"But... It Doesn't Hurt!"

Dear Dentist: Just Make it Make Sense.

We've all been there. The day has been marked on your calendar for months - you've adjusted your schedule to come in late or leave early for a quick check up and dental cleaning. No biggie!

Check in - check!

Paperwork - check!

Medication updates - check!

X-rays - check!

Goody bag - check!

During your exam, you may overhear your dentist slip into "data input mode", saying a combination of numbers and letters to be recorded in your chart as they examine your x-rays, teeth, gums, and the soft tissues in your mouth.

Then, your dentist says something you didn't anticipate.... a diagnosis... what?! That doesn't add up! Nothing even hurts!

Whether it's a painless spot on your tongue, a gum issue, an unusual finding on your x-ray, or a dreaded cavity - any diagnosis can bring up unsettling feelings of anxiety and fear - especially when everything seemed fine just moments earlier. Accepting a new diagnosis can be very difficult - even more so when you've been feeling fine and it's a complete surprise. However, when it comes to conditions that affect your oral health, sometimes having “no symptoms” is, in fact, a symptom...

So if you find yourself saying or thinking "But it doesn't hurt!" in protest to a diagnosis in the dental office, here are 3 Things to Know and 3 Things To Do to feel confident before moving forward with treatment:

3 Things to Know

1. The outermost layer of our teeth, enamel, doesn't have any nerve fibers.

This means if there's a cavity, chip or crack confined to this tooth layer, it would be completely normal for you not to notice it day to day. A compromised part of our teeth's armor, the super strong enamel layer, can lead to a painful or unhealthy situation if allowed to progress over time without any treatment. Certain clinical patterns of chips, cracks, wear & tear might mean we are grinding or clenching our teeth at night without feeling a thing! Although not painful, these conditions still require treatment to optimize your oral health.

2. The innermost layer of our teeth does contain nerve fibers - but if these tissues are damaged, dying, or fully necrotic, our ability to feel pain is often affected.

If a cavity has slowly deepened over time, a tooth could: a) hurt for a few minutes to an hour once and never bother you again, b) be slightly sensitive but not so much you'd say it hurts, or c) could have no pain or sensitivity at all. This range of sensations can indicate nerve tissue damage in the innermost layer of a tooth. This type of tissue damage requires treatment to either avoid an infection or treat one that's already present. Leaving infections to linger anywhere in our bodies without appropriate treatment can turn into a dangerous situation.

3. Many oral diseases are completely painless!

Pain is an important part of our bodies' alert system, but an absence of pain does not indicate the absence of disease. Gum disease, tongue and soft tissue lesions, slow growing cysts, and other major pathologies can all fall into this category. All of these can cause inflammation, tissue damage and other complications that can impact your daily life without timely treatment.

3 Things to Do

1. Ask Questions:

First, ask yourself - "Do I trust my dentist to offer me a reliable path to oral health?"

If the answer is no, it’s time to dig deeper! Move on to steps 2 and 3 below.

If the answer is yes, thats great news! When you trust your dentist, it becomes easier discuss your diagnosis and what your options are.

Advocate for yourself with this simple phrase: "I'd like to ask some more questions before we get started." If you don't understand your treatment plan, make sure to get you questions answered before you sign on that dotted line to consent to treatment.

2. Address Anxiety & Trust Issues

Dental anxiety can lead to treatment avoidance, and this can damage your health.

It's important to let your dentist know if this is a challenge you face so they can help you address it medically.

If you feel anxiety is not the problem and you simply don't like your dentist, their diagnostic process, or their office, it's time to move on - Find a new dentist for a comprehensive exam for a fresh start. They can fully evaluate your concerns with their own data collection process.

When you trust your dentist you should feel safe knowing your concerns are their top priority. Ask trusted friends or coworkers for a recommendation if it's been a while since you've had a check up.

3. Try Telehealth

If you're having an emergency and haven't been to a dentist in years, the emergency room isn't always the best option. A Telehealth Consultation with a licensed dentist is a great way to talk through your situation in a HIPPA compliant, digital environment. For this type of consultation you can safely provide the data you have - submit any images & medical history information, and a description of the problem. They'll let you know if you need to go to an emergency room or if you can wait they give you a referral to a dentist in your area to follow up with.

Get medically sound advice concerning all things oral health, from a toothache to dry mouth to clear aligner therapy to a spot you just noticed on your tooth, without exposing your personal information online on a reddit forum or facebook group. You'll also get follow up instructions and a referral for an in person appointment to find your dental home.

In Summary

If you receive a dental diagnosis, know that you are not alone. Far from it.

More than 25% of adults in the US have untreated cavities and almost 50% of adults over the age of 30 have signs of gum disease. - cdc.gov

Oral conditions like these tend to be chronic and progressive.

When you have no symptoms and and just need someone to make it make sense, lean on your new toolkit to advocate for yourself:

1 - Ask Questions

2 - Address Anxiety & Trust Issues

3 -Try Telehealth

These 3 steps can empower you to protect your health and move forward with treatment.

Want to learn actionable steps to optimize your oral health? I'm partnering with the Teledentists to add more resources on how we can best care for ourselves and our families. In the meantime, leave a comment or question below.

Health & Blessings,