MORRIS – Morris dentist Dr. Keith Jaeschke retired Feb. 10, although he still occasionally helps out at Matthew P. Bell and Associates General Dentistry, where he practiced.
During those four decades Jaeschke saw dentistry evolve. He recently discussed some of those changes and how they impact people today.
HIV and hepatitis C
Jaeschke said in those early days, dentists practiced "wet-fingered," meaning no gloves and no masks.
"It was 1978 and AIDS had not become a concern in dentistry," Jaeschke said. "We were not, at that point, using gloves, and, of course, AIDS changed that situation. But you had a much bigger chance of having hepatitis being transmitted during medical or dental procedures or oral surgery, and you had more documented cases of it being transmitted."
Still, hepatitis C didn't carry the same concern or the same emotional impact AIDS did, even though hepatitis "is much more virulent than the AIDS virus." And then, of course, AIDS at the time meant death, he added, while hepatitis did not, even though some people did die from it.
"[Hepatitis] was certainly not identified in dental school as, 'This is huge; this is major, and you have to be concerned,'" Jaeschke said. "It was just a part of being a health care professional. You had a chance of coming in contact with it; you had a chance of getting it."
Although dentists were thorough in their sterilization techniques 35 years ago, the techniques themselves have improved, Jaeschke said.
Thirty-five years ago, dentists sterilized their instruments by immersing them in certain chemicals, Jaeschke said. Today, many dentists sterilize by autoclaving: high heat and pressurized steam, more than 212 degrees, he said.
While chemical sterilization did the job, "the autoclave sterilization is far superior," Jaeschke said.
Fillings: White and silver
White fillings existed in 1978 but were generally reserved for front teeth, Jaeschke said. Not only was insurance less likely to pay for them, the materials weren't strong enough to hold up on the back teeth, he added.
"The white fillings have reached the point where they're so strong and durable, they look 10 times better than the mercury fillings," Jaeschke said. "This has been the biggest reason to see silver fillings falling out of favor."
He debunked the myth that mercury fillings are poisonous to people and said the real concern lies in removing the filling and then disposing of it. The truth is, mercury as a filling revolutionized dentistry.
"We could fix teeth with it and it would last," Jaeschke said.
Implants and crowns
Implants as used today weren't "on the horizon 30 years ago," Jaeschke said. These, too, have dramatically changed dental care for patients, making them "the closest we can come to giving you back your own teeth." Their quality has improved, too.
"They hold better, they feel better, and you can chew better with them," Jaeschke said.
Ditto for the materials used to create crowns and bridges. For many years porcelain was the "gold standard" but it tended to chip or crack. Zirconium is much stronger, Jaeschke said.
Education and awareness
People today know the importance of dental health, Jaeschke said. They're brushing and flossing on a regular basis, they understand the sugar to cavity connection, and they're receiving regular checkups.
"People also have more disposable income where they can say, 'I want to keep my teeth,'" Jaeschke said. "Thirty, 40 years ago, people assumed dentures were the natural course to go. I think it's a change in perception that teeth are important, you don't have to lose your teeth, we can keep teeth for a lifetime."
Dental exams for infants
Even though 6-month-old babies don't have many teeth, if any, the half-year mark is a good time for a first dental visit. Dentists can gauge overall development, as well as any abnormalities, of the bones, tongue and mouth, Jaeschke said.
Also, if baby teeth start breaking down, they could affect, in a minor way, the health and position of the permanent teeth, he added.
Regular dental cleaning is important for both children and adults to remove plaque, which gradually builds up on teeth into tartar, he said. Even "brushing and flossing five times a day" won't remove it.
Oral health and overall health
Who'd have thought a refreshing slice of lemon in a glass of water can hurt one's teeth? Occasionally no, but if it's a longstanding habit, the citric acid in the lemon can erode tooth enamel, Jaeschke said.
Gastroesophageal reflux disease can do the same, especially on the back teeth. People with bulimia show "wear and tear of the enamel on the inside of the teeth." Certain types of medications can have side effects on teeth, too, Jaeschke said.
Conversely, the inflammation caused by periodontal disease can contribute to heart disease, Jaeschke said.
"The health of your mouth is definitely a gateway to the rest of your body," Jaeschke said.
It's still a huge problem, Jaeschke said, and it's more than tooth loss. Periodontal disease also affects the tissues and the underlying bone that support the teeth. Periodontal disease can even affect people who don't get cavities.
"People will say, 'I had perfect teeth, no cavities, and they all fell out,'" Jaeschke said. "The bacteria that causes cavities is different from the bacteria that causes periodontal disease."
Regular teeth cleaning, at home and by a dentist, helps to prevent periodontal disease by removing tartar, he said. When tartar builds up, gums become inflamed and then infected.
"Every human body is different," Jaeschke said. "The smallest amount on some people can create tissue problems. Other people can take a lot more."
Pros and cons of retirement
The pros, of course, are spending more time with family and traveling. The cons are missing patients who have become like family, especially those who remained patients for 38 years, Jaeschke said.
From time to time over the years, Jaeschke used his skills simply to help patients in need and would then "forget to send them a bill." But he wasn't alone in generosity.
He recalled a family who recently offered to pay for dentures for a woman who, one by one, had lost her teeth and had forgotten how to smile. When she received her dentures, she nearly cried, Jaeschke said.
But he felt most gratified when she returned the next day.
"She told me, 'My mouth is so sore from smiling. I think I smiled in my sleep,'" Jaeschke said. "That made my day."