How Small Dental Problems Become Big Ones

October 15, 2019

Author : Dr. Spiro Condos

In my practice, I often see patients who have small dental problems, sometimes for years. They end up in my chair when those small dental problems become big ones.

The most common reason that people ignore dental problems is fear – fear of pain, fear of expense, fear of being embarrassed, or fear of missing time at work. Most dentists, myself included, understand, and are compassionate people with dental phobia. In fact, dental anxiety is now a medical term.

Many people do not know that dental science and technology have evolved tremendously compared to when they were youngsters. Today, dentists can perform even complex procedures and cause little (or no) discomfort for their patients.

To demonstrate how small dental problems can become big ones (and maybe scare you into getting that little filling taken care of), here are four real-life case studies of patients I’ve recently seen in my office.

Patient A: Patching A Bridge Over and Over Again (or Mr. Busyness Man

Patient A had an old bridge that needed to be replaced. Every time he came into the office for a checkup, he begged me just to “patch it” because he didn’t have the time (which wasn’t much) to devote to having it replaced. This went on for four years.

When he came in for his last checkup, decay had spread so far and caused so much gum loss that Patient A could no longer wear a bridge. I had to extract several of his teeth and put in several implants, which resulted in much more time and money than a new bridge would have cost him in the first place.

The Bottom Line: If you have an old bridge and your dentist has advised you to have it replaced – do it!

Patient B: No X-Rays For Me! 

Patient B dutifully appeared every six months at my office for her regular checkups and cleanings. However, she refused to let us take x-rays due to her fear of radiation. Consequently, I couldn’t keep tabs on what was going on with her mouth – underneath the surface.

Not long ago, the patient appeared at my office, suffering from a severe toothache. She had decay so deep the only solution was to extract the tooth. 

About dental x-rays: I try to limit x-rays to once every two years for patients who have a low risk of decay or gum disease, although the frequency of x-rays has to be individualized for each patient.

It’s smart to limit your exposure to radiation. However, the amount of radiation you are exposed to from dental x-rays is lower than what you get flying in a plane from New York to California! And, no one has ever contracted cancer from dental x-rays. I’m very passionate about this topic – see my comments in The New York Times.

The Bottom Line: Your dentist does not have x-ray vision!

Patient C: Just Scared To Death

When he became my patient, Patient C hadn’t been to a dentist in ten years. When he was a child, he had a very traumatic dental experience. As an adult, the only time he ever went to a dentist was if he had a toothache so terrible that he had no choice.

Consequently, Patient C’s mouth was in serious trouble. He was so terrified of me that I couldn’t even touch him without anesthesia, laughing gas, or general sedation. (He’s a very macho guy and skydives regularly).

I felt so badly for this patient and I set out to do everything I could to treat his dental problems and try to eliminate his dental anxiety. I put together a treatment plan and brought in an anesthesiologist. I performed extractions, placed implants, and finished them off with temporary replacement teeth – all in one visit. The entire time, he was sound asleep.

Today, Patient C comes in for his regular appointments with a smile on his face – a much better-looking smile than when he first appeared. He still has a bit of fear, but a little laughing gas and topical anesthetic seem to take care of it nicely. 

The Bottom Line: If you need to be sound asleep during a dental procedure, don’t be afraid or embarrassed…just ask!

Patient D: Twenty Years Of Pain

For many years, Patient D experienced clicking, pain, and stiffness in her jaws. Her jaw symptoms made her life miserable. By the time she found me, she had been to numerous dentists in the city and had spent over $80,000.

When I performed a head and neck exam, it was easy to see that she had pain in her jaws and neck. Interestingly, she had not noted the pain on her intake form. When asked she said, “I am so tired of telling dentists and TMJ experts about my pain that I didn’t even bother to tell you.”

It was apparent Patient D had a TMJ (temporomandibular joint) problem. I always try the most conservative and inexpensive treatment first, as a test to see if it brings relief. In this case, it did.

When Patient D returned to my office a week later, she said, “This is the first time in twenty years, I’ve been out of pain.” That was 20 years ago – and she’s still my patient!

The Bottom Line: Expensive does not always equal better.


Small dental problems can become big ones for a variety of reasons. My commitment is to provide you with the most compassionate, affordable, comfortable, and least time-consuming path to enjoying the benefits of a healthy mouth – for life.

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