Dear Fearful, 

There is no easy answer to this question. I can tell you this:

If you see an American dentist who is licensed in your state, you can rest assured the dentist has a college degree and 4 years of dental education. American dentists are very well educated. 

American dentists are required to ” keep up” with their profession and must do classes every year to stay on top of new trends. 

If you see an ADA dentist, you should know that they are bound by a higher set of ethics than what the state requires. 

However, I think the most important thing about choosing any healthcare provider is finding someone you are comfortable with. There are many competent dentists out there, but they all have different personalities and different values. Choose one that matches you and then really communicate with them about your health. 

Dr. H

Dear Not a tooth model,

A 2013 study published in The British Journal of Sports Medicine looked at athletes who visited the dental clinic for Olympians at the 2012 London Games. 

Oddly 55% of them had cavities, 45% had dental erosion, 76% had gingivitis, and 15% had serious periodontitis! And these people are truly the epitome of physical health. 

It is also interesting to note that Michael Jordan had significant dental issues during the 1984 Olympics. His dental issues were severe enough that they could’ve kept him from playing in a game. 

There are numerous reasons why athletes could have such bad teeth: 

1. Athletes burn an enormous amount energy while exercising, so they eat and drink more frequently than the average person — and the more food that comes in contact with teeth, the greater the chance for tooth decay. 

2. The type of food and drink that athletes consume often comes in the form of sports drinks, energy drinks and nutrition bars, which can wreak havoc on teeth. Note that Gatorade may actually erode teeth faster than soda. 

3. Athletes often suffer from dehydration caused by extensive sweating. The lack of water in the body means less saliva in the mouth, and one major function of saliva that few people know about is to protect enamel on teeth. 

4. Many people (not just athletes) grind their teeth during intense physical effort. It is possible athletes grind more because of the stress of playing at such a high level. 

Please get your cavities filled, change your brushing and flossing habits to 3 times per day, and keep training! 

Sincerely, Dr. H

Dear Furious, 

This is a common concern that I hear. I would like to change the discussion to skin and then explain: 

I was taught to wash my face with soap when I was a little girl. My primary goal in doing this was to remove enough dirt to keep my mother from coming in and washing my face! 

Then, in fifth grade, I started to get acne. This prompted me to use Clearasil. 

In college my face got dry AND I had acne. I switched to Proactive. 

After I had my first child, I noticed the acne had changed and that I was getting sun spots. I changed products again. 

Then I turned 40 and … wow! I have a whole crazy regime of products to keep my skin healthy! 

Now back to teeth: 

Most of us were taught to brush and floss our teeth when we were little children. We were taught when we had a mouth full of baby teeth and brushing was fairly easy. 

Hopefully in middle school someone taught you how to brush your adult teeth.

It is likely that you have received no instruction since that time. However, your mouth and teeth have continued to age- just like your skin! By aging, I mean that you probably have more fillings than in childhood and perhaps you even have a crown or two. You probably have lost bone around some teeth and a few teeth have shifted out of place. This is normal aging. 

It is important that someone teaches you how to manage this aging in your mouth in order to keep you healthy. 

I am sorry the hygienist did not fully explain this to you. You deserve to know what is happening and why. 

Sincerely, Dr. H