Dental Health 101

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

By Karen Quinn

Illustration: Nishant Choksi

Get Felt Up

Are you being properly screened?

At her private practice in West Seattle, Dr. Christine Kirchner checks every patient for signs of oral cancer. So when she found an unusual spot on one of her regular patients, a forty­something merchant marine who had been a smoker, she sent him straight to the oral surgeon with a specific description of the spot and its location. Sure enough, the patient had carcinoma in situ (a very early stage of cancer that has not yet spread) on the base of his tongue. The surgeon removed the spot, and the patient has been cancer-free ever since.

Thanks to his routine dental checkup, Kirchner’s patient avoided a disease that afflicts 36,000 Americans each year. Recent research shows that patients who smoke, drink alcohol heavily, or have been exposed to the HPV virus are most likely to contract oral cancer, but scientists insist that everyone should be screened for the disease every six months.

Dentists provide the first line of defense with thorough screenings, and Seattle’s Fred Hutchinson Cancer Research Center is leading the nationwide effort to better predict the progression of the disease and the survival of patients. Dr. Chu Chen, a public health scientist at the Hutch, enlisted volunteer patients from the University of Washington and Harborview medical centers for the study, the first of its kind. “Worldwide, oral cancer is the sixth most prominent type of cancer,” she says, “and it’s pretty deadly.” Currently about 21 percent of diagnoses come too late, and Chen’s study could bring that number down.

Every visit to Kirchner’s office includes a meticulous screening. You should expect your dentist to look at and feel all the surfaces of your tongue, neck, jaw, gums, and cheeks. Kirchner also swears by an LED tool called a Velscope, which lights up the cells on the inside of your mouth and detects any abnormalities. Brian Hill, founder of the Newport Beach, California–based Oral Cancer Foundation, insists that “visual and tactile screenings are the backbone of early detection,” and a thorough exam only takes about five minutes.

Chew on This

Grinding your teeth can be hazardous to your smile—and your wallet.

Illustration: Nishant Choksi

Dr. Jeffrey Schur, an orthodontist in Bellevue, had a patient with a slight overbite who was grinding his teeth in the middle of the night. But with no pain or clenching during the day, the patient was able to easily ignore it. By the time he wore his teeth down to half their original size, his unchecked night grinding problem had cost him thousands in dental bills.

“Grinding, particularly in your sleep, is very damaging to the teeth,” says Schur. When you’re sleeping, you’re likely to use a lot more force than you would when awake, which causes permanent damage to your pearly whites. “It forms cracks,” he says, “and like cracks in a windshield, they propagate, until fragments of the teeth eventually break off.”

Night grinding can be solved very simply with a night guard, which a dentist fits specifically to your bite. But when a patient doesn’t address the problem, he or she is likely to end up with cracked teeth, broken crowns, and bite correction orthodontics. Schur could have noticed the warning signs: worn teeth, a clicking jaw, and an uneven bite. “A lot of people go to the dentist because of pain,” he says, “but most of the dental problems we deal with as adults progress silently and painlessly, and the dentist is really the only one who is going to catch those problems.”