Are silver fillings a health risk? Are there alternatives?

Dental amalgam, or silver filling material, is a mixture of mercury, and an alloy of silver, tin and copper. Once ‘bound’ by the hardening process, release of mercury in silver fillings is so small that it is much less than what patients are exposed to in food, air and water. Studies with radioactive labeling of the mercury in amalgam have not found elevated mercury levels in the serum or blood after silver fillings are placed. Silver fillings are not often used.  There are, however, other materials that can be used for restorations. These include gold, porcelain, and composite resins. All have their pluses and minuses. Ask your dentist about the alternatives.

What are dental implants?

Dental implants are titanium replacements for tooth roots. In modern dental implants, known as osseo-integrated implants, your own bone actually grows and fuses with the titanium implant. Implants can replace a single tooth or  several teeth, support bridges, or support dentures. Dental implants are comprised of three parts–the implant (replaces the root), the abutment (replaces the above gum portion of the tooth), and the implant crown(covers the abutment and looks like your own tooth), or over denture.

Implant placement is a very routine procedure, usually with very little post-operative pain.

Is fluoride a health risk?

Dental fluoride is a compound of the element fluorine, which is commonly found in water, soil, air and in most foods. Fluoride is most effective when tooth buds are forming, long before eruption of the teeth into the oral cavity. Fluoride can be absorbed into the tooth enamel and dentine. Once teeth are developed, fluoride makes the entire tooth structure more resistant to decay and promotes re-mineralization, and can aid in repairing early decay before damage is visible.

Certain geographic areas in the United States have water with a naturally occurring high content of fluoride. Few side effects have been noted in people who grew up using the naturally fluoridated water. Although the result of the highly fluoridated water is very hard enamel and very little tooth decay, discolorations of the enamel can occur. Your pediatrician or dentist can help decide proper fluoride level for children.

Are dental x-rays dangerous?

Without x-rays, your dentist will be unable to detect decay between the teeth, or under the gumline, with a visual examination. If decay progresses the treatment will change from a small filling, to a large filling, to a crown, to a root canal, to extraction.

X-rays also helps your dentist determine the presence or degree of periodontal disease, abscesses, and many abnormal growths such as cysts and tumors. They can help pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination.

Our office uses digital radiography, which greatly reduces dental x-ray exposure. Our doctors, and staff, are sensitive to patient concerns about exposure to radiation. Every precaution is used to take your radiographs safely, while minimizing exposure.  Make certain your dentist is aware of any special circumstances and other recent exposure to radiation.

Do bleaching or whitening products damage the teeth?

Bleaching, or whitening products do not damage the teeth, but it can cause gum irritation and temporary tooth sensitivity.  Whitening products do not damage existing restorations, but will not lighten them either.

What are porcelain veneers?

A veneer is a very thin custom shell, usually made of tooth colored porcelain, that is bonded to the surface of a prepared tooth. Veneers can drastically improve the appearance of the front teeth by masking discolorations, chips, or re-aligning teeth that are slightly out of position. Be aware that a slight thickness of enamel must be removed to make room for the veneer, otherwise the teeth appear ‘bulky’.

What is a root canal?

Each tooth has one or several canals.  Nerves and blood vessels reside in each canal. If the nerve dies due to trauma or infection, the result can be a root end abscess or extreme pain. A root canal procedure removes the infected tissue and the canal is filled with a rubber-like material to protect against further invasion or infection by bacteria.

What is a cap? What is a crown?

A cap, or a crown, is the  same procedure.It is a restoration (metal, ceramic, or ceramic metal) that fully covers the crown of the natural tooth. Used when a large portion of the natural tooth is lost it replaces the lost portion and adds support and strength. It is permanently cemented, or bonded ,to the remaining tooth structure.

What causes gum disease?

Between each tooth and the surrounding gum tissue, there is a little ‘ditch’ known as a sulcus. It is kind of like the space between your finger and your finger-nail. When bacteria are allowed to reside in this little ditch the result is inflammation of the tissue(gingivitis) which leads to the ditch getting progressively deeper with several side effects(periodontal disease). First, the deeper the ditch, the more difficult it is to clean and eliminate bacteria. Secondly, as the ditch gets deeper the supporting bone is eroded, and there is progressively less bone to support the tooth. Often, this disease is not painful and if diagnosed in the later stages it becomes difficult to save the teeth. If your gums bleed regularly when brushing, seek treatment immediately.

What causes my jaw to pop when I open it?

The joint (temporomandibular joint) located just below and in front of the ear rides on a ‘disc’. The disc can snap out of postion and makes a popping noise.

No treatment is required unless pain is associated with the “pop” or the jaw locks.

What causes tooth decay?

Tooth decay results from a bacterial film (plaque) in your mouth feasting on carbohydrates in food. The by-product of bacterial replication is acid which damages the enamel over time and weakens the underlying tooth, allowing decay.

Is there a treatment for ulcers or canker sores in the mouth?

Ulcers in the mouth or lips are usually caused by a type of herpes virus that almost everyone has in the body. There are many causes for canker sores. At home treatments, such as salt water rinses, baking soda pastes, dotting on milk of magnesia, or over-the-counter painkillers can help reduce pain.  It takes about 7-10 days for the lesions to heal.Prescription anti-viral medication can be effective at lessening the severity and duration if started at first sign of occurrence.

 What causes me to grind my teeth?

Tooth grinding (bruxism) is usually habitual (much like nail biting) or a response to stress. Habitual grinding is difficult to stop because it happens when you are sleeping. If the grinding is  stress related then some form of stress management is helpful.

Clenching is also common and can cause as much damage to the teeth as grinding. Clenching is often a daytime habit.

Grinding or clinching can be very damaging to the teeth and also difficult to stop. The clenching/grinding habit can result in teeth being excessively worn, fractured enamel, or gum recession. A ‘nightguard’ may be prescribed to mitigate damage but will not stop the clenching or grinding habit. A custom night guard can be made in our office, usually in just a few days.

Are there alternatives to dentures?

Advances in implant placement offers several modes to either support a full denture or support ‘fixed’ bridges which are permanent and non-removable. Paired with 3D imaging, wonders can be accomplished as far as restoring a whole mouth with implants.  Talk to your dentist about the possibilities.

Is there a best time to remove wisdom teeth?

If wisdom teeth need to be extracted, the procedure is best done before the roots are fully formed, usually in the adolescent years. Such timing makes the procedure easier and with less trauma.

Can water irrigation systems eliminate the need to floss?

Water irrigation systems are very good for removing debris around your teeth and gums but it will not remove the film of ‘plaque’. Plaque is the slimy carbohydrate film that forms when bacteria are allowed to organize on the teeth for more than 12 hours. Plaque is the causative factor in both decay and periodontal disease.  Plaque needs to be physically disrupted, or removed, daily. Water irrigation systems can be a great aid in cleaning periodontal pockets when used with an antibacterial solution, after plaque has been disrupted.

What is root planing?

Root planing is a thorough cleaning of the  root surfaces below the gum line. After a local anesthetic is administered, any hard deposits that can harbor bacteria are removed and the root surface is polished to discourage further bacterial colonizing. If the periodontal ‘pockets’ are moderate, the pocket depth usually decreases as swelling decreases and the gum re-attaches to the root surface. In the early stages of periodontal disease, this procedure can stop and reverse some of the damage.

My gums bleed when I brush, is this serious?

Bleeding gums is an early indication of gingivitis, or swollen gums; usually caused by plaque and/or calculus accumulated under the gum-line. Gingivitis is the early sign of periodontal disease. If left untreated, gingivitis will most likely progress to periodontal disease and lead to bone loss and eventual tooth loss. If bleeding persists for more than two to three weeks, consult your dentist.  Gingivitis can usually be reversed within a couple of weeks by having a thorough dental cleaning, followed by proper brushing and daily flossing.

How often should I see my dentist?

Rule of thumb is every six months or more frequently to get your teeth cleaned. By seeing your dentist twice a year, your dentist can monitor your oral health and help you prevent any problems that may arise before they became uncomfortable or require more comprehensive or expensive treatment. The dentist may suggest more frequent visits or less frequent visits, depending on the the patient’ oral history and current health.

After Hour Emergencies:

Our patients are able to contact one of our doctors for emergency care.  Instructions are given on our after hours recording. Call 964-0255. Remember, most pharmacies close at 6:00pm.

Post OP Sensitivity

 Preparing the tooth for a filling or crown stresses the nerve within the tooth. Root canal therapy can cause inflammation. Extractions can cause swelling or pain.Take an over the counter painkiller. Ibuprophen (Motrin, Advil) is best. 600 mg, 4 times a day, up to 2400 mg a day. Sensitivity usually subsides over a few days, to a few weeks. If you are experiencing a toothache that is not relieved by anti-inflammatory medication, or persists for more than 24hrs, please call the office. 964-0255

If a temporary falls off

Call the office for an appointment.The temporary crown is necessary to maintain position of the prepared tooth. If the temporary is left out the tooth may drift and the permanent crown may not fit.Replace the temporary with denture adhesive or temporary cement (available at any drug store), or even toothpaste to temporarily hold it in place. Unless you are experiencing severe pain, a lost temporary is not an emergency.

If you have severe pain or swelling that extends beyond the area of the tooth (into the cheek, neck, tongue, etc.)

Call the office immediately–964-0255. If not contraindicated, take 400-800mg of Ibuprofen every 4-6 hours. You may also go to the hospital emergency room.

Office hours: 8:30AM to 5PM, Monday through Thursday