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Ask the Dentist: Who else doesn’t believe in stop-gap measures?

According to one dictionary, this is a stop-gap measure:
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According to one dictionary, this is a stop-gap measure:

“Something that can be used until something better or more permanent can be obtained: Housing the homeless in shelters has to be seen as a stopgap measure.”

One person interviewed on ‘Experiencing homelessness’ by on the TV news recently, was complaining of the lack of high speed WIFI in his temporary accommodation. Huh? People use stop gap measures for home repairs, auto repairs, boat repairs and much more. A big plug inserted into a hole in the hull isn’t designed to do more than get you into port. It is an emergency measure.

How does this relate to dentistry? We do see some of the same ‘put it off until later’ attitude with oral health. Any time we try and make something ‘make do’ for a while – the ‘while’ part should be defined.

Our mouths absorb a great deal of wear and tear. They tolerate abuse and neglect long before pain demands a change in tactics. Very often this relates to preventative measures. One good example are sealants, for both children and adults. The notion that coating a tooth with a protective shield of some sort will prevent or reduce cavities is a popular mindset. Some think that this ‘coating’ reduces the need for regular preventative maintenance including brushing, flossing, and checkups. They do help – but are not a panacea which means you don’t do your part because that is ‘covered’. Sealants are losing their place in the sun as of late, because those with sealants determined they were in fact ‘protected’ and were immune. It doesn’t negate daily oral care.

It’s a fact that 80 per cent of tooth cavities occur in the ‘lines’ that are evident in the bottom of the tooth surface. The aforementioned sealants job was to coat those lines. If there was any slight moisture on the tooth, the sealant is compromised and decay can form beneath it. Another tool is to perform a fissurotomy - the conservative clinical procedure to treat non cavitated pit and fissure caries or initial caries. A burr is used to gently erode the fissure as a forerunner to the placement of a dental coating to protect it. Again – a stop gap measure. It is dependent upon absolutely no moisture being under the coating, and is a temporary measure.

A colleague who performed primarily emergency dentistry had a very high ratio of two day dental patients not showing up for their second day of treatment. They were 100% subsidized including flights, hotels, taxis, and meals, and once the pain was gone during Day 1 there was little impetus to show the next day for the actual repair. His theory was to never totally eliminate discomfort on Day 1 in order to actually complete the treatment on Day 2! True story. Absolutely not politically correct but 100 per cent accurate. You’ll never see that in the ‘news’.

The reality in emergency dentistry is that we see many patients on a repeated basis. Most hospitals do not have dentists on staff, and if a patient shows up with a dental emergency they are provided antibiotics, given a prescription and told to make an appointment with a dentist. Often a few days or a week later they are back to the ER because the pain hasn’t been fixed – only diluted temporarily.

Let’s look at a recurring situation. A patient shows up seeking whitening services. These vary widely, from over the counter to take home trays to Zoom! treatments. Upon an initial examination, a dentist discovers caries (cavities) or some other issue which is demanding attention. The patient is offered the option of repairing the dental problem, but defers and wants the whitening only. This is an INFECTION, and the patient simply wants to cover it up! Real live patients make this request daily. Would you wash and wax your car in the driveway if it wouldn’t run to the corner without stalling? Literally, this is the identical scenario.

There is a product advertised on TV lately which is essentially a set of snap on aligners which fit atop existing teeth. Of course they are bright white, and from a distance might mask as actual teeth to an onlooker. The ad claims this is a great alternative to expensive dental treatment for photo opportunities! Repeat: “HUH”?

In dentistry there is no quick fix. Temporary means temporary. You care for your teeth, or you lose them. Forget stopgaps. Exactly like your car, your roof, and your furnace!

Dr. Michael Dolynchuk is a General Dentist practicing in Caroline and Red Deer.



Byron Hackett

About the Author: Byron Hackett

I have been apart of the Red Deer Advocate Black Press Media team since 2017, starting as a sports reporter.
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