Brighter Smiles: It’s Just a Word

When we ask for a Kleenex® or a Ziploc® we may not necessarily get that brand, but we know we will get a tissue or a sealable plastic bag. It is always interesting to me hearing the different things people say in the dental office that seem to be “standard” among the general population.
For example, most people use the term “Novocain”. Even dentists, including myself, use this term daily to describe the local anesthetic used to anesthetize or “numb” teeth before they are worked on. Novocain® (procaine), apparently still available for purchase, has not been used in dentistry for probably 100 years, but we still use the term because everyone seems to know what we mean. We may say “Novocain” but that is not what we are writing in your medical record.
Another term that is commonly used by patients and those in the dental office is “cleaning”. This term is a poor choice of words to accurately describe the service that a hygienist performs. The problem with this word is that it downplays the actual procedure. “I need to cancel my cleaning appointment. Oh, you don’t have anything for me for 2 months? That’s okay, it’s just a cleaning”, is commonly heard in the dental office.
We say “cleaning” because it’s easier than saying, “We’ll see you Monday, Mary, for your periodontal maintenance and exam which includes a full periodontal exam, scaling and polishing of all surfaces of the teeth, full dental exam, oral cancer screening and an update from the doctor to review this information with you.” If you have, or should have your teeth cleaned every 3-6 months, the word “cleaning” to describe the service being performed is very inaccurate.
The term “crown”, or “cap” as some people use, usually make patients cringe. “I need a crown? I thought I just needed the filling replaced”, is common to hear. Patients tend to think that they are losing their tooth if they need a crown. While this is not the case, what if the dentist said that you need an onlay? Have you heard that term?
I read an article in the paper recently entitled, “Are Crowns Made in a Day Worth the No Wait?” This article describes some of the uses of CAD/CAM (computer-aided-design / computer-aided milling) technology to produce “crowns” for teeth the same day in the dental office. The technology is used in about 10-15% of dental offices.
In the article mentioned above, there was not one mention of the term onlay. An onlay, or partial crown, for lack of a better description, is one of the major advantages of CAD/CAM technology. It often allows the dentist to perform more minimally invasive dentistry for specific teeth.
The primary focus of the article was to point out that these CAD/CAM crowns may not be the best choice for patients or dentists if used on front teeth. The argument is that a dental ceramist in a dental laboratory can make “prettier” teeth than a dentist can in a dental office. While this may be true for some circumstances, the column downplayed some of the major advantages I see with the use of this technology. We say “crown” but it really means, “an indirect, bonded, protective restoration.” A “crown” may cover the whole tooth or just part of the tooth.
The materials we use and the services we perform in the dental office are constantly changing. Let the dentist and dental hygienists use their knowledge, skills and technology to do great things to care for your dental health. Don’t get hung-up on words. Ask questions! Keep an open mind and become an active participant in your dental health.
Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com