Until recently anyone who needed to repair cavities in his or her teeth ended up with a mouth full of “silver” fillings. Dental amalgam, which has a silver appearance, was the tooth restoration material of choice. Amalgam, a combination of metals including silver, mercury, and other metals, is still used — but today there are other options that mimic the original teeth they are restoring.

You may have read about some people's concerns about the mercury used in dental amalgam. According to the American Dental Association (ADA), scientific studies have found no ill effects arising from using dental amalgam in fillings for adults or children: “While questions have arisen about the safety of dental amalgam relating to its mercury content, the major US and international scientific and health bodies, including the National Institutes of Health, the US Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.” Dental amalgam is still used for molars (back teeth) that must withstand heavy pressure from chewing.

For teeth that are more visible, materials that look and perform more like the original teeth — and are thus more pleasing in appearance — are now available. Dentistry is now taking a “biomimetic approach” (from words meaning “life mimicking”). The new materials — composite resins and porcelains — look like teeth because in many ways their structure imitates the biologic structure of teeth.

Composite resins are made of a plastic material (methacrylate) combined with fillers made of silica, a form of glass. They are able to bond to natural tooth structure and resemble the dentin, the inner layer of the tooth, which has a porous structure similar to bone.

Dental porcelains are a form of ceramic. They are non-metallic materials formed by the action of heat, like the ceramics used in porcelain cups and bowls. They come in a powder form that is mixed with water, shaped, and then placed in an oven until they reach the proper hardness. The end product is translucent and very hard, resembling the densely packed crystals of calcium that make up a tooth's normal outer layer, the enamel.

The old amalgam fillings required removal of tooth material to prepare a site in which they could be placed. Composite resins and porcelains can be used to treat teeth that have small or large amounts of damage to their natural substance because the materials bond directly to the remaining dentin and enamel. Thus they end up stabilizing and strengthening the restored tooth, as well as providing a natural-looking appearance.

Contact us today to schedule an appointment to discuss your questions about tooth colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

Did you know that the bacteria that cause tooth decay are usually transmitted to children from their parents, through sharing the same spoon or kissing? Once inside the child's mouth, the bacteria live on the teeth in what is called a biofilm. When the child consumes sugary foods or drinks, the bacteria act upon the sugar to produce acids that eat away at the child's teeth, producing tooth decay.

These bacteria thrive on carbohydrates such as bread, sweets, and sodas. Even fruit juices, which offer more vitamins than soda, are filled with sugars that lead to decay. The child's saliva works hard to neutralize the acidity produced from these foods, but if the child often snacks between meals this neutralization process doesn’t have a chance to occur.

The first sign of decay may be white spots on the teeth, an indication that minerals in the surface enamel have been dissolved in certain locations. Before it goes any farther, this process can be reversed by reducing the exposure to acids and using fluorides to strengthen the tooth surface.

Make sure your child sees a dentist by his first birthday, to provide preventive care and treat any beginning decay.

You can also help your child develop the habit of brushing his teeth with fluoridated toothpaste. It is important to use only a smear of toothpaste on the brush for very young children, and a pea-sized amount on the brush for children over the age of 2. Sometimes small children swallow their toothpaste, and excessive amounts of fluoride can cause staining on the teeth. When your children are very young, you must brush their teeth. As they get older, they can do it themselves, with your supervision. We can also apply fluoride varnish to strengthen the tooth surface and make it resistant to acids.

Brushing twice a day is a good start. But it can't prevent tooth decay when a child is eating carbohydrates all day. One way to reduce the use of sugar is to use xylitol, a naturally occurring sweetener that looks and tastes like table sugar and improves oral health. Studies have shown that use of this sweetener reduces tooth decay in children.

Another good idea is to wean children from bottles and training cups as early as possible. Sometimes children are given bottles filled with milk or sugary beverages at bedtime to help them relax. A better idea for their teeth is to teach them to drink from a regular cup filled with milk — or preferably, with water.

Contact us today to schedule an appointment to discuss your questions about tooth decay in children. You can also learn more by reading the Dear Doctor magazine article “Managing Tooth Decay In Children With Chronic Diseases.” While this article focuses on children with health challenges, it contains excellent advice to help all children prevent tooth decay.

If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.

Self Test For Sleep Apnea

While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.

1. Are you a loud habitual snorer?
2. Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
3. Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
4. Do you find yourself easily falling asleep throughout your day at work or at home?
5. Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
6. Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?

If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.

Learn More

Learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.” Contact us today to discuss your questions or to schedule a consultation.

Root canal, or endodontic (“endo” – inside; “dont” – tooth) treatment, is often wrongly perceived as a highly unpleasant experience and one that causes tremendous pain. However, the truth is that the procedure actually relieves the pain being caused by an infected and inflamed tooth pulp (inside of the tooth). Advances in dentistry have made treatment virtually pain free and it can be completed relatively quickly, usually in a single visit. Left untreated, infection can spread into the bone immediately around the tooth's root, so prompt attention is the best course of action.

If the term “root canal” still sends shivers down your spine, don't despair. Here is some information that should help put your mind at ease.

• Root canal treatment is necessary when deep decay or trauma has caused the inside (pulp) of the tooth to become inflamed or infected. Symptoms of infection can include sharp pain when biting down, lingering pain after consuming very hot or cold foods, a dull ache and feeling of pressure near the infected tooth, and tender gum tissue surrounding the infected tooth.
• After a local anesthetic is administered to numb the infected tooth and its surrounding area, we will make a small opening on the chewing surface of the tooth. This will allow us to remove dead and dying tissue from the pulp and to then clean and disinfect the root canals. Using small instruments, we will shape the canals and seal them with biocompatible filling materials.
• You may feel slight tenderness at the treated site for a few days, but this is quite manageable and can be relieved with over-the-counter (OTC) non-steroidal, anti-inflammatory pain relievers such as aspirin or ibuprofen. You should refrain from chewing on the treated tooth until your follow-up appointment. A crown or other restoration may be needed to protect the tooth and restore it to full function.

If you think you might be a candidate for a root canal treatment, schedule an appointment as soon as possible. If you would like to learn more about the process of root canal treatment, please read the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

Of all the teeth in the mouth, the ones receiving the most discussion and controversy would have to be the wisdom teeth or third molars. And this is not just a recent phenomenon, as people have been discussing them for centuries! See how much you really know about wisdom teeth by taking our quick and easy true/false self test.

1. Third molars received their name, “wisdom teeth,” because a moderate amount of wisdom is supposedly achieved in life about the time they appear.
   True or False
2. Wisdom teeth and all of their associated problems are commonplace in the practice of dentistry.
   True or False
3. Because wisdom teeth are so unpredictable, they typically make their appearance between the ages of 17 and 25.
   True or False
4. The most common consequence of impacted wisdom teeth is gum (periodontal) disease.
   True or False
5. If wisdom teeth are not removed, they will become impacted or cause crowding. This is why so many people require orthodontic treatment (braces).
   True or False
6. While most people have four wisdom teeth, having more (supernumerary teeth) or less (hypodontia) is possible.
   True or False
7. Through dental x-rays and routine check-ups, we can predict the timing and way in which wisdom teeth become visible (erupt).
   True or False
8. An impacted wisdom tooth, by definition, is a third molar that is colliding with or jammed against another important structure, such as an adjacent tooth, the gums or other important soft tissues in the mouth, or nerves and blood vessels.
   True or False
9. The primary symptom for indicating you have an impacted wisdom tooth is pain.
   True or False
10. If wisdom teeth need to be removed, it is best to remove them at a younger age rather than waiting until periodontal disease has started.
    True or False

Answers: 1) True. 2) True. 3) True. 4) True. 5) False. While wisdom teeth can be a factor in crowding, some people have no issues with these teeth. For them, they grow into proper position and are healthy teeth. 6) True. 7) False. Unfortunately, it is not possible to predict the way wisdom teeth will erupt. 8) True. 9) False. In some scenarios, impacted wisdom may cause no pain. 10) True.

To learn more about wisdom teeth and in particular, impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or you can contact us today to schedule an appointment to discuss your questions.