Wednesday, November 16, 2011

First Sign of Aging: There Goes My Cementum!!

Yesterday I went to the dentist because I have had intermittent tooth pain since July. Yes, July. Five months later I was finally able to coordinate my schedule with the dentist's schedule and get in to see him. The nurse took an x-ray and the dentist came in a few minutes later, sat down next to me, and calmly said, "You're getting old".  I'm very well aware I'm getting old since the price of all my dermatologic interventions (creams etc) is rising in direct correlation with my slowly advancing wrinkles. So this was not news.  I'm willing to accept that things aren't going to work as well over time, but I wanted to know if there was something dental hygeine-wise that I should do differently.

First, some background on the tooth pain. One of my upper right molars hurts ONLY when I eat super concentrated sugar. Like Skittles. But baked goods and chocolate are okay. The inside of Nutri-Grain bars is not okay. The pain is pretty sharp but only lasts for a few minutes, then goes away completely. Back in July, I decided to brush more aggressively and often (three times a day instead of two) and lay off the sweets (not that I eat many anyway) and see if I could improve things on my own. Well, the pain stayed away because I didn't eat sweets but when I tried again....OUCH!

Apparently, this is due to the age-related degradation of my cementum. No joke. So the outer-most layer of the surface of our teeth is a one to two cell layers of a substance called cementum that covers the roots of our teeth. Over time, this layer can erode. Mr Dentist assured me that I have excellent teeth and no signs of decay, this can be just a natural part of aging teeth.

Dentinal tubules
The next layer of our teeth is called dentin. It underlies the enamel and surrounds the nerves of our teeth. Dentin is sensitive to touch and other stimuli. And dentin is holey, like swiss cheese. The holes are called 'dentinal tubules' and they connect to odontoblasts that connect directly to the nerves. This was news to me-our teeth are naturally holey?  Once the cementum is gone the dentin and the dentinal tubules (holes) and thus the nerves, are exposed to the elements. These holes generally cause no problems but they can if the odontoblasts move and irritate the nerve. Odontoblasts are particularly sensitive to fluid movements. Mr Dentist said that the sugar isn't directly hurting my teeth, rather the osmotic pressure of highly concentrated sugar is drawing water from the roots of my teeth which irritates the ondontoblasts and it is the pain of this osmosis that I am feeling. As soon as the sugar dissolves so does the pain. He described the root of the tooth as a little man whose head was being pulled into the pores of the tooth whenever I ate sugar and the pain was his head getting stuck. Who knew?

I was mighty happy to not have a cavity. I happily declared, "fine I just won't eat concentrated sugar!" to which he responded, "No need to do that, as long as you can just deal with the pain". I guess I'm really not causing my teeth any harm, it's just more of a nuisance, but I'm going to lay off the pain-inducing sugar nonetheless- who gives themselves pain on purpose??!!??

So my teeth aging turns out to be an inconvenience rather than a health-issue or even an expense. I hope the rest of my body ages as gracefully (yes, laugh lines I'm talking to you- GO AWAY!!!)


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