Dentist of Reddit were asked: "What's the dirtiest mouth you ever had to clean?" These are some of the best answers.
1/23 I've pulled teeth that are literally squishy (due to decay). Grabbing these with a forceps is like squeezing a little white bean.
2/23 One pt of mine, I could smell before I'd enter the room. All of her teeth were caked in calculus and plaque, with pus and blood seeping up from the gums. All of the teeth had to go, and each extraction only made the smell worse. I've had lots of serial extraction -> immediate denture patients, but never one that smelled so bad as her.
3/23 I had a patient whose insides of his mouth was covered in layers of multicolored calculus. Black, green and red. I had to ultrasonic scale each individual tooth for a good few minutes, unearthing layers upon layers of mineralized crap. The stench was also horrendous.
At that point I wondered if I was a dentist or an archeologist.
4/23 I was in dental school doing a hospital rotation. We were asked to do a dental exam on an unconscious man who had been found unconscious while high on heroin. He was going to recover, but was sedated. He was septic with a bacteria commonly found orally, (Strep veridans, perhaps?).
One exam... there was also a thick white crust covering his extremely dry mouth and tongue. We debated what it might be, with one guess being a severe Candida overgrowth. We cultured it and found no fungal growth under the microscope. He was brought to the dental clinic for debridement. When he came to our clinic and water was sprayed trying to clean him up, it became clear what it was. He has sinus drainage into his mouth that had dried and he essentially has a quarter inch thick layer of booger covering his mouth and throat.
Enjoy your dinner.
5/23 People show up with severely infected teeth (puss seeping out from the gums around the tooth, the tooth itself floating in its socket like a buoy). Often times these abscesses must be drained with a small incision and strategic finger pressure. The smell can be horrific.
6/23 More than once I have had a patient who came in with thick hardened plaque (calculus) completely covering the teeth. I had to explain to the patient that if I cleaned off all the calculus, the teeth will fall out.
I have also had teeth so broken and loose they fell out while trying to make an impression. I guess it saved them the cost of an extraction!
7/23 The worst I've seen was on an adult patient of mine with Down Syndrome. It had been a few years since he'd seen any dentist and I lucked out, I guess.
For our patients with DS, their periodontal health is already compromised, but this poor guy really was in a bad state. He had terribly overgrown gums that made it look like he had adequate support, but when I probed them I got incredibly deep readings, like 9-10mm on every tooth. And each tooth was coated in brown, thick, sticky calculus. As a reference, a healthy tooth will get a 1-2mm reading.
I spoke with his guardian that he'd likely lose many teeth but that he really needed a cleaning otherwise. I also questioned why there was such a long lapse in treatment (pretty much neglect...) and they explained they just took over his care and that he used to be in a group home. We agreed to do an initial cleaning and reevaluate after a healing period. I swear I felt like getting a jackhammer for the calculus, and the pieces I pulled out from under his gums were as big as teeth. We also had to pull severely decayed first molars.
I ended up doing a nice service for him and got him cleaned up. But his oral health was never really great and he'd always get huge pieces of calculus. But he lost no other teeth and his new caregiver was much better so he pulled through nicely.
8/23 Had a patient come in with the worst smelling breath you could imagine. Guy had advanced periodontal disease, massive gum recession, and all his teeth on the mandible (bottom) looked like one solid chunk. He essentially had a massive calculus bridge. Well - he was in for a new patient exam and hadn't been to the dentist in decades. In order for us to properly examine your teeth - we had to SEE your teeth, so we couldn't really even take films with the extent of this guys calculus buildup from gross negligence over the years.
Hygienist comes up and asks me what we should do, I state if you can't properly diagnose with what you have (rather, the dentist diagnose), you need to do a gross debridement (this is the name of the actual code). This essentially means "cleaning" the sh*t off the teeth so we can actually assess what we need to do for treatment.
Hygienist's new patient exam turns into a 3 hour long appointment. Sh*t is caked on like igneous rock formations and she's broken several scaling instruments in the process. Finally, the sh*t is off his teeth and we can properly use our diagnostic tools to determine what course of restoration we need to take (or what options).
This guy had SUCH advanced periodontal disease that the bone levels on his mandible had receded so much along with his tissue that once the calculus bridge on this guys mandible was removed, all his anterior teeth (front teeth) we're - and I sh*t you not - moving forward and backwards with his rate of BREATHING. It looks like an oscillating fan - just back and forth, back and forth. You could extract these teeth by pinching them with your fingers and pulling them out.
9/23 I work in a low income clinic, most people that come in have little to no oral health care knowledge and have never been to the dentist so they have something called Periodontal disease (Perio) and cavaties. The worse perio gets, the worse your breath gets...
So fast forward to the moment. A new patient came in and usually I am immune to the smelly breath (my mask will cover most of it but sometimes I do smell something) but this patient opened their mouth and I just about threw up in my mouth. It was absolutely disgusting. I had to excuse myself. Luckily, I have some essential oil that I put in my mask for that exact reason so I put some on and then I had the patient rinse with Listerine and the smell got 10x worse.
I began the cleaning and even with all the water and rinsing I felt the smell was just getting worse (usually it gets better). So I excused myself again and sat in the back for a minute and I just did not know what to do. I can't just excuse the patient for bad breath but I did not want to finish the cleaning. Not a huge story but definitely left me dumbfounded.
10/23 Had someone glue their tooth back in. (It had fallen out because of chronic gum disease) - definitely a weird one!
11/23 Saw a little girl who ended up with an infection throughout her whole mouth due to lack of brushing. She had sores all over her mouth & plaque everywhere. It was even built up on the roof of her mouth.
12/23 I was a dentist in the Navy. We were in Kenya working on military exercises with the Kenyan army. During the 3 weeks there, the state department told us to set up a DENTCAP/MEDCAP (civic action program). We pulled hundreds of teeth that day, so many we ran out of forceps. A woman of about 40 came up to us with a terrible swelling in the upper right jaw. Checked her out and she had and abscessed tooth. Got her numb, pulled the tooth, maggots fell out of the socket. My HM2 threw up.
13/23 God I wish I had pictures but this child came in without being seen in our office for 7-8 years with braces. He came one day with 7-8 missing brackets no wire but the worst of all, it looked like the kid had not brushed his teeth in that time frame. He had caries all over his teeth the only piece of healthy teeth left was directly under the brackets he had left. The Xray we took looked like a goddamn jigsaw puzzle with all the root re absorption and the 3,4 cysts he had in his mouth We decided on the spot to take off the braces, Put MI paste on the patient and refer him to his GD which he probably did not go to. But the most horrifying of all was the smell, oh god the smell, I can remember it vividly even to this day. Like a mix of rotting pork and standing water.
14/23 Person never took a shower and hadn't brush his teeth cos he couldn't afford a toothbrush. BO, cigarette smells, decay and swelling everywhere, the stench of bad gums, bad breathe, tongue having all sorts of fluffly dirty stuff on it. My assistant and I had to line the inside the inside of my mask with eucalyptus oil. It didn't help much
15/23 A 36 year old female recovering meth addict. Her teeth were so badly decayed and covered in calculus that a "calculus bridge" had formed on the tongue side of the lower anterior teeth, essentially gluing them together. My oral surgery instructors decided that before we pulled all her teeth, I needed to debridge them so as to not have pieces of calculus fall into the sockets during extraction and lead to healing issues. When I signed in with my periodontal faculty to scale and debridge her teeth, my faculty member actually told me she was jealous that I got to scrape and blast all of that sh*t off. It was like using a wrecking ball with so much junk coming off those teeth.
16/23 An older lady with very bad periodontal disease who also smoked religiously. Those two odors combined produced such a horrid stench that I had to dab orange oil inside my mask when I went to extract her teeth.
17/23 We get some grody stuff back in the lab every now and then but this one sticks out. One day we get a denture back in the lab to remove the soft liner (which has to be ground out using a lathe). I can see a dark spot under the liner, which usually means it was loose and food has collected underneath, and prepare to smell a smelly smell. Upon hitting this spot with the burr, I get the normal horrific smell of rotting food, but there's something else. Something moving. I shit you not, there was a small collection of maggots there. Maggots that were living in the patient's mouth. And that is the story of how I vomited at work.
18/23 I was a dental assistant and assisting the dentist with a deep cleaning. She was scraping at the gum line of a back molar when she thought she chipped off a large part of the patients tooth. It was long and kinda cresent moon shaped so it didn't go right up my suction tube and got stuck across it. While the dentist was apologizing profusely to the patient, she noticed the tooth was smooth and wasn't chipped at all.
The 3 of us further examined what she scrapped off and the patient said, "Oh, that's a toe nail." It was disgusting. I didn't say anything but the dentist did say it's not good to bite your nails, especially on your toes because there is the risk of foot to mouth disease. She had amazing bedside manner, I just wanted to throw up.
19/23 Nurse here. During my first clinical rotation in a nursing home, I had a patient with dentures. When I took his dentures out to clean them, the area that was up against his gums on both the top and bottom denture was caked with rotten food. It looked like chewing tobacco (he did not chew tobacco) and smelled like death. It took me ten minutes to get them clean. I think I was the first person there to bother taking them out of his mouth to clean them properly.
20/23 General/Cosmetic dentist here. I once had a patient come in complaining about a lost veneer. It turns out what she had done is buy a box of plastic stick-on French manicure nails and superglue the tips to her teeth. She had been re-sticking them for years, but she finally got tired of it and wanted me to use some of my "dental glue" to get them to stay on more permanently.
When I refused and instead tried to get her to let me clean off the layers and layers of crusty glue and food and plaque, she was PISSED and stormed out screaming about how I was only in this for the money and how dare I not help out a poor mother. The thing is, from a distance, they didn't actually look all that bad. Up close, a rotting disaster, but from afar I was actually pretty impressed with her ingenuity.
21/23 Once made dentures for a fifteen year old whose teeth were absolutely destroyed by drinking soda and eating sweets.
22/23 Was working in hospital and a Maori woman came into the clinic. She was complaining of pain in her front tooth. She had had multi extractions in the past and also had a lot of carious lesions in her mouth. The front tooth in question looked nothing like a tooth, asking her about it, she said that she'd had the tooth extracted some time ago, but didn't like the gap.
One day she had been walking along the beach and found a dead seagull. She basically took it home, cut the beak off and shaped it and then superglued it into her mouth. It flapped around of course, but she seemed happy with it. Although the gum around it had turned malignant, probably due to the superglue and also the continuous irritation of this beak.
23/23 A patient came in saying he felt like it was time to get his teeth out since the ones remaining were mobile and he had a "small hole" in one of the molars and its was starting to hurt. I took a look. 2 cavities had combined to take out pretty much the entire inside of the tooth, somehow the shell was intact and he was still using it to chew. Amazingly when we did the extraction it came out in one piece.