Dental Health 101

Four of Seattle's top dentists reveal how routine dental checkups can protect your smile.

By Karen Quinn

Illustration: Nishant Choksi

Bright Whitening

That blindingly white smile may obscure serious problems.

Michael Tillotson, a 23-year-old environmental technician from Windermere, visited the dentist every other year or so. In between visits he relied on over-the-counter tooth-whitening strips, but, he says, “they hurt.” The pain he experienced was “like biting something cold.” For Tillotson, the solution was simple: Ditch the strips. But according to Wallingford dentist D. Andrew Lewis, tooth sensitivity from whitening should never be brushed aside. “Patients who don’t have a regular dentist are using over-the-counter products in an unsupervised way,” Lewis explains, “so there may be underlying issues that cause the sensitivity.”

Tooth sensitivity arises because the delicate root is disrupted by the whitening process. Products that use dissolving strips work by stimulating the fluids deep inside your teeth and breaking down the organic materials that cause stains. If you have weak enamel, fractured teeth, or, as Tillotson did, cavities (all of which are otherwise pretty painless), the whitening process can agitate your exposed nerve endings and cause a jolt of extreme pain.

It’s not that whitening is bad for you. The problem, Lewis says, is that people are more concerned with having white teeth than achieving overall oral health. “Whitening products really have become very safe, but it’s always better to get a professional opinion instead of just going to Safeway.” To encourage patient visits, Lewis—along with many other dentists on our list—offers free whitening to new patients. “It’s a value-added service,” he says. “You come in for a complete exam, and then the whitening is supervised.”

And whether you decide to whiten at the dentist’s office or at home, your hygienist can work with you to minimize discomfort. “Sensitivity issues can be taken care of in a lot of ways,” Lewis explains. When appropriate, dentists may recommend a desensitizing toothpaste or enamel-strengthening fluoride. “If you have sensitivity, get it looked at right away,” says Lewis. “It might be more serious than you think.”

Flaming Lips

Flossing isn’t everything when it comes to healthy gums.

Dr. Thomas Kang is a periodontist: a dentist who specializes in gums. Like most dentists, he advises his patients to floss. But for Kang, the issues go beyond flossing. In fact, a patient who comes to his Federal Way office with chronically inflamed gums is more likely to be sent to a primary care doctor than to be sent home with an extra box of floss.

Illustration: Nishant Choksi

Kang remembers one active, healthy patient in her mid-40s whose dental implant wouldn’t heal properly. When the implant ultimately failed to integrate, he sent the patient to a physician, who diagnosed her with Type 2 diabetes. “Uncontrolled Type 2 diabetes can lead to poor wound healing,” he explains, “but once her physician was able to treat her condition, we could perform the implant successfully.”

The take-home message is simple: “It’s not ‘floss or die,’” says Kang, “but having your dentist monitor your periodontal health regularly is very important.”