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rittapokie · 2 years

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Dentists refuse to treat me because my social anxiety makes my blood pressure go up when I leave the house and it’s EXTREMELY frustrating. I want to take care of my cavities, but I keep getting sent home for a problem I can’t solve. I’m already on blood pressure meds and it’s normal at home.

STUFF NOBODY EVER TOLD YOU ABOUT TEETH (and how to take care of them if you are poor and/or depressed)

Contrary to what the US health industry would have you believe, your teeth are NOT luxury face bones. You need them. Healthy teeth are a cornerstone of good health in general for a lot of reasons. You can’t eat well without them. You need them to speak. And tooth bias is real.

This makes me very sad because I love teeth. I am not a dentist. I’m a biological anthropologist whose expertise is oral disease and the evolutionary anatomy of teeth. My dad’s an oral surgeon and I worked in his office from the tender and illegal age of 8 to the ripe old age of 18, which is when I went to college. At 12, I was assisting with the disposal of biowaste, aka packaging up the teeth to send them to dental schools. I live, breathe, sleep, and occasionally eat teeth. I found a human incisor on my floor this morning and wasn’t even surprised. I study how teeth go bad partly so that I can help living people protect the teeth they’ve got. It’s my goal with this post to teach you about a couple of different types of procedures and oral injuries, as well as what you can do to help keep your teeth functional. So in this post, what I am going to do is outline a few common things that can go wrong with your teeth, how they happen, and how to catch them before they get bad. A lot of the advice in this post is for people who maybe can’t get to the dentist for a cleaning and checkup every six months. This post is also gonna be LONG AS HELL and there is going to be a separate post called “luxury face bone hacks for the busy/broke/b’mentally ill” or something like that, so like. If you don’t like super long posts, just hit this one with a like and actually read through that one.

First, let’s talk about dental anatomy.

What Are Teeth?

Teeth are extremely cool. They’re these amazing little packages of dentin pulp, protected by enamel, nestled into the jaw like truffles in a box of chocolates, held in place with a teeny tiny ligament. They’re gorgeous– enamel is a beautiful substance, translucent and opalescent. Teeth are also extremely weird when you think about them. You have these weird not-bone things emerging from holes in your jawbones. They’re snapped into place with a biological bunjy cord and you can actually SPRAIN THEM if you put too much pressure on them.

Here are some important things to know about teeth!

First, the nerves in your teeth were never meant to be exposed to the air. They only process stimulus one way: pain. This means that when you get a cavity or do anything else that exposes the nerve, it is going to hurt like a bitch.

Your teeth may come loose! Usually they stay put and go back to normal in a day or two. Don’t panic. This is usually the result of you spraining your dental ligament that holds the tooth in place.

Root canals suck but they can prevent dental abscesses. Dental abscesses can kill you. If they spread and get into your sinuses, they can cross the blood/brain barrier and you will die. This doesn’t happen much any more, but in rare cases… it can.

The phrase “like pulling teeth” is a misnomer. Pulling teeth is extremely easy if you know what you’re doing. Extractions are usually a very simple procedure. What’s complicated is things like root canals and setting up implants, which, in the case of implants is the literal opposite of pulling teeth.

Pregnancy will fuck up your teeth because a.) the fetus is leaching your vital essence and other nutrients and b.) your hormones are telling a lot of ligaments in your body to loosen up to get ready to give birth. Sometimes wires get crossed and other ligaments at non-mobile joints get the loosen up message, too. Just be sure to keep up your dental hygiene regimen during pregnancy and you’ll be fine.

Your gum tissue isn’t just weird wet skin. It’s a mucous membrane that protects the mouth. It can get diseased and inflamed, so pay attention to it! Also, there’s a lot of blood vessels so if you poke yourself with something, you’ll bleed like a stuck pig for a minute. The kind of bleeding you should be worried about is prolonged bleeding, where you see blood welling up around your teeth for no apparent reason.

Now that you’ve been equipped with some fun facts, lets talk about diseases and procedures.

Braces: if you’re reading this, you probably don’t need them

First: Pediatric orthodontia is largely a scam. People who put standard braces on their child before that child has lost all of their baby teeth are stupid and causing their child needless pain because those teeth are going to fall out anyways and the alignment of the adult teeth was decided long, long ago. The kids who NEED orthodontic intervention are kids with bad crossbites/underbites/overbites. This requires specialized headgear most of the time and is more intense than the standard braces because they are made to solve a much bigger problem. The standard bracket-and-wire braces? Don’t put those on a child. They won’t help. Also, your kid doesn’t have their third molars yet, and those are the molars most likely to come in twisted anyways.

As an adult, you may want braces for cosmetic reasons or for comfort reasons. This is a CHOICE that is YOURS TO MAKE. If your dentist suggests you need braces, ask why. You don’t have to get them. Now,If you have certain kinds of dental overlap- like, your lateral incisors have been pushed behind your frontals- then yeah, you should get braces. But is it the end of the world if you don’t get braces? No.

Wisdom tooth removal: you might not need it

The human jaw is in a state of evolutionary mismatch right now. Basically, our last molar, the third molar, doesn’t come in until we’re an adult. Unfortunately, thanks to ten thousand years of agriculture, give or take a few millennia, we have much more gracile jaws than our ancestors. There’s not always enough room for it. Now, this isn’t true for everyone, because no two skulls are identical and all, but sometimes there is a condition where you really should get those suckers out. If they are impacted, or coming in sideways, they can push your other teeth out of alignment and cause jaw issues down the line. If they come up straight, don’t worry about it.

Cavities: you need to get these taken care of

Cavities are a pain in the ass and are honestly the main reason you should go to the dentist for checkups, so that they can take the x-ray of your mouth and see how any potential trouble zones are progressing. You should call a dentist and seek help if you notice pain that persists over three days, as that’s an indicator of something more serious than just a sprain.

Tooth Grinding: this is a problem

If you grind your teeth, your dentist may recommend a night guard. Actually listen to them about this. Grinding your teeth can cause major jaw alignment problems that are a pain to fix, so just bite the silicone and suck it up. Also maybe talk to a therapist if you can, because grinding can be a result of stress/anxiety.

Whitening your teeth: bad idea

First off, your teeth ain’t supposed to be white. Enamel is not white. Enamel is translucent and pearlescent, so its actual color is very hard to pin down. Your teeth are naturally going to look more ivory-colored over time. That’s just part of being human and having teeth. Embrace it. You are a badass omnivore with thirty-two gorgeous enamel teeth. They weren’t put in your mouth to look pretty, they were put in your mouth to feed you.

Second: Whitening your teeth weakens your enamel. Once your enamel’s gone, it ain’t coming back, baby. There are some gentler whitening methods, like whitening toothpaste, but these are only going to give you about one to two shades worth of improvement. If you have extremely stained teeth and you want to whiten them, make sure you talk to your dentist about all the risks. Unfortunately, there is no truly safe and effective home-style (read: not a million gotdang dollars) remedy for whitening teeth.

There are a few that are kicking around, but seriously, some of them are dangerous. Do NOT rub wood ash on your teeth. That’s lye. Don’t put that in your mouth. Do NOT use actual bleach, hair dye developer, or non-dental peroxide gel. They are poisonous. DO NOT PUT ACETONE ON YOUR TEETH i have seen this exactly once and the person came into my dad’s office with chemical burns on their gums and lips. I do NOT want to see this again.

It is a misconception that brushing your teeth keeps them looking white. Brushing your teeth removes plaque and biofilm, but those buildups don’t actually stain the enamel itself. Instead, really the only way to keep your teeth looking light is to pay attention to what you’re putting in your mouth. If you’re a tobacco user, vape! Tar is a major staining agent. Coffee’s also a major stainer, and the big trick there is to put a little milk in it. See, enamel staining doesn’t come from the color of the food. It comes from chemical properties. Acidic foods stain because acid damages enamel. Food with high levels of tannins, like coffee or tea, stain because the tannins change the PH of the mouth. So what you should do to avoid staining is balance your mouth PH by eating something basic after eating something acidic. Add a lil milk to your coffee or tea to weaken its acidity just a bit. Swish with water afterwards to help clear the acid. Don’t eat lemons or any other acidic food after drinking coffee. Why would you want to eat lemons after drinking coffee, anyways? Seems like a weird flavor combo to me.

And while we’re on the subject…

MOUTH CHEMISTRY

What’s in your mouth? Your teeth, your gums, your tongue, your spit… yeah, your spit. Saliva’s important. It’s probably THE most important thing in protecting your teeth because salivary production constantly washes the teeth, clearing off as much bad bacteria as possible. If you have an issue with saliva production, you should drink as much water as you can throughout the day, and get a bottle of dry mouth tabs for nighttime. Or daytime, if they don’t bother you. This is really important because dry mouth is a major side effect for a lot of drugs, like anti-depressants. This is actually a huge part of my research- the population I study used a natural painkiller, but in the end its use caused them more pain because the way it works, it decreases the efficacy of the salivary glands. They stop making sufficient saliva, the teeth dry out, the mouth PH changes, and the bacteria that destroy enamel go buckwild. If you can’t make your own spit, store bought is fine. Water for the day, tabs for the night.

Now, you might think that ok, acid isn’t great, let’s eat more basic foods to balance that out. You can, but it… isn’t great. Your saliva is naturally acidic for a reason, and if you neutralize it completely, that ALSO messes with your teeth. You should be drinking plain water as much as possible.

Seltzer and Soda

Some people think seltzer may hurt your teeth, but it really won’t… unless it’s citrus-flavored. Reason: citrus seltzer uses citric acid as a flavoring agent, and that messes with your teeth. So if you want to drink citrus seltzer, drink it with a meal or with food. Don’t sip it slow over the day.

Soda, on the other hand is a goddamn nightmare. The acid’s kind of a problem but the sugar… dear god the sugar. So. your teeth are covered in a bacterial biofilm. Some of these bacteria excrete acid, and that’s what gives you cavities. This is another part of my research- looking at how cavity prevalence changes as sweetening agents and sugar availability changes. As different carbohydrates enter the diet, populations’ disease responses change. I know more about this than probably anybody else in the world, and here is what I know: the best thing you can do for your teeth is stop drinking American soda.

It’s the corn, you guys. The chemical compounds in corn make the cavity-causing bacteria kick into overdrive. Sodas sweetened with high fructose corn syrup create the perfect environment for these dudes to excrete out a storm. Sugary beverages in general promote cavities, but NOTHING does it like sodas sweetened with high fructose corn syrup or any other corn byproduct. Try to limit your soda and juice consumption and if you can, make sure that when you do have them, you’re getting some food,too.

Other Acids

Ok this next part is going to deal with eating disorders. I’m going to be talking about some of the side effects of bulimia, what they can do to your teeth, and how you can take care of them. Eating disorders are serious business and I hope if you need this section you are in supportive recovery and have the love and support and resources you need. If you don’t want to read about what this can do to your teeth, scroll real quick until you seen the big green text.

If your teeth are in frequent contact with stomach acid, acid etching can be a real problem. Your enamel is tough but stomach acid is gnarly, and your gums don’t have that same protection. If you find yourself vomiting frequently, for whatever reason, try to swish water around in your mouth afterwards to help clean it out. I know that’s not the thing that’s likely on your mind after that, but a lot of what we’re doing here is damage control. I’m not here to judge you in the slightest. I’m just here to help you with your teeth.

Do not brush your teeth immediately after vomiting. The enamel is weaker, and you can cause even more damage by brushing too hard. Wait for at least an hour until after you’ve rinsed your mouth to avoid spreading the acid around.

You can also add some (1-2 tsp) baking soda to the water you rinse with, if you feel ok with doing that. It will taste gross and salty but it will help neutralize the acid. You just rinse with this, you don’t swallow.

ok that part is over

TOOTH HACKS

This is the funnest part, I get to tell you good ways to take care of your teeth that require very few spoons and very little money!

Brush ‘em twice a day. Once when you get up to clear out whatever happened the night before, and once before you fall asleep. You can brush more but you don’t have to. Use a soft-bristled brush and whatever toothpaste you like. If you hate mint, kid toothpaste that tastes like bubblegum or berries is totally fine!

Don’t want to get out of bed? totally fine. Use a finger toothbrush! these are designed for babies which is actually great because they are SUPER soft. If you have sensitive gums, these are going to be really helpful.

Don’t have access to a finger toothbrush? honest to god you can just dip your finger in water (though a mix of water and baking soda or water and salt is better) and brush your teeth with just your finger. The point of this isn’t to freshen your breath or anything, it’s just to get the biofilm off of your teeth and protect them.

Floss. This gets the biofilm out from between your teeth and promotes good gum health. Don’t just run it between the teeth- you need to floss below the gumline a little bit to help clean out plaque.

If you don’t have the spoons to do your whole mouth, floss between your molars if you can.

There’s lots of products that are great for people who can’t go through the whole flossing routine. Pre-threaded flossers are ideal because they’re designed for minimal effort and maximum gain. These are also killer for people with physical disabilities that affect hand dexterity.

If flossing hurts because you have sensitive gums, a water flosser can really help. This is more expensive but will last a very long time.

You can also get topical numbing gel that you can smear on your gums when flossing. Just be careful that you’re not flossing too hard because you can’t feel it. This brand is kind of expensive but it has a nice minty flavor. If you have a dollar and a way to get there, I saw Orajel at Dollar Tree yesterday… when I was buying a bunch of those pre-threaded flossers to throw in my car. I oughta do a Dollar Tree field trip to show you like, what products are available at the absolute cheapest in the US. Dollar Tree has a LOT of good dental options.

There’s a tiktok that says you can use a strand of hair to floss. This is a bad idea. A single strand of hair is likely to break and can cut into your gums. If you want to use hair as floss, you need to use a couple of strands twisted together. Go slow and gentle if you’re using hair. Obviously actual floss is better but this isn’t “perfect dental tips for perfect people,” this is “life sucks but your teeth don’t gotta.”

If you can’t floss or can’t brush, gargle. Put two tsp of baking soda in a glass of warm water. Swish it around, spit it out. If you can do that, you’ve helped clear out biofilm and bacterial waste.

Prioritize your teeth. You only get two sets and you lose the first one by the time you’re twelve. If you can only do one hygiene thing today, make it be your teeth.

Eat some pineapple. Bromelain, which is only found in pineapple, is super good at protecting enamel.

That’s… all I got for you now. Take care of your teeth!

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