Metal amalgam fillings for dental caries have been used since the mid 19th Century. Although newer, “natural color” filling materials have become available, amalgam remains a standard choice among dentists.
Dental amalgam is a metal alloy created by carefully combining exact proportions of mercury, silver, tin and copper. Though quite pliable when first mixed, the alloy eventually sets into a very hard substance that stands up well against the forces produced by the mouth’s natural chewing function. The presence of mercury, however, has raised concerns for some that the metal’s toxic properties pose a risk to the patient’s health.
But after decades of research, the American Dental Association and other health organizations have concluded that dental amalgam “is a safe, reliable and effective restorative material.” Studies have determined that any free molecules of mercury that could potentially enter the bloodstream are trapped in the set amalgam. And although the amalgam can release mercury vapor during chewing, the amounts are well below the levels considered harmful.
Dental amalgam has proven to be versatile, effective and economical. It doesn’t create an allergic reaction, is quite durable, and doesn’t interfere with normal chewing function. It does, however, have its drawbacks. Its use can require more tooth material to be removed to keep the fillings in place, and they can increase temperature sensitivity during the initial four to six weeks. And, of course, their metallic appearance, especially when used in more visible front teeth, reduces their aesthetic appeal.
Other, more cosmetically appealing types of filling material have been developed over the years. These include composite resin fillings, a mixture of glass or quartz in a resin medium; glass ionomers, made of acrylic acids and fine glass powders and best used in areas not subject to heavy chewing; and resin ionomers, similar to glass ionomers but with the addition of acrylic resin. Each of these has their advantages and disadvantages (as well as cost considerations), but they’re main advantage over amalgam is their mimicry of natural tooth color.
The choice of either dental amalgam filling or one of the tooth-color alternatives depends on what you may need and can afford. Rest assured, though, that if the choice is dental amalgam, this restoration workhorse can provide you years of safe and effective service.
If you would like more information on your options for tooth fillings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Silver Fillings.”
The perception that orthodontics is mainly for children or teenagers is changing rapidly. The number of adults seeking treatment for misaligned teeth is on the rise, especially with the development of less intrusive treatments like clear aligners.
Still, as an adult you may be wondering if having your teeth straightened is really worth the effort. There are good reasons to consider orthodontic treatment even when your teen years are well in your rear view mirror — and improving your smile is only just one of them.
To be sure, smile enhancement is an important reason. We place a high value on presenting our best appearance; indeed, our self-assurance and esteem suffers if we feel we have a less than pleasing smile. Adults who improve their smiles through orthodontics typically see a rise in confidence and an improvement in life attitudes that can have a positive impact on their social, career and financial development.
But there is another reason: as a general rule, misaligned teeth do not function as well. Biting, chewing and speaking may be more difficult. Over the long-term misaligned teeth and the resulting poor bite can have an adverse effect on nutrition, social skills and normal tooth wear.
What's more, misaligned teeth are more difficult to clean even with conscientious daily hygiene. Despite your best efforts, this can lead to increased plaque that causes tooth decay and periodontal (gum) disease. In regard to gums, misaligned teeth may be more prone to receding gums which further exposes teeth to harmful bacteria. Realigning teeth can vastly improve dental hygiene.
As with considering any dental procedure, the first step is a complete dental examination to measure the level of misalignment, as well as the current health of your teeth and gums. After that, we can discuss your orthodontic options for not only correcting your smile, but improving your oral hygiene which can have a pronounced improvement in your oral health as well.
If you would like more information on the benefits of orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Why Straighten Teeth.”
That “squeaky clean” feeling on your teeth might be the most noticeable result of a professional cleaning performed by a dental hygienist. Rest assured, though, there's more to it — regular professional cleanings yield long-term benefits to your oral health.
A basic procedure known as coronal cleaning removes plaque (bacteria and leftover food deposits) on the crowns, the visible portion of the teeth. If you are showing signs or are at risk for gum disease (a bacterial infection of the gum tissue) your hygienist may also initiate cleaning below the gum line with a procedure called scaling. This common technique removes plaque and tartar (hard deposits) above and below the gum line using either a traditional set of hand instruments (known as curettes) or an ultrasonic scaler, a device that uses vibrations from ultrasonic frequencies and water to remove plaque and tartar.
Root planing takes the cleaning even deeper, using curettes to remove plaque and tartar adhering to tooth roots. This is typically necessary for patients with advanced gum disease, and may need to be repeated over a number of visits as inflammation subsides.
Polishing is another common hygienic procedure performed both above and below the gum line. It's the procedure you most associate with that feeling of smoothness after a cleaning. The hygienist will typically apply to the teeth polishing paste held in a small rubber cup attached to a motorized device. As the motor rapidly rotates the rubber cup, the paste works into the teeth to remove surface stains and bacterial plaque. While it's considered a cosmetic procedure, it's more accurately defined as a prophylaxis, a dental term derived from the Greek meaning to guard or prevent beforehand.
Professional cleaning performed by a dental hygienist is only one half of an overall hygiene plan; the other half is your own daily habit of brushing and flossing. Both your daily hygiene and regular dental checkups and cleanings will go a long way toward preserving your teeth as they were meant to be — for a lifetime.
If you would like more information on teeth polishing, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Polishing.”
People who fly or scuba dive know firsthand how changes in atmospheric pressure can affect the body: as minor as a popping in the ears, or as life-threatening as decompression sickness. Pressure changes can also cause pain and discomfort in your teeth and sinuses — in fact, severe pain could be a sign of a bigger problem.
Barotrauma (baro – “pressure;” trauma – “injury”), also known as a “squeeze,” occurs when the unequal air pressures outside and inside the body attempt to equalize. Many of the body's organs and structures are filled with air within rigid walls; the force created by equalization presses against these walls and associated nerves, which in turn causes the pain.
The sinus cavities and the middle ear spaces are especially sensitive. Each of these has small openings that help with pressure equalization. However, they can become swollen or blocked with mucous (as when you have a head cold), which slows equalization and contributes to the pain.
It's also possible to experience tooth pain during pressure change. This is because the back teeth in the upper jaw share the same nerve pathways as the upper jaw sinuses — pain originating from the sinuses can be felt in the teeth, and vice-versa. In fact, it's because of this shared pathway that pressure changes can amplify pain from a tooth with a deeper problem, such as a crack, fracture or a defect in dental work.
Besides problems with your teeth, the severe pain could also be related to temporo-mandibular joint dysfunction (TMD), which is pain or discomfort in the small joint that connects your lower jaw to your skull. There are a number of causes for this, but a common one for scuba divers is an ill-fitted regulator mouthpiece that they are biting down on too hard while diving. A custom-fitted mouthpiece could help alleviate the problem.
If you've been experiencing tooth pain during pressure change events, you should see us for an examination before you fly or dive again. There might be more to your pain — and correcting these underlying problems could save you extreme discomfort in the future.
If you would like more information on the effects of atmospheric pressure changes on teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”
If the words “root canal” frighten you, what you probably don't know is that “root canal treatment” doesn't cause pain, it alleviates it — by treating infection deep in the root of your tooth.
- What is a root canal? The central chamber of a tooth contains the living vital tissues comprising the pulp including its nerves and blood vessels. The interior of the tooth's roots containing the pulp make up its root canals.
- How do I know if a tooth has a root canal infection? Symptoms of root canal infection may include sharp, intense pain when you bite down, a dull ache or pressure, or tenderness and swelling in gums near an infected tooth. There may be lingering pain after eating cold or hot foods. However, sometimes an infected tooth may stop hurting and you no longer feel pain. This doesn't mean the infection has gone, only that the nerve may have died. Make an appointment if you suspect that you have any or some of these symptoms.
- Why would a tooth need root canal treatment? If the tissues in the root canal/s become infected or inflamed because of deep decay or trauma to a tooth, root canal treatment is needed to treat the infection and save the tooth. If left untreated, root canal infection can spread into the bone immediately around the root.
- What takes place in a root canal procedure? After a local anesthetic is administered to numb the tooth and surrounding area, a small opening is made in the biting surface for a back tooth, or behind a front tooth. Dead and/or dying tissue is removed from the pulp chamber and the root canals are cleaned, disinfected, and sealed to prevent future infection.
- What can I expect afterwards? Your tooth may feel tender or sensitive for a few days. You can take over-the-counter non-steroidal anti-inflammatory medication, aspirin or ibuprofen, for example, to relieve pain or discomfort. Contact us if you have pain that lasts more than a few days. A crown is usually needed to protect the tooth following root canal treatment. Further arrangements need to be made for this stage of the procedure. Don't chew on the affected tooth until symptoms subside and the tooth has been restored as necessary.
- Who performs root canal treatment? While all general dentists have received training in endodontic treatment and can perform most endodontic procedures, in complicated situations you may be referred to an endodontist, a specialist in root canal diagnosis and treatment.
Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can learn more by reading the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”
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