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The Skeleton King
Jul 16, 2011



So a week ago I was posting in a thread about Shmorky's ex-fiance and her horrible hell mouth and I was encouraged to start a thread here.

I am a student of dental hygiene, graduating and getting certified in 10 months. So far I have worked with over 30-40 patients with a very wide variety of dental health, and get new ones all the time. I won't be able to answer everything, as I am still going through the program yet but I have an extensive knowledge already and can answer most questions.

Also, if any other goons work in dental fields, feel free to answer questions. I don't know everything about teeth and greatly appreciate more dental goons helping to spread the knowledge!



So here's a couple of commonly asked questions I get:

Q: What is a dental hygienist?
A: Most people think of a dental hygienist as a nurse for a dental office. Most people are wrong and you shouldn't listen to them. A dental hygienist does about 95% of the work in a dental clinic, and will be the person working on you almost every time you go to a clinic. The hygienist does everything except for a tiny number of very specific things that legally only the dentist can do. In general, if the actual structure or placement of the tooth is not being altered then the hygienist is doing the work.

Things that I do in my college clinic: Take x-rays, examine and assess the condition of the patient's oral cavity (I'll get to the specifics of this part in a later post), screen the patient for any possible signs of cancer that manifest in the head or neck, clean the teeth (an extremely involved process, I'll get to the details later), administration of local anesthetics and nitrous oxide, sterilization of instruments and the work station, and take extremely detailed notes on everything.

Q: I read this article about fluoride and it says...
A: Listen here, buddy. Fluoride is good for you and the people who keep writing those articles are idiots and are hurting people by talking crap about things they don't understand. Fluoride is a naturally occurring mineral that the body cannot produce on its own. Fluoride bonds to the surface of the tooth and helps to remineralize the enamel that covers the crown of your tooth. Without it cavities will form far more easily.

I love fluoride and I will not hear any of you disrespect it.

Q: But I heard its turning the frogs gay!
A:

Q: What's wrong with my teeth?
A: STOP! I cannot legally give you advice or diagnosis. Not only am I a student at the moment, but even if I was licensed right now I could not legally give advise or diagnose anyone who is not my patient.


Lastly, be patient when waiting for me to answer questions. I am lazy and will often take a while to even see your post so don't expect too much of me. I will try to answer within a couple of days but no promises.

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The Skeleton King
Jul 16, 2011



Reserved for more information about dental hygiene as I get around to posting it.

The Skeleton King
Jul 16, 2011



Also here is the post that I made that got this thread requested, slightly edited for more accuracy. This one is about the mouth of Shmorky's gross ex-fiance. Everything in brackets was added later for accuracy:


The Skeleton King posted:

As a hygienist I can tell you what I see wrong in her mouth just by looking at the picture in the OP. This will get detailed, so take a seat.

First thing I see, heavy grayish-brown staining on her anterior teeth. Cause is likely drugs, I'm betting on tobacco but I can only imagine what else has been going on in there. [There can be other, less serious causes, but knowing what I know about her, I suspect drugs.] [The staining is] not a big problem in itself, but the staining suggests that there will be problems under the gingiva (the gums). There's something fucky going on with her molars but without a better view I can't identify it.

It's obvious she isn't brushing or flossing. I won't even bother going over that.

She has some significant crowding in her mouth. [Crowding is usually not a serious problem and is common, but can contribute to problems in more serious cases]. Notice how some teeth are pushed in front of other teeth. This poor alignment is likely the only thing that isn't her fault and can't be fixed without orthodontic intervention.

She seems to have all of her anteriors, which means that if she's lost teeth [she claims to have lost three as of the time of this picture], it'll be the posteriors (molars, premolars).

Her gums fill the spaces between the teeth the way they should [which is good], but that doesn't mean they're healthy. Chances are that her gums do not appear inflamed due to the use of tobacco (which hides the more obvious signs of inflammation). Going by how pale they are (though this may just be the lighting) and the poor condition of her visible teeth, I'd bet that shes got plenty of trouble going on under those gums.

You probably all want to know what's going on with that one tooth, you know the one. I have no loving clue what the hell she did that one. Either that tooth is not fully erupted, has been hit with some serious trauma, or it's been ground down or dissolved somehow. It might even be a baby tooth that never came out. I can't say for sure.

I guarantee that she's lost some of her alveolar bone [the part of your jaw bones that holds your teeth in place]. If teeth are coming out and she can't chew food effectively like she says, then there is definitely bone loss [this happens during periodontal disease if untreated. The damage cannot be undone].

If bone loss is as bad as I think it is, then there's no way in hell she's getting implants to replace those teeth, because they'd fall right out.

Overall, her mouth is not doing well. The full extent of the damage can't be determined without a full clinical examination and x rays, however the initial impression is not good. If teeth are indeed already falling out, then I would bet that she is not going to keep the majority of her dentition. She should go to a free clinic (these are usually set up by the state for use by the homeless, disabled, or otherwise financially impaired, so she has no excuse for not at least trying to get help from one).

The Skeleton King fucked around with this message at Oct 12, 2017 around 22:10

Psychedelicatessen
Feb 17, 2012


For years I've been using the rubber brush toothpicks to floss, because I can't use thread on my molars without choking myself. An acquaintance recently told me that thread is much better, but refused to elaborate on why it's better.

Is there actually a "best" floss? Also what tooth is the One Tooth, because there's two-three candidates in that hosed up meth mouth.

The Skeleton King
Jul 16, 2011



Psychedelicatessen posted:

For years I've been using the rubber brush toothpicks to floss, because I can't use thread on my molars without choking myself. An acquaintance recently told me that thread is much better, but refused to elaborate on why it's better.

Is there actually a "best" floss? Also what tooth is the One Tooth, because there's two-three candidates in that hosed up meth mouth.

Good question. There isn't a best floss for everyone. Thread is the most universally effective, but if its difficult for you to use then there are alternatives that work. You can use interdental brushes (they're like pipe cleaners for teeth) or a floss holder, which is exactly what it sounds like (it's some kind of Y shaped thing that holds floss between the prongs).

Know that floss holders and floss picks are different. Floss picks have the floss built in and are generally inadequate for a really good flossing. Holders have you put the floss in it so you can use fresh floss throughout the flossing.

There's also water picks that are like tiny fir hoses that blast out the plaque under your gums.


Reaching molars is always tough if you're holding the floss with your fingers, especially if you have your wisdom teeth, so these alternatives might help.

Canine Blues Arooo
Jan 7, 2008

when you think about it...i'm the first girl you ever spent the night with


Grimey Drawer

My most recent new fidget is flossing. This is particularly funny given the thread title, but can you actually floss too much? Also, I have a really hard time flossing between my Wisdom teeth and the second molar. How do I not suck at that? Literally answered above this.

havent heard a peep
May 29, 2003

When Steve Jobs died it wasn't the first job I'd lost that week.


What is the fastest cost effective or next up in cost whitening solution?

I use floss picks to get matter out and it fits my needs. I also have a water pik that I haven't used yet.

I'm going in for a cleaning with floride on Monday and will see if I can get a copy of my rap sheet to share.

Kritzkrieg Kop
Nov 4, 2009


What's your opinion on when to actually get wisdom teeth taken out?

How often do you encounter breath so bad you want to retch?

The Skeleton King
Jul 16, 2011



Canine Blues Arooo posted:

My most recent new fidget is flossing. This is particularly funny given the thread title, but can you actually floss too much? Also, I have a really hard time flossing between my Wisdom teeth and the second molar. How do I not suck at that? Literally answered above this.
Its hard to quantify how much flossing is too much. There is such a thing since you would eventually fatigue the surface of the tooth and the gums. If you do it gently you could probably floss five times a day or more without any trouble. If you experience discomfort after flossing a lot you should probably dial it back just a little.

havent heard a peep posted:

What is the fastest cost effective or next up in cost whitening solution?
Fastest? No clue. There's so many different ways to whiten teeth that I cant remember which ones are better than others. I would ask your hygienist when you go there.

Kritzkrieg Kop posted:

What's your opinion on when to actually get wisdom teeth taken out?

How often do you encounter breath so bad you want to retch?
When to remove wisdom teeth is pretty straight forward to me; its whenever they are causing a problem. Most professionals have differing opinions on wisdom teeth, but there is no reason to do anything with them unless they are causing problems.


Bad breath isnt too often a problem. It takes some especially bad stuff to get to me. We sometimes give people a toothbrush and tell them to go brush if they have bad enough breath.

Also, please brush before going to a dental clinic. Its just rude to show up with bad breath.

The Skeleton King fucked around with this message at Oct 13, 2017 around 19:21

Hobologist
May 3, 2007


My dentist in California insists on cleaning my teeth with the metal spike herself. Is that something hygienists aren't allowed to do in every state or is she just being old and picky?

Lareine
Jul 22, 2007

she had tiny Italian boobs.
Well that's my story.


Last time I had work done, it involved getting an inferior alveolar nerve block done by the hygienist and um, it didn't go so well. On top of getting some "shock", the injections themselves REALLY REALLY loving HURT. I'm no stranger to dental procedures but this was perhaps the most painful I've ever had. I wept afterwards.

What I'm asking is, would it be considered offensive if next time I needed to be anesthetized, I ask for the doctor to do it instead?

Earwicker
Jan 6, 2003



The Skeleton King posted:

Q: I read this article about fluoride and it says...
A: Listen here, buddy. Fluoride is good for you and the people who keep writing those articles are idiots and are hurting people by talking crap about things they don't understand. Fluoride is a naturally occurring mineral that the body cannot produce on its own. Fluoride bonds to the surface of the tooth and helps to remineralize the enamel that covers the crown of your tooth. Without it cavities will form far more easily.

I love fluoride and I will not hear any of you disrespect it.

What is the source if this anti-flouride movement? Growing up in California all I remember is hearing that for some reason the city of Santa Cruz opposed water flouridation, but that was like 25 years ago and I don't remember the reason and just assumed it was typical Santa Cruz hippy poo poo. Is there some bigger movement pushing this mentality, what is their agenda?

symphoniccacophony
Mar 20, 2009


I'm a lazy rear end and I know that I should floss more, I've seen these water pick and air flossing machines out there that I think may making flossing less like a chore.

What's your opinion on these and if you have any recommendation on which to get?

SamDabbers
May 26, 2003

Oh my god...

Lipstick Apathy

https://www.youtube.com/watch?v=Qr2bSL5VQgM

Naerasa
Aug 5, 2004

Dislikes: Middle-class ideals


symphoniccacophony posted:

I'm a lazy rear end and I know that I should floss more, I've seen these water pick and air flossing machines out there that I think may making flossing less like a chore.

What's your opinion on these and if you have any recommendation on which to get?

I'm not the OP or a dentist but I got one of those water picks (some waterpik cordless variant) and it's changed my life. It's so nice to be able to blast out all the crap that settles in hard to floss places, and my teeth feel cleaner than they have in years.

The Skeleton King
Jul 16, 2011



Hobologist posted:

My dentist in California insists on cleaning my teeth with the metal spike herself. Is that something hygienists aren't allowed to do in every state or is she just being old and picky?

A metal spike? Like a sickle-scaler? Those are perfectly normal and used in all offices for removing calculus (the science word for hardened plaque) from the tooth surface above the gingival margin (where the tooth passes beneath the gumline).

Lareine posted:

Last time I had work done, it involved getting an inferior alveolar nerve block done by the hygienist and um, it didn't go so well. On top of getting some "shock", the injections themselves REALLY REALLY loving HURT. I'm no stranger to dental procedures but this was perhaps the most painful I've ever had. I wept afterwards.

What I'm asking is, would it be considered offensive if next time I needed to be anesthetized, I ask for the doctor to do it instead?

I don't think its offensive, though the person you are asking might. They must have really messed it up for it to hurt so bad.

Also, here's a secret: a lot of dentists are more poorly trained in local anesthesia than the hygienists. Sadly most programs for both hygiene and dentistry don't put much priority on anesthesia. I'm lucky that the program I am in is putting a lot more time into practicing anesthesia than most.

The Inferior Alveolar nerve block is a bitch of a block to do, by the way. Most people mess up on those once in a while simply because they are so easy to mess up due to anatomy making it tough. You will have a hard time finding anyone in the field who doesn't mess those up once in a while.

Earwicker posted:

What is the source if this anti-flouride movement? Growing up in California all I remember is hearing that for some reason the city of Santa Cruz opposed water flouridation, but that was like 25 years ago and I don't remember the reason and just assumed it was typical Santa Cruz hippy poo poo. Is there some bigger movement pushing this mentality, what is their agenda?
I have no clue, but it is very annoying.

PT6A
Jan 5, 2006
I'm white as fuck, let me tell you how names are pronounced.

Yours is pronounced "Toby"


Lareine posted:

Last time I had work done, it involved getting an inferior alveolar nerve block done by the hygienist and um, it didn't go so well. On top of getting some "shock", the injections themselves REALLY REALLY loving HURT. I'm no stranger to dental procedures but this was perhaps the most painful I've ever had. I wept afterwards.

What I'm asking is, would it be considered offensive if next time I needed to be anesthetized, I ask for the doctor to do it instead?

If you're nervous about it in the future, get nitrous oxide. It's wonderful and it wears off quickly, so it's not like sedation dentistry which is expensive and you'll be out of it for a day or so. I request it for any work when freezing takes place, because although I'm not overly anxious, I figure why the hell not make it a little bit more enjoyable for myself?

Anne Whateley
Feb 11, 2007


Why are floss picks inadequate compared to other kinds of floss?

What's the best (most effective, least barfy) way to get the crap off the back of your tongue?

batmansdrawers
Jan 1, 2006

Y-Y-Y-Yoda

The Skeleton King posted:

There's also water picks that are like tiny fir hoses that blast out the plaque under your gums.

I still can't decide if buying a water pick is good or not? I thought about it, but upon research get "Dentists say water picks are a waste of money" thrown in with "Dentists love water picks!"

So, as a studying professional, what is the verdict?

Eric the Mauve
May 8, 2012

Making you happy for a buck since 199X


FWIW last month my dentist said "they're slightly better than nothing if you absolutely can't or won't floss your molars, but if you don't actually floss your molars then I'll be making money off you for years to come and water picks won't change that."

Youth Decay
Aug 17, 2015


Eric the Mauve posted:

FWIW last month my dentist said "they're slightly better than nothing if you absolutely can't or won't floss your molars, but if you don't actually floss your molars then I'll be making money off you for years to come and water picks won't change that."

Ugh, I really need to use a water pick because I have a small mouth and somewhat crowded teeth and can never really get into between my back molars and especially my wisdom teeth (still got all 4 of 'em). And of course as a result of lovely dental hygiene flossing is quite painful and often results in bleeding so the water pick at least feels like I'm not torturing my mouth.

I have been avoiding the dentist for 2 years now and finally set up an appointment and I'm terrified of what I'm going to find. My teeth don't hurt (unless I'm flossing them) and they look nowhere close to the Hellmouth above but my gums are definitely in trouble.

uvar
Jul 25, 2011


Here's a mundane, vague question - I use an electric toothbrush with three modes that seem like the same movement at low/medium/high intensity. Is there any downside to just using the highest setting all the time, since that presumably gives the most vigorous brushing? It's not like I'm ripping my gums open every time.

Slightly less mundane - where do extracted teeth end up?

Great, now I've thought about dentists too much and I'm paranoid about cavities.

Caufman
May 7, 2007



Related to the odor question: Could you tell if I went into the clinic that I just performed oral sex?

Scudworth
Jan 1, 2005

When life gives you lemons, you clone those lemons, and make super lemons.


Dinosaur Gum

Earwicker posted:

What is the source if this anti-flouride movement?

There's 3 main mindsets against this, it's a perfect storm.
It started in the cold war as fear of a communist plot (seriously, the Dr Strangelove clip) and government mind control device. This persists.

Then there's the libertarian view of "the GOVERNMENT can't force me to drink MEDICINE"

Then there's the god drat "toxins" neo-health idiot view. It's all these groups together.


https://en.wikipedia.org/wiki/Water...ion_controversy

Eric the Mauve
May 8, 2012

Making you happy for a buck since 199X


Scudworth posted:

There's 3 main mindsets against this, it's a perfect storm.
It started in the cold war as fear of a communist plot (seriously, the Dr Strangelove clip) and government mind control device. This persists.

Then there's the libertarian view of "the GOVERNMENT can't force me to drink MEDICINE"

Then there's the god drat "toxins" neo-health idiot view. It's all these groups together.


https://en.wikipedia.org/wiki/Water...ion_controversy

These groups comprise approximately 1%, 4% and 95%, respectively, of the anti-fluoride movement in the US. Mostly it's a weird alliance of Green Party supervegans and Christian private school/homeschool moms.

Jiminy Christmas! Shoes!
Nov 6, 2002



How do you respond to studies that suggest flossing actually does nothing?

https://apnews.com/f7e66079d9ba4b4985d7af350619a9e3


quote:

National Institutes of Health dentist Tim Iafolla acknowledged that if the highest standards of science were applied in keeping with the flossing reviews of the past decade, “then it would be appropriate to drop the floss guidelines.”

The Skeleton King
Jul 16, 2011



batmansdrawers posted:

I still can't decide if buying a water pick is good or not? I thought about it, but upon research get "Dentists say water picks are a waste of money" thrown in with "Dentists love water picks!"

So, as a studying professional, what is the verdict?

They are drat good. You don't NEED to get one, as standard dental floss will do the job adequately, but water picks are really drat good.

Burt Sexual
Jan 26, 2006

I AM SO SICK OF EVERY SINGLE WOMAN ON THIS PLANET AND THEIR UNFAIR ROLES EXCEPT FOR AIDA CUEVAS, MY RANCHERA PRINCESS. WOMEN ARE YUCKY (EXCEPT FOR AIDA)!


Jiminy Christmas! Shoes! posted:

How do you respond to studies that suggest flossing actually does nothing?

https://apnews.com/f7e66079d9ba4b4985d7af350619a9e3

Yeah I was in that Shmorkey thread saying floss and someone posted this. The way it reads is that there isn't any good/high volume studies done, not that it doesn't work at all.

SamDabbers
May 26, 2003

Oh my god...

Lipstick Apathy

The Skeleton King posted:

They are drat good. You don't NEED to get one, as standard dental floss will do the job adequately, but water picks are really drat good.

I add a small amount of mouthwash to the tank before power-washing between my teeth. It makes my gums feel extra fresh.

Burt Sexual
Jan 26, 2006

I AM SO SICK OF EVERY SINGLE WOMAN ON THIS PLANET AND THEIR UNFAIR ROLES EXCEPT FOR AIDA CUEVAS, MY RANCHERA PRINCESS. WOMEN ARE YUCKY (EXCEPT FOR AIDA)!


SamDabbers posted:

I add a small amount of mouthwash to the tank before power-washing between my teeth. It makes my gums feel extra fresh.

use ACT to get extra bonus govt levels of flouride

The Skeleton King
Jul 16, 2011



Burt Sexual posted:

Yeah I was in that Shmorkey thread saying floss and someone posted this. The way it reads is that there isn't any good/high volume studies done, not that it doesn't work at all.

Agreed. I can tell when a patient doesn't floss for long periods of time. Calculus builds if it is not disrupted, and flossing is how you disrupt it. A toothbrush cannot reach those critical areas between the teeth the way floss can.

Beethovens Fist Symphony
Oct 21, 2008


uvar posted:

Slightly less mundane - where do extracted teeth end up?

I got my four wisdom teeth pulled last year and they let me keep em

Earwicker
Jan 6, 2003



a while ago I switched from traditional floss to those little y-shaped floss pic things. I find them much easier to use. any reason thats a bad idea?

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Lareine
Jul 22, 2007

she had tiny Italian boobs.
Well that's my story.


Jiminy Christmas! Shoes! posted:

How do you respond to studies that suggest flossing actually does nothing?

Yeah, that's bullshit. I know because I can tell you what happens when you DON'T floss. You get cavities between your loving teeth and they sometimes even need to drill through healthy tooth to reach the cavity properly. It loving sucks.

I mean, what... they gonna argue that leaving food between your teeth to rot doesn't actually cause problems?

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