Q. I have some old silver fillings which are beginning to look bad. What can be done to improve them.

A. Silver amalgam fillings, which are composed of 50% mercury and 50% silver alloy ,eventually need to be replaced. It may surprise you to know that the average life span of a silver filling is five to eight years. Your dentist can tell you when they appear to NEED to be replaced due to leakage, breakdown or recurrent decay.

If your concern is strictly COSMETIC, there are many new methods available to replace the fillings with beautiful, functional long lasting restorations.

Such things as white filling materials, porcelain inlays , crowns and veneers may be used to give you the smile you are seeking.

There is currently a great deal of interest in new reinforced hybrid materials. These beautiful resin materials may be reinforced with fibers, similar to fiberglass, and used in very conservative inlays and bridges without having to grind away a whole healthy tooth.

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Q. I would like to have my teeth whitened. There are so many products and ads for whiteners that it is hard to decide which is best. what do you recommend?

A. You are correct. There are many products and techniques available. Some work great and some don't work at all. The various over the counter products give the least predictable results.

To get a really great result you should probably use one of the products sold through dental offices which utilize custom made trays for home app- lication of a bleaching gel.

There are several great ones out there. Our favorite is Nite White® Excel. Besides giving a great result, this product has overcome the sensitivity problem seen with some of the other products .

We also get questions about "laser whitening". With this method a laser is used as a light source to activate the bleaching gel which is applied to your teeth in the dental office. It may be necessary to use the at home trays in addition to this initial lengthy treatment. Side effects can include senstivity to treated teeth.

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Q. I am missing several teeth. A friend told me that she recently had implants to replace her missing teeth and is very happy.What are implants?

A. Dental implants are a wonderful way to replace missing teeth when certain conditions exist. Such things as your overall general health and the length of time you have been missing your teeth must be considered. The replacement of missing teeth using dental implants frequently requires a team approach.

After your dentist does a thorough examination and treatment plan the surgical phase of treatment takes place. In most cases a periodontist or an oral surgeon will put the implant(s), the artificial root(s) into the jaw. When healing is complete, usually after 4-6 months, The tooth or bridge segment can be placed on top of the healed implants by a general dentist or a prosthodontist . Some dentists are trained to place the surgical part of the implant as well as the prosthetic or tooth part.

You should ask your dentist if you are a good candidate for implants and ask for a referral if he or she doesn't do them.

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Q. There are so many different toothbrushes on the market today. How do I know which one is the right one for me?

A. This is a good question, which we hear daily. The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head and how frequently you replace your brush.

We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums.Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose.

We recommend replacing your brush at least once a month.

My employees and I all brush, on average, 5 times a day. We brush first thing in the morning, after each meal and at the end of the day .

If you are not able to do this because of your busy schedule, we recommend brushing twice a day at a bare minimum.

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Q. When I visited my dentist for my last checkup, she told me that I have impacted wisdom teeth and she wants to remove them. They are not bothering me. Should I see a specialist if I decide to have them removed? What should I do?

A. Having regular dental checkups with x-rays allows you to learn about potential problems and have them corrected BEFORE they begin to bother you. There are a number of reasons for recommending removal of unerupted or impacted teeth. Your dentist may have seen that these teeth could cause problems for the adjacent teeth if left in place. There is also the possibility that you could develop such things as a cyst or abscess if left in place.

General dentists who provide any specialty service such as root canal treatment, braces, oral surgery or periodontal surgery are required by law to adhere to the same standard of care provided by a specialist

Your dentist should be happy to talk more with you about this. If you still have questions, you might want to see another dentist for a second opinion.

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Q. I just recently went to a new dentist for a checkup and cleaning and asked him to check a cap that that was put on one of my front teeth by my former dentist. He informed me that I did not have a cap on any of my teeth. I know my last dentist fixed a broken front tooth and said he capped it. Who should I believe?

A. You have just experienced one of a number of common misunderstandings we see in dentistry today. Terminology used in dentistry is not 100% uniform throughout our profession. Both dentists were probably "correct".

The word "cap" as used in dentistry by different dentists can refer to a number of different things. A pulp cap refers to a calcium containing dressing placed under a deep filling to stimulate healing. A full crown, made by a dental laboratory which completely covers the outside of your tooth is frequently called a cap. A partly broken tooth may be built up by your dentist in the office with a bonded filling material. This is called a cap or "capping" by some dentists. This sounds like what you probably had done.

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Q. My son is six years old and starting to get his permanent teeth. I am concerned because the teeth are discolored. Some even have a brownish or greenish hue. What caused this and what can be done about it?

A. From your description, it sounds like a very normal situation and nothing to be concerned about. When the teeth are forming in the jaws, they are surrounded by a soft tissue membrane called Nasmyth's Membrane (named after Alexander Nasmyth, a Scottish dental surgeon in London who died in 1847).

As the teeth erupt, remnants of this membrane remain on the surface of the enamel. The fibrous nature of the membrane readily picks up coloration from food.

In most cases normal chewing and brushing will remove the remnants with time. If they don't come off, they can be removed by having a professional cleaning.

Other causes for staining of teeth include high fevers during infancy, too much fluoride in drinking water and certain medications if taken while the teeth are still forming.

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Q. It has been quite a while since I have been to a dentist because I cannot stand the sound of the drill. I think I have a new cavity but am reluctant to call a dentist . What can I do? I don't want a toothache and certainly don't want to lose my tooth.

A. Dental technology has come a long way in recent years. If you have a new cavity that requires a filling, there is "new" air abrasive equipment which replaces the drill for removing decay. It is quick, silent and in most cases you do not need a shot of anesthetic because there is no heat or vibration to cause pain.

Air abrasion theory has been around in dentistry since the fifties but has only recently become practical to use because of downsizing of equipment and the development of filling materials which can be used with the new way of preparing teeth for fillings.

Our patients love it. For youngsters who are experiencing their first cavity, it is a great way to go - no noise, no needle, no pain! It won't work for all cavities, but with your dislike of the drill, you should certainly see a dentist who uses this technology.

 

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Q. My boyfriend thinks it would be neat if I got my tongue pierced. What can you tell me about this? I am a little concerned about whether it would be safe. I do have pierced ears and have not had any trouble with that.

A. In a word (or four) PLEASE DON"T DO IT! Fortunately, I have only seen a couple of these in "real life". I have read of numerous cases in our dental journals which have resulted in all sorts of problems.

To begin with, the tongue is an extremely vascular organ, which means that it has loads of blood vessels. A tremendous amount of swelling is expected when the tongue is pierced and a large oversized "barbell" is initially placed to accomodate for the expected swelling.

This can cause difficulty in breathing and swallowing. Eating, drinking and speech are all impaired. The large barbell flops around and has caused unrestorable fractures of teeth when accidentally bitten.

The barbell can come unscrewed and be swallowed or possibly be aspirated, sucked into the lung. Either of these could require surgery.

I repeat, PLEASE DON'T DO IT!

 
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