Can That Dental Procedure Wait?

Technically, the recession is over. But dentists say that many people are still holding off on dental spending -- either by not going to the dentist at all or putting off the more expensive treatments. Even insurance holders (50 percent of Americans) typically pay more than half of the dental charges for anything other than cleanings and checkups, according to the latest data from Dental Market Research. That means many procedures are still expensive: A dental crown, for instance, generally costs patients approximately $450 out of pocket, even after a 50-percent reimbursement from their insurance carrier.

“Financially, it’s a hard world these days,” says Dr. Shehzad Sheikh, founder and director of Dominion Dental Care in Sterling, Va. “It’s not that people don’t want to get dental work done; it’s just that a little chip on a tooth that’s asymptomatic is a low priority. But it’s a mistake to defer the procedures you really need, because the problem could get worse and more painful -- and end up requiring more extensive and expensive treatment.” Here is a guide to help you figure out what can wait and what can’t.

A Filling (for a chipped filling or tooth)
Can it wait?
“If a filling has a chip in it but you don’t have a cavity, or if you have a chipped tooth without any symptoms, you might be able to wait a while for a new filling -- but only your dentist can tell for sure,” says Sheikh. Keep in mind that with a chipped tooth, bacteria are more likely to get stuck in the tooth’s crevice, which can lead to decay.

Regular Cleanings
Can it wait?
“You don’t want to miss those twice-a-year hygiene appointments, because small problems could get worse,” says Sheikh. “If your dentist catches something early, it can be a quick and easy fix.” Also keep in mind that fluoride treatments, which aren’t always covered by insurance, are worth the money because they help re-mineralize the teeth and protect them from decay.

Cosmetic Work
Can it wait?
If you want to bleach your teeth or get veneers to improve your smile, those procedures can wait because they’re not a necessity. Plus, they won’t make a difference to your long-term oral health.

Deep Cleanings
Can it wait?
“Sometimes you absolutely have to have scaling and root-cleaning done,” says Sheikh. But in some instances, you might be able to defer the procedure (which can cost more than $1,000 for the entire mouth) if you have regular cleanings every three months instead of every six. “That way, you may be able to get some semblance of control over the gum tissue,” says Sheikh.

A Root Canal
Can it wait?
“For a root canal, there aren’t any options: If you don’t do it now, you’ll end up losing the tooth. And if there’s infection, it could spread to other parts of your body,” explains Sheikh.

A Crown for a Serious Chip or Cavity
Can it wait?
“The longer you wait, the more prone you are to getting bacteria stuck around the tooth,” which can accelerate the rate of decay, Sheikh warns. In addition, if you need a crown to relieve pain (from a nerve that’s affected, for example), the pain could get worse and you could end up needing a root canal.

Ultimately, you’ll need to see your dentist to determine what can wait and what can’t. “If you come in for cleanings and X-rays, we can get a more realistic picture of what’s going on and can assess which procedures can wait,” says Sheikh. Ultimately, it’s a judgment call better made with your dentist’s advice.


Best Supplements for Strong Teeth

I’m 56, but my teeth and gums don’t look a day over 30. And it’s not just because I’m a dentist. Many people my age have gums that have receded, which means their gums have essentially pulled away from their teeth and created pockets where bacteria thrive. If the pockets grow large enough, teeth become loose.

To prevent this, do what I do: Brush, floss, eat right and take a couple of extra nutrients. Here, my four must-have supplements for strong teeth and healthy gums:

Every day, I chew a supplement that contains 60 milligrams of coenzyme Q10, or CoQ10, an antioxidant that helps maintain the soft tissues in your body -- including your gums. Some early research suggests that taking CoQ10 can even help shrink the pockets caused by gum disease.

My CoQ10 chewable supplement also contains calcium, a mineral found in your jawbone. If you don’t get enough calcium, your jaw weakens, loosening your teeth. Men and women between the ages of 19 and 49 need 1,000 milligrams of calcium daily, while those over 50, like me, require 1,200 milligrams. A cup of milk or yogurt packs about 300 milligrams, and an ounce of most cheeses has about 200 milligrams. You can find a cool calcium calculator at It’s designed for teens -- the group that has the highest calcium requirements -- but anyone can use it by inputting his or her age.

Vitamin D
To absorb calcium, your body needs vitamin D. According to the National Center for Health Statistics, one-third of Americans don’t get enough. I follow the Institute of Medicine’s recommendation and get at least 400 IU daily. Milk has about 100 IU per cup, and a 3-ounce serving of fattier fish, like salmon or mackerel, contains about 300 IU. If you don’t drink milk or eat fish, you could probably use a supplement of 400 IU daily.

Vitamin C
There’s one more super-important nutrient for your teeth: vitamin C. It’s a building block for collagen, which helps keep your teeth attached to your gums. A study in the Journal of Periodontology found that men and women who consumed fewer than 60 milligrams of vitamin C daily were 150 percent more likely to have gum disease than people who took in at least 180 milligrams. Fruit and veggies are the major sources of vitamin C (one orange alone has 60 milligrams). I get enough C in my diet, but if you don’t, consider taking a supplement.

Tip: Avoid Fizzy Supplements
Don’t buy the chewable vitamin C tablets or any kind of supplement that fizzes when you dissolve it in water. Chewable and fizzy vitamins lower the pH in your mouth and erode your tooth enamel. In fact, a recent study from the University of Helsinki found that fizzy supplements, including those that contain calcium, caused teeth to lose minerals. The worst offenders were the fizzy vitamin C supplements. They corroded the teeth so much that the layer below the enamel was exposed.

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