a silent one. I looked at websites after i found out i had it. The pictures all showed teeth in horrible shape. Mine were and still are beautiful, straight and strong. But i have seen the xrays myself and have gone to several different specialists who all agree basically --the one i chose is willing to try to save as many teeth as possible. :You really need to care for your teeth before it is too late. The dentists who tried to sell you cosmetic surgery and all that other expensive stuff are probably not the right ones for you. Find someone who is conservative but knowledgeable. (my current dentist teaches at a graduate dental program at a well respected university). If i had had a dentist who did probing for pockets my disease would have been discovered years ago and i could have gotten away with just a deep cleaning, and follow up regular cleanings and periodic exrays. If you have no insurance, you can go to a clinic to get the xrays. Where I went they charged $88 for a full mouth xray. you do not need them everytime you go. And a cleaning varies in price from dentist to dentist. Ask around for someone recomended by a friend or coworker, someone who has the same goals you do.

Ok, I'm half convinced. I take the point that you can never be sure what is happening below the gumline, but from my quick research on the subject it seems as if you were pretty unlucky, and that having advanced gum disease without any symptoms at all (swollen or bleeding gums) is rather unusual. That said, I hadn't known what an unpredictable disease it was until I did some research. In particular, how it's possible to acquire it fairly suddenly by being exposed to certain types of bacteria. So yes, I can see the point in at least having a dentist check your teeth regularly.

I grew up in the UK, so I don't think I was exposed to flouride other than in toothpaste. I've just inherited a lucky set of genes toothwise, my father went through life with only a couple of cavities and no gum disease.

Still not 100% convinced about the need for over-zealous cleaning unless there is evidence of significant buildup below the gums, though. I heard (anecdotally) that it's possible to manage tartar buildup with good brushing, and that cleaning (i.e. scraping) too often can actually encourage faster tartar accumulation. I would be interested if any dentists could comment on this (it may be rubbish of course). If anything, I expect to have less tartar / potential gum problems this time around than the last time I saw a dentist, as I've had no gum problems whatsoever (last time I'd noticed slight redness / occasional bleeding when brushing immediately before seeing the dentist, which is what motivated me to go. Not that I had any gum disease or anything). I used to smoke a bit then too - I don't anymore.

Yes, I guess you're right, I should find a conservative dentist. The problem I have is that I'm always living somewhere different so I always have to find someone new, which is a big hassle as well as being a bit of a lottery....

LOL, half convinced. Tell us how getting a cleaning once a year hurts you? Also, you think 1 time a year is too often?, I go every 3 months and my gums are better.

And by the way, your enamel coming off and bleeding/red gums means you do NOT have healthy teeth and are stages of gingivitis so you do not have healthy teeth as you say which leads me to believe that:

1 . You are just too lazy to go to a dentist, or
2. You are too cheap and dont want to spend money, or
3. You are scared to go because they may find problems

There is no reason to NOT get a regular 15 minute cleaning once a year. So no more trying to convince you because it seems like you have other reasons for not wanting to go.

Peace :)

Seems to me that the cleaning can't hurt...I agree w/ the others. I know it's expensive and seemingly "overly" charged, but think of it this way: You could have a deep cavity and not even KNOW It...and when a cavaty gets very deep you end up needing a root canal. Mine was bad enough to feel pain but I had no idea the thing was even there, at the last molar in my mouth on the TOP I rarely chewed there and didn't "see" it in the mirror and I do inspect my teeth. However, there was a massive hole there, no pain w/ it, only the other areas I had cavaties in, that have been filled recently. I am glad I got to my root canal when I did though, as I may have been facing an abcessed tooth had I waited...that's a very painful condition.

We don't need to convince you, look at the tarter build up, that should convince you enough. With all that buildup, your breath must be really bad as well.

Just go!

Right... so much for reasoned discussion...

And by the way, your enamel coming off and bleeding/red gums means you do NOT have healthy teeth and are stages of gingivitis
I don't have bleeding/red gums. At all, in the slightest. They are pale pink and slightly stippled like they are supposed to be. I did notice a tiny bit of blood on my toothbrush for about 2 days immediately before seeing a dentist 5 years ago. It was probably just from a sharp bit of pizza crust.

The only time I have had any enamel coming off was when a dentist chipped it off. Now, it is possible that tartar build up was a factor, and it is possible that the dentist was careless, or that my particular type of enamel is more susceptible to scraping or whatever. That's one of the things I'm trying to find out. Given that this is the only trouble I've ever has with my teeth and that it was directly precipitated by a visit to the dentist, I hardly think it is unreasonable for me to ask questions.

Tell us how getting a cleaning once a year hurts you?
It probably doesn't, but it might, given my particular circimstances. Again, this is what I am trying to find out.

There is no reason to NOT get a regular 15 minute cleaning once a year.
Apart from the fact that it may (please note the qualifier) damage my enamel or encourage further tartar buildup.

leads me to believe that:

1 . You are just too lazy to go to a dentist, or
2. You are too cheap and dont want to spend money, or
3. You are scared to go because they may find problems

Well, it leads you to believe that because your premises are false. Your mild hostility leads me to believe that you may just be jealous of my good teeth, but I didn't consider it necessary to say that.

Whereas I generally accept that health care professionals know what they are talking about and take their advice, I also know that there are nearly always trade-offs with any form of treatment and that whatever is regarded as orthodox at any given time 1) may not be in 10 years time 2) may be the best course of action for the average person, but not necessarily for any given individual.

We don't need to convince you, look at the tarter build up, that should convince you enough. With all that buildup, your breath must be really bad as well.

Just go!

No tarar buildup visible to me, although I'm sure there must be a fair bit there. And no, my breath is fine, thank you very much, (first thing in the morning excepted!)

But doubtless I will go, at least for a checkup.

You definitely sound like you are one of the lucky few to never see the dentist and have virtually no problems. I'm kind of that way myself but I still go. I'm 32 and have NEVER had a cavity, but they did discover a deep pocket and bone loss around one of my teeth a few years ago (because I never flossed). When it's localized like that, the early stages of gum disease can EASILY go unrecognized and progress to moderate and advanced stages without your knowledge. Those stages are the silent ones. You still need to go to make sure problems don't develop. You should be getting a full mouth series of x-rays once every 3-5 years, bitewings once a year, and a full mouth perio chart once a year to cover your bases. That is the only way to know if your teeth and gums are truly healthy. As far as your incident during your last cleaning, while it's possible to remove some enamel during a cleaning, it would take a lot of effort on his part, unless your enamel was already compromised in some way. Also, tartar acts as insulation on the tooth, and once removed, the exposed tooth will feel much more sensitive to temperatures. Look, I know from personal experience that it's hard to go when you seemingly have no reason to. I've been told I have practically no tartar each time I go. But I just look at is as preventive maintenance on my mouth. I've been blessed with pretty good "dental genes", so I'm going to do my part to make sure I don't take for granted the good hand I've been dealt.

Yeah, fair enough. I'm out of the country at the moment but am going back home for a month in a few weeks time. I've asked someone to book me an appointment with their dentist.

As far as your incident during your last cleaning, while it's possible to remove some enamel during a cleaning, it would take a lot of effort on his part, unless your enamel was already compromised in some way. Also, tartar acts as insulation on the tooth, and once removed, the exposed tooth will feel much more sensitive to temperatures.
The missing enamel is right on the top of one of one of my molars, perhaps about 1/4 of the top surface. The problem is that when it's exposed, and I bite something hard in just the right place, it's quite sore. As I say though, it's been fine for the past 2 or 3 years since the tartar built up again. Am I right in thinking that the real danger with tartar is when it acumulates at or under the gumline? Is there any reason that the tartar couldn't be left on just the top of just this one tooth?

Is there any reason that the tartar couldn't be left on just the top of just this one tooth?

Eww. Tartar is calcified plaque. Plaque is a biofilm full of nasty bacteria. I guess you could brush your tartar daily and keep it as clean as possible, but seriously, they have very good materials these days that will take care of your problem a little better. It might be as simple as a composite filling at this point. Just do it. Tartar is nasty above or below the gumline.