来自牙医们你所不知道的50个秘密.doc

50 Secrets From Your Dentist来自牙医们你所不知道的五十个秘密Dentists from across the country tell us what theyre really thinking as they peer at our teeth. 来自全国的牙医告诉我们当他们在凝视病人的牙齿时脑海中的真实想法By Chris Woolston Translated by 袁勇翔 口腔0501 2602050126Do you floss about as often as you flip your mattress? Do you spend more time putting toothpaste on your brush than actually cleaning your teeth? Dentists notice these things. And thats not all. They also know when youre asking for a procedure thats going to disappoint you and when insurance companies are stinting on the care your smile needs. We asked 22 dentists from across the country to tell us what theyre really thinking as they peer at our teeth. What came out of their mouths will change the way you treat yours.你会像经常拍打你的床垫那样经常用牙线清洁牙齿么？你挤牙膏的时间会比你实际刷牙的时间要久么？牙医们发现了这些。并且这还不止是全部。他们在你上门并要求一项会令你失望的口腔治疗的时候就知道了一切；他们在保险公司忙于为你微笑买单的时候就洞悉所有。我们邀请了全国22位牙医告诉我们他们在凝视患者口腔时的真实想法。他们的肺腑之言将改变我们对待自己口腔的方式。You Dont Get It你不明白的Some truly educated people think that if nothing in their mouth hurts, theyre fine. High cholesterol doesnt hurt, either, but its a big problem. I honestly think that the general population doesnt understand that their mouth is part of their body. 一些确实受过良好教育的人们认为如果嘴巴不疼痛就没问题。高胆固醇也不会让人感到疼痛，但却是个大问题。坦白的说，我觉得大众并不认为他们的口腔是他们身体的一部分。- Danine Fresch Gray, DDS, general dentist, Arlington, Virginia If your hands bled when you washed them, youd run to the doctor. But in the publics mind, bleeding gums are okay. Unless youre really whaling away with your brush, if your gums bleed even a little, thats periodontal disease, period. 如果洗手时发现流血了，你会跑去医生那里。但在公众的脑海里，牙龈出血却没什么大不了的。除非你用牙刷猛戳牙龈，不然的话即使是一点点的流血，也说明那就是牙周疾病，说完！- Ron Schefdore, DMD, general dentist, Chicago, Illinois The advice to see your dentist twice a year applies only if you have healthy gums. Most people dont. 一年看两次牙医的建议仅仅适用于拥有健康牙龈的人。但大部分人不符合这个要求。- Chris Kammer, DDS, cosmetic dentist, Middleton, Wisconsin Many of my patients have periodontal disease affecting their back teeth, but their front teeth are fine. Evidently, they brush only what others see. 我许多病人的后牙患有牙周疾病，但前牙确实好的。很明显，他们只清洁他人看得到的部分。- Joel Slaven, DDS, general dentist, Valencia, California Dentists often tell patients with advanced gum disease to floss more often. But flossing is useless at that point. Imagine trying to clean out the bottom of a shirt pocket with a piece of string tied to your fingers.牙医经常让罹患进展期牙龈病的患者更为频繁地使用牙线清洁牙齿。但是在那种情况下牙线已经没什么作用了。试想一下你能否用绑在手指的细线清洁你衬衣口袋的底部？- Reid Winick, DDS, holistic dentist, New York, New York People come to me with a mouthful of tooth decay and say, I got my grandfathers soft teeth. I dont even know what soft teeth are. 人们常常带着一整口龋坏了的牙齿跑过来对我说：“我得了我爷爷的软牙病！”我甚至连软牙病是什么都不知道。- Bryan Tervo, DDS, expert at JustA When someone meets you for the first time, the first thing they notice is eyes. Second is teeth, and third is hair. But people spend way more money on their hair than their teeth.当某人第一次遇见你时，他第一注意你的眼睛，第二就是牙齿，第三是头发。但是人们往往花费更多的钱在他们的头发而不是牙齿上。 - Damian Dachowski, DMD, general dentist, Horsham, Pennsylvania Proper oral hygiene requires ten minutes of brushing and flossing every day. The average adult spends two or three minutes total, and kids do even worse. 保持适宜的口腔卫生要求每天十分钟的刷牙和牙线清洁。但是成人平均每天总共只有2到3分钟，小孩就更少了。- Joel Slaven, DDS Our Noses Still Work我们的鼻子仍旧有感觉People who smoke try to cover it up with mints or mouthwash, but that stench is steeped into their gum tissue and the tissues in their mouth. 烟民试图用薄荷和漱口水掩盖口气，但是那种恶臭已经浸入了他们的牙龈组织和其他口腔粘膜里。- Jennifer Jablow, DDS, cosmetic dentist, New York, New York Brushing doesnt go deep enough into the gums to reach the plaque that causes bad breath. You need to floss every day and get a cleaning every few months. If you do all that and still have bad breath, I start looking into diet and checking for health problems. 刷牙并不能清楚牙龈深部造成口臭的菌斑。你必须每天使用牙线并且隔几个月做一次洁治。如果你都做了但是仍然有口臭，我就会开始调查你的饮食并检查健康问题。- Ned Windmiller, DDS, general dentist, Stillwater, Minnesota A mouthwash with alcohol dries out your mouth - youll smell nice and minty for a half hour, but then the bad breath comes back worse than ever. 含酒精的漱口水是你的口腔变得干燥-你会在半小时内获得良好且带薄荷清香的口气，但接下来口臭卷土重来并且变本加厉。- Gary Herskovits, DDS If your breath is bad, we wont tell you unless you ask. 如果你有口臭，你不问的话是不会有人告诉你的。- Gary Herskovits, DDS, family dentist, Brooklyn, New YorkNew and Improved? Yeah, Right“全新升级的”？好吧，行Theres no reason to sanitize a toothbrush unless youre sharing it with other people. Those UV devices and other germ zappers are totally unnecessary. 如果你不是和其他人共用一把牙刷，那么你没有必要对牙刷进行消毒。哪些紫外线设备和电子灭菌设备真的一点必要都没有。- Joel Slaven, DDS Theres a limit to what toothpaste can do. New whitening formula? It can get rid of surface stains, but it cant whiten like a bleach. 牙膏的作用是有限的。新款增白型么？他能去除表面牙渍，但是不能达到漂白的功效。- Careen Young, DDS, prosthodontist, Beverly Hills, CaliforniaThe electric toothbrush is one of the best things to ever happen to dentistry. The newer ones replicate professional cleaning - they wont reach much below the gum line, but theyre far superior to regular toothbrushes. The cheap ones are okay for kids, but youll have to pay more than $75 for a really good brush with a warranty and replacement heads. 电动牙刷是牙医学史上最伟大的发明。最新款式能带给你最专业的刷牙体验-它们仍旧不能清洁龈下，但已经远远比普通牙刷高级。便宜的给小孩用还行，但是你要花费额外的75美金才能得到一个有质量保证的可换刷头的高质牙刷。- Danine Fresch Gray, DDS I wish people still used the Waterpik a water-shooting device that was popular in the 1970s. Each tooth is surrounded by a putrid, germy moat of saliva. If you replace that moat every day, youll go a long way toward keeping your mouth clean and your gums healthy. 我希望人们仍在使用冲牙器（七十年代风靡一时的冲水设备）。每个牙齿就像一座由腐臭的充满细菌的护城河围绕起来的城堡，如果能每天更换护城河的水，你才能具有清洁的口腔和健康的牙龈。- Chris Kammer, DDSWe Blame You When Baby Teeth Go Bad 孩子们的牙坏了都怪你们Its not unusual for me to see a beautiful little child dressed to the nines with teeth rotted down to the gums. And Ill see teenagers from affluent homes with nine cavities. 穿着漂亮但满嘴虫牙的漂亮小朋友并不少见。并且我经常见到富裕家庭的孩子们的牙齿有很多龋洞。Its just a total breakdown in parental supervision. 这真是父母彻底的监管不力。- Joel Slaven, DDS For the past 20 years, weve been telling parents about baby bottle tooth decay and not to let a child go to sleep with a bottle. But I havent seen much of a change.过去二十年，我们一直在告知家长们奶瓶龋的危害并且告诫他们不要让孩子含着奶瓶入睡。但是我并没发现有啥改观。- Winifred J. Booker, DDS, pediatric dentist, Owings Mills, MarylandThe bacteria that cause cavities can be spread from mother to baby through saliva. If you have poor dental health and you taste your babys food and then pop the same spoon into his mouth, youre putting him at risk. 造成龋齿的细菌能通过唾液进行母婴传播。如果你的牙不健康但却用同一把勺子既试吃又喂养，那么你的孩子就很有危险了。- Mark Helpin, DMD, pediatric dentist, Philadelphia, PennsylvaniaKids with dental problems often struggle in school. Theyre distracted and easily agitated. Teachers will say they have behavior problems, but they really have toothaches. 牙齿不好的孩子在学校艰难的生活着。他们时常心不在焉并很容易被激怒。老师们常常说他们的教养不好，但真正困扰他们的仅仅是牙疼而已。- Winifred J. Booker, DDS I have to extract a lot of baby teeth that are abscessed or heavily decayed. Parents think theres no reason to pay attention to baby teeth because they fall out. But when a tooth comes out prematurely, other teeth crowd in to fill up the space. Without the right treatment, it turns into a mess. 我经常不得不拔除大量脓肿病灶或严重龋坏的乳牙，但家长们却因为乳牙的缺失不屑一顾。但是如果恒牙过早萌出，其他的牙齿便会向之靠拢并填补空隙。处理不当的话，整口牙就乱套了。- Paul Hettinger, DMD,general dentist, Orlando, FloridaI call soda pop the liquid chain saw. It cuts through teeth. And its not just the sugar - its the acid. 我把碳酸饮料比作液态线锯。它能锯断牙齿。并不只因为它含糖还有酸。- Chris Kammer, DDSFree Advice免费的建议If you want to reduce the bad bacteria in your mouth, you should be all over xylitol a sugar substitute found in chewing gum. It changes the chemistry of your mouth. Six or seven pieces of xylitol gum every day will help keep cavities away. 如果你想减少口腔有害菌，多吃木糖醇吧（经常被口香糖采用的蔗糖替代物）！它能改变口腔化学环境。每天六到七片木糖醇口香糖能预防虫牙。- Chris Kammer, DDSSome people give up on tooth whitening because the gel irritates their teeth and gums. Just use a fluoride rinse or gel before and after - itll make your teeth much less sensitive. 人们常因美白牙胶对牙齿和牙龈的刺激过大而放弃使用它们。其实只要在使用前后使用含氟漱口水或凝胶即可它们能是你的牙齿变得不那么敏感。- Ned Windmiller, DDSWith any kind of mouth piercing, theres a huge risk of infection if its not done in a really sterile environment. Ive seen cases where weve had to cut out pieces of the tongue because the infection was so rampant. Even when things go well, virtually everyone I see with a tongue piercing has chipped front teeth. Dont pierce your tongue.如果牙体酸蚀并不是在彻底除菌的环境下进行的话，其风险是极高的。我曾见过许多因为感染过于猖獗而不得不切除部分舌体的病例。即使一切进展顺利，事实上我见过所有酸蚀到舌体的病人都有前牙的部分缺损。不要酸蚀到舌头了！- Jay Grossman, DDS, cosmetic dentist, Brentwood, California Quit Worrying不用担心Amalgam silver fillings do release a small amount of mercury through wear and tear in the mouth. But youd have to have about 300 fillings for the mercury level to get high enough to pose even the smallest risk.银汞充填体确实会在日常使用中释放少量的汞。但是除非你口内有300个左右这样的充填体，不然就连最小的危险浓度都达不到。- Edmond Hewlett, DDS, prosthodontist, Los Angeles, California Taking metal fillings out can release more mercury than leaving them in.取出金属充填体过程中释放出的汞量大于它们自然释放的量。- Brody Hildebrand, DDS, orthodontist, Dallas, TexasComposite tooth-colored fillings are popular, but a metal filling is going to be more durable, especially for bigger jobs. 与牙齿一个颜色的复合树脂充填体很受大家欢迎，但是金属充填体却更耐用，尤其是对于承受咀嚼力较大的牙齿。- Brody Hildebrand, DDSI have amalgam fillings in my own mouth. Theres no proof that they do any harm. Convincing patients to remove their fillings for health reasons is quackery. 我口腔里就有银汞充填体。还没有证据能证明它们有任何危害。使患者相信银汞充填体有害健康的这一做法无疑是庸医所为。- Michael Alkon, DMD, general dentist, Holmdel, New Jersey A lot of patients are worried that dental X-rays can cause cancer, but if youre outside for an hour, youre exposed to more radiation than youd get from a full set of dental X-rays. What I worry about is that if I dont take an X-ray, I might miss something serious.许多病人担心牙科x线片拍摄会致癌，但是如果你在室外待一小时，你将暴露在比一次全套牙科x检查还要多的放射线之下。但是我真正担心的是，如果不拍摄x线片，我可能会遗漏更严重的问题。- Bryan Tervo, DDSWe Hate Insurers Too我们也恨保险公司A few decades ago, most insurance plans would cover up to $1,000 or $1,500 in dental bills every year. Today, a single crown can cost that much, but most policies still have the same limit. People are getting teeth pulled that could be fixed because they cant afford to pay for the work.几十年前，大部分保险计划每年能承担1000至1500美金的牙科费用。今天，一个单纯的冠修复就要花费这么多的钱，但是保险的政策仍然照旧。于是人们仅仅因为负担不起医疗费用而倾向于拔牙而不是冠修复。- Bryan Tervo, DDSPatients seem receptive to everything I say until I tell them how much it costs. I feel really good when patients accept 40 percent of what I recommend.病人们在我告知他们总的费用之前都能认可我所有的建议。但最后他们如若能接受40%的话我就已经深感欣慰了。 - Joel Slaven, DDSIf youre missing teeth, chances are that your insurance company wont cover implantsonly one out 22 insurance companies I deal with covers them, even though theyre better than dentures in every way.如果你缺了牙，你的保险公司多半不会负担种植牙修复的费用-尽管种植义齿在任何方面都要优于可摘义齿，我遇到过的22家保险公司里却只有1家能为种植修复买单。- Joel Slaven, DDS Your Teeth Can Alert Us to Disease你的牙能预警其他疾病Misaligned teeth can cause migraine headaches. If we can align the teeth and fix the bite, the pain often goes away.牙列不齐能导致偏头痛。如果我们能排起牙列和恢复正常咬牙合，偏头痛便不治而愈。- Mai-Ly Ramirez, DDS, general dentist, San Francisco, CaliforniaOne of the first signs of diabetes is bleeding gums. I started taking blood samples from all my patients with bleeding gums and bone loss around the teeth and discovered that many of them were diabetic or prediabetic. 糖尿病早期表现之一就是牙龈出血。我曾经采集过我所有牙龈出血和牙周骨质吸收病人的血样，发现他们之中大部分是糖尿病或早期糖尿病。- Ron Schefdore, DMD Were Not Miracle Workers我们不会创造奇迹Patients come in with pictures of celebrities and say, I want to look just like her. Im sitting there thinking, You cant have a smile that looks like Angelina Jolies, because you dont have a face that fits those teeth. Its like when you get your hair color done - you cant just put the same highlights or lowlights in everybodys hair.患者经常拿着一张名人的照片对我说：“我要看起来跟她一模一样！”我当时就想，你不可能拥有安吉丽娜朱莉（古墓丽影女主角）那样的微笑，因为你没有一张和那些牙相配的容貌。就像你去做染发一样-你不能保证每个人对着头发的光照射角度百分之百一样。 - Jay Grossman, DDSTeeth get whiter when they dry out. Some dentists promise that their office procedures will make your teeth four shades whiter. But if you leave your mouth open for an hour, you could easily be two shades whiter just from dehydration. 牙齿在干燥的时候看起来要更白一些。有些牙医能保证他的治疗手段能使你的牙齿比原来白四个等级。但你其实只要张嘴半个小时使牙齿脱水就能轻松地增白两个等级。- Careen Young, DDSIf you bleach your teeth too often, it can thin the enamel. Your teeth can end up almost translucent. 如果你过于频繁地漂白你的牙齿，你的牙釉质将会变薄。久而久之，你的牙齿就变成半透明的了。- Jennifer Jablow, DDSWe Feel Your Pain我们感同身受People say something difficult is like pulling teeth. But pulling teeth is really fast and easy. 人们经常描述意见事情很困难的时候拿拔牙做比喻。但其实拔牙是一件易如反掌的事情- Mark Mutschler, DDS, pediatric dentist, Oregon City, Oregon Everyone should be able to get basic dental care. At our public health clinic in the Shenandoah Valley, we see a lot of people who dont have money, and some of them need to have every tooth in their head taken out. Its like a Third World country. 每一个人都应接受到最基本的牙科护理。在我们位于谢尔南多峡谷的公共健康诊所，我们见到太多的贫困病人，有些人甚至需要拔出整口的牙齿。这就像在第三世界国家一样。- Lori Wilson, DDS, general dentist, Petersburg, Virginia I tell nervous patients that we can give them the sedative triazolam an hour or so before their appointment - they just need to have someone else drive. It works so well that sometimes they dont remember the appointment. 我告诉紧张的病人我们可以在就诊预约一个多小时前提供镇静剂-他们只要开车过来取就行了。药效好的超乎我们想象以至于大多数病人连就诊预约都忘记了。- Chris Kammer, DDSA study showed that tooth implants increase libido, probably because people feel much more confident without missing teeth or dentures sliding all over the place. 研究表明种植牙能提升性欲，多半是因为病人不需要再担心缺牙或是假牙掉得到处都是而变得自信满满。- Jim Janakievski, DDS, periodontist, Tacoma, WashingtonMany people without insurance dont go to a dentist until theyre in a tragic situation. They could wind up needing $20,000 worth of work. 很多没买保险的人们在口腔状况极其恶劣之前是不愿意去看牙医的。但最终却发现总体的开销已经高达20000美金。- Paul Hettinger, DMD We Choose Our Own Dentists Carefully我们在选择自己的牙医时也是很小心的Cosmetic dentistry works only on a healthy mouth - you cant build a house on a swamp. But if you look around, you can find a dentist who will do cosmetic work without treating your gum disease first. There are a lot of incompetents and outright charlatans in my profession. 美学牙科学医生只为健康的口腔服务-因为你不能在沼泽之上盖房子。但你只要留心身旁的诊所，你会发现有很多牙医在进行口腔美学修复前并不处理你的牙龈疾病。可见在我们这一行里也有相当多不称职的彻头彻尾的骗子。- Joel Slaven, DDSI put in veneers for a living, but theyre really overused. At some offices, patients come in for a simple cleaning and are sold on the idea of getting veneers too. Veneers are excellent for making teeth longer, but if what you want is to get your teeth whiter, use a bleach. If theyre too crowded, get them straightened.我以做全冠修复为生，