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I understand that you have fear of going to the dentist. This is usually the result of negative previous experiences at the Dentist as a child and the anxieties that were felt way back then being carried forward to the present.

I'm more curious about your fear of introducing the tooth brush into your mouth...you say you have not brushed for 4 months. That would suggest that before 4 months ago, you were able to brush at least occasionally, if not the recommended twice each day. So my next question would be was there anything specifically that you can recall happening or anything that you were told or that you heard about at around that 4-month ago time that seemed to give rise to this fear? Are you able to tell what the nature of the fear is? Is it perhaps a fear that the toothbrush is unclean? Is it a fear that the toothbrush might cause you discomfort or pain? Are you concerned that by now if you resumed brushing your teeth that your gums would start to bleed and you have fear about this? It is a very interesting situation, from a clinical standpoint...

Now, to address your question specifically of "what will happen..." and "...have I done any permanent damage to my teeth?". Several things will tend to happen if home plaque control - that is brushing and flossing - is discontinued. The plaque continues to accumulate all the time. Plaque is comprised of bacteria that are normally present in your mouth. These bacteria adhere to the various surfaces in your mouth and begin to proliferate forming a delicate film, called "plaque", which, at first, that is quite easy to remove. If this film is not removed regularly, the bacteria continue to replicate and the film becomes thicker.

After about a week or 2, the plaque film begins to take up minerals from your saliva. This is the point at which the plaque begins to transform into what is commonly referred to as "tartar", technically called "calculus". This calculus adheres very tenaciously to the tooth surfaces and can no longer be simply brushed away. It will need to be removed by the Hygienist, leaving nice, clean, smooth surfaces once again. At that point, resuming twice daily brushing will prevent most of any future tartar from forming, as tartar can only form from undisturbed plaque.

When the tartar and plaque accumulate under the gumline, near the supporting bone, the body sees it as an irritant and slowly will cause the bone nearest the tartar and plaque to be removed...almost as if the body wants to keep the bone "at a safe distance" from the irritant. This process is known as "Periodontal Disease". It used to be known as "pyorrhea" but that term is no longer used. The problem is that once this bone supporting the teeth is gone, it is essentially gone forever, even if that tartar and plaque were to be removed. Though the process is usually quite slow, it is inexorable: more plaque grows, becomes tartar and more supporting bone is lost. Ultimately, sometimes after many years, sufficient supporting bone is lost that the teeth begin to become loose. Ultimately, if the process is not interrupted, these teeth that are infected with periodontal disease will be lost.

So that is "what happens" if you no longer brush your teeth. That is not to mention "halitosis", which is the technical term for "bad breath"...not brushing your teeth will result in bad breath due to the volatile gases that are also produced by the live plaque bacteria.

Regarding whether you have done any damage to your teeth, I can only tell you that longterm undisturbed plaque will often lead to tooth decay underneath the plaque, due to the acids that the bacteria produce. Also, the above process of irreversible bone loss on average takes about 3 months in laboratory studies

When researchers simulate what happens in humans using lab animals, they find that if they do no plaque control on the lab animals that whatever damage is done is reversible, for the most part, up to about 3 months. Thereafter, the bone loss that occurs tends to be irreversible.

I've given you quite a bit of information. I hope this helps you. Please feel free to reply with any additional information with which I may be able to help you further. I'll be notified via email and then I'll get back to you. Best of luck with trying to take care of your teeth!

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