Over the last century and a half millions of people have had a tooth cavity filled with “silver” amalgam. Perhaps you’re one of them. The use of this effective and durable filling has declined in recent years, but only because of the development of more attractive tooth-colored materials.
At the same time there’s another issue that’s been brewing in recent years about this otherwise dependable metal alloy: the inclusion of mercury in amalgam, about half of its starting mixture. Various studies have shown mercury exposure can have a cumulative toxic effect on humans. As a result, you may already be heeding warnings to limit certain seafood in your diet.
So, should you be equally concerned about amalgam fillings — even going so far as to have any existing ones removed?
Before taking such a drastic step, let’s look at the facts. To begin with, not all forms of mercury are equally toxic. The form causing the most concern is called methylmercury, a compound formed when mercury released in the environment combines with organic molecules. This is the form certain large fish like salmon and tuna ingest, which we then ingest when we eat them. Methylmercury can accumulate in the body’s tissues where at high levels it can damage various organ systems.
Dental amalgam, on the other hand, uses elemental mercury. Dentists take it in liquid form and mix it with a powder of other metals like silver, tin and copper to create a pliable paste. After it’s placed in a prepared cavity, the amalgam hardens into a compound in which the mercury interlaces with the other metals and becomes “trapped.”
Although over time the filling may emit trace amounts of mercury vapor, it’s well below harmful levels. You’re more likely to encounter “un-trapped” mercury in your diet than from a dental filling. And scores of studies over amalgam’s 150-year history have produced no demonstrable ill effects due to mercury.
Although it now competes with more attractive materials, amalgam still fills (no pun intended) a necessary role. Dentists frequently use amalgam in less visible back teeth, which encounter higher chewing pressures than front teeth. So, if you already have an amalgam filling or we recommend one to you, relax — you’re really in no danger of mercury poisoning.
As a member of the best-selling pop group Spice Girls, Mel C (AKA Sporty Spice) enjoyed her share of musical superstardom. At the band’s peak in the Nineties, the young singer’s signature look featured baggy sweatpants, an assortment of tattoos, a nose stud and a gold-capped incisor, front and center in her mouth. Today, Melanie Chisholm is still singing — but now she’s a mom, an amateur triathlete… and that gold tooth is just a memory. Not only that, her smile looks more evenly spaced and whiter than it did when she was referred to as the “tomboy” of the group.
What happened? In our view, it all boils down to changing tastes — plus a little bit of help from dental professionals. As the “wannabe” singer proves, there’s no single standard when it comes to making your teeth look their best. Your own look is unique to you — and your smile can reflect that individuality.
For example, crowns (caps) are substantial coverings that may be placed on teeth when they are being restored. They are available in three types: gold, all-porcelain, or porcelain-fused-to-metal. The latter two are tooth-colored, while the gold is — well, shiny like gold bling. Which one is right for you? In many cases, it’s your choice.
Likewise, dental veneers — wafer-thin shells that can correct cosmetic issues by covering the surface of your teeth — can be made in a variety of shades. Their hues may range from natural ivory to Hollywood white, and everything in between. What’s the best color for you? Only you can say.
Some people opt for a “smile makeover” that uses small irregularities in the spacing and color of teeth to create a more “natural” look. Other folks want a perfectly even, brilliant white smile that dazzles the eye. Still others are looking to match or restore the smile they once had — perhaps even re-creating a signature gap between the teeth. As long as there are no other dental issues involved, the choice is yours.
So if you’re unhappy with your smile — or if you feel it doesn’t reflect the person you “wannabe” — why not talk to us about a smile makeover? Just call our office to schedule a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
You may not be nervous at all about visiting the dentist. But put yourself in a child’s place — a routine dental visit could be an anxious experience for them, and even more so if it involves dental work.
Dental professionals recognize this and go to great lengths to make children’s visits as pleasant as possible. It’s common among pediatric and family dentists to see child-friendly exam rooms and a well-trained staff experienced with interacting with children.
While this helps, some children still struggle with anxiety. Dentists have one other technique that can ease a child’s nervousness: conscious sedation. This technique involves the use of pills, inhaled gas or intravenous drips to help patients relax.
Sedation is different from general anesthesia, which uses drugs to render a patient unconscious so they won’t experience pain. A sedated patient remains in a conscious but relaxed state: they can still breathe independently and, with the most moderate form of oral sedation, be able to respond to touch or verbal instructions.
Oral sedation may also be accompanied by other methods like nitrous oxide gas that also aid with physical discomfort. Many drugs used often have an amnesiac effect — the patient won’t remember details about the procedure, which could contribute to less anxiety in the future.
Typically, a child receives an oral sedative just before the procedure. Most drugs are fast-acting and leave the child’s system quickly afterward.Â A staff member monitors their vital signs (pulse, respirations, blood pressure, etc.) during the procedure and after in recovery. They’ll remain in recovery until their vital signs return to normal levels and then be able to go home. They should stay home the rest of the day under adult supervision, but should be alert enough the next day to return to their normal activities.
Relieving anxiety is an important tool to ensure your child receives the dental care they need. It also creates a positive experience that could encourage a young patient to continue regular dental care when they reach adulthood.
If you would like more information on conscious sedation for children, 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 “Sedation Dentistry for Kids.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
X-rays are such a routine part of dental care that it's easy to overlook how much this technology has revolutionized detecting and treating tooth decay. It's safe to say x-rays have helped save hundreds of millions of teeth over the last hundred years.
Thanks to its unique properties these invisible electro-magnetic waves give us precise images of the interior structure of teeth and gums. It's so precise that we can clearly detect even a small spot of softened, decayed tooth structure on an exposed x-ray film, often before it becomes visible to the naked eye. As a result, we can begin treating the decay earlier, minimizing the damage and increasing the chances for preserving the tooth.
There are a variety of ways we can utilize x-ray technology in diagnosing dental problems. The one, though, that's used the most is called the bitewing. The name comes from wing-like tabs extending out from a thin frame holding a segment of unexposed film. A technician places the frame inside the patient's mouth with the film on the tongue side of the teeth, and has them bite down on the tabs to hold the frame still. They then aim a camera at the patient's outer cheek, which then emits a very short burst of x-ray energy to expose the film.
Bitewings are popular because they give a full view of the back and side teeth, where decay is often hard to detect, with very little radiation exposure to the patient. And as x-ray technology has progressed over the years with digital processing and more efficient equipment, we can acquire sharper images with even less exposure. We've also developed standard protocols for when and how often we perform x-rays, so that we're getting the most diagnostic benefit for the least amount of exposure time.
Those few minutes getting an x-ray may seem routine, but the benefits to your dental health are truly amazing. The bitewing and other forms of x-rays play a huge role in helping us keep your teeth as healthy as they possibly can.
If you would like more information on x-ray diagnostics, 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 “Bitewing X-Rays.”
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