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Posts for: May, 2014

FrequentlyAskedQuestionsAboutTooth-ColoredFillings

Are tooth-colored fillings safer than silver fillings?
No. Both are considered safe based on the most reliable and up-to-date scientific evidence. Still, tooth-colored fillings do have some definite advantages. Not only do they blend in with your smile far better than “silver” (dental amalgam) fillings, but they often require less removal of healthy tooth structure. That’s because in order to fill a tooth with amalgam, it is necessary to create indentations in the tooth called “undercuts” to hold the amalgam in; this requires the removal of some healthy tooth material. With a tooth-colored filling, we need only remove the decayed part of the tooth to place the filling.

Are there any disadvantages?
Yes, tooth-colored fillings don’t always wear as well as metal fillings — particularly on back molars where they are subjected to the most stress from chewing. They are also more expensive and less likely to be fully reimbursed under dental insurance plans.

Are there different types of tooth-colored fillings?
Yes, three different choices of tooth-colored fillings are available:

  • Composite — This mixture of plastic and glass is the most common type of tooth-colored filling. Newer materials can hold up almost as long as amalgam fillings and look very natural, though they can stain over time just as natural teeth do.
  • Porcelain — High-tech dental ceramics are considered the most aesthetic choice of filling material. They don’t stain as composites can, but their relatively high glass content can make them more brittle and prone to breakage. They may be more expensive than composites.
  • Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings blend in acceptably well with natural teeth and have the advantage of releasing small amounts of fluoride to help prevent decay. However, they generally don’t last as long as other restorative materials.

We would be happy to offer guidance on which choice would be best in your own unique situation.

If you have any questions about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”


By Phil Hart, DDS
May 22, 2014
Category: Dental Procedures
Tags: root canal  
DoesRootCanalTreatmentLastForever

Perhaps you’ve been told that you need to have root canal treatment in order to save one or more of your teeth. By now, you know that the procedure itself is essentially pain-free, and that it has an excellent chance of success. But you may be wondering — just how long can you expect that “saved” tooth to last?

The short answer is: decades… or even a lifetime. But in just the same way that no two fingerprints are exactly identical, neither are any two teeth with root canals. There are some factors that could result in one tooth having a greater longevity after root canal treatment (RCT) than another — but before we go into them, let’s look at what RCT actually involves.

When infection and inflammation is allowed to get a foothold deep inside a tooth — usually due to uncontrolled decay or trauma — the nerves, blood vessels and connective tissue that make up the tooth’s pulp begin to die. If left untreated, the infection can spread out of the tooth and into the bone of the jaw. This may lead to further problems, including the development of a painful abscess, and eventual loss of the tooth.

Root canal treatment involves gaining access to the infected pulp tissue through a tiny hole made in the tooth, and then removing it. Next, the space inside the tooth is disinfected and filled with sterile material, and the access hole is closed. Afterward, a crown or “cap” is often needed to protect the tooth and restore it to full function in the mouth.

One factor that can influence how long a treated tooth will last is how soon the tooth is restored following the root canal procedure: The sooner it receives a permanent filling or crown, the longer it is likely to last. Another factor is whether or not the underlying infection has spread into the bone of the jaw: A tooth that has received RCT promptly, before the infection has had a chance to spread, is likely to have greater longevity.

Some of the other factors that may influence the longevity of a tooth after RTC are: the location of the tooth (front teeth are easier to treat and receive less biting force than back teeth); the age of the individual (teeth become more brittle over time); and what other work needs to be done on the tooth (such as the placement of posts, which may in time weaken the tooth’s structure.) In general, however, there’s no dispute that a tooth which has received a quality root canal treatment should last for many years to come — if not an entire lifetime. And to many people, there’s simply no substitute for having your own natural teeth.

If you would like more information about root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?


ChildStarNolanGouldTalksAboutToothExtractionsOrthodonticTreatment

Nolan Gould of the hit TV show Modern Family has an uncommon gift for comedy, but he also has a very common orthodontic problem: too many teeth for the size of his mouth, which often results in “crowding.”

“My teeth used to be pretty messed up,” Nolan recently told Dear Doctor magazine in an exclusive interview. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. They had to remove those two (extra) teeth,” he said.

Although being born with extra teeth is somewhat unusual, needing to have teeth extracted for orthodontic reasons is not. In fact, orthodontic treatment often involves removing teeth to relieve crowding. It makes sense when you think about it: When there are too many teeth for the size of the dental arches (upper and/or lower jaws) or the teeth are larger in size than the dental arch can accommodate, there may not be enough space to align them properly. The necessary space can be created by removing teeth.

The teeth most frequently extracted for orthodontic reasons are the first bicuspid teeth. These are the ones right between the cuspid, or eyeteeth (under the eyes) and the molars (biggest back teeth). Once there is enough space, the orthodontist can choose from a variety of orthodontic appliances to align the teeth, depending on the specific needs of the individual.

In Nolan's case, it was the extra two teeth he was born with that were removed. Afterwards, the young actor's orthodontist was able to shift Nolan's remaining teeth into proper alignment using orthodontic appliances called Crozats. Made of metal wires, Crozats go around the back teeth and behind the front teeth, making them virtually invisible.

“You can remove them, which is really good for acting, especially because you can't see them,” Nolan explained. “I can wear them 24/7 and nobody will ever notice.”

Nolan's orthodontic appliances may not be noticeable, but his fabulous smile certainly is!

If you would like to learn more about improving tooth alignment with orthodontics, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on “Tooth Removal for Orthodontic Reasons.”


PatientsonBloodThinnersRequirePrecautionsBeforeandDuringOralSurgery

The proliferation of drugs to treat all manner of diseases and conditions has heightened concerns not only about general side effects, but also how a particular drug may affect treatments for other conditions. There are indications, for example, that drugs classified as blood thinners could cause complications for patients undergoing oral surgery.

Blood thinners like Warfarin are typically prescribed to patients with artificial heart valves or who are at significant risk for stroke, heart attack, or the formation of clots that could potentially damage the heart and lungs. The drug reduces the coagulation (clotting) mechanism in blood; aspirin taken regularly should also be considered a blood thinner.

As with any invasive procedure, blood thinners can complicate oral surgery. Blood doesn’t clot normally and so bleeding during a procedure is more difficult to stop. This doesn’t necessarily mean the surgery can’t be performed. For one thing, many oral procedures like tooth removal involve little trauma to tissues and bleeding in the hands of a careful and experienced surgeon. The surgeon can also use hemostatic agents during surgery that will stabilize blood clotting, as well as suturing the incision in such a way as to reduce bleeding from surface capillaries. In the case of a tooth extraction, a bone graft placed within the empty socket not only reduces bone loss from a missing tooth, but can also enhance bleeding control.

In consultation with your medical doctor, it’s also possible to temporarily stop or reduce your medication dosage in anticipation of a pending oral surgery. While it may not be safe to stop the drug altogether, a reduced dosage can ease the anti-coagulant effect and reduce any complications from bleeding that might occur during the surgery. You can then resume normal dosage soon after the procedure.

During your pre-op examination, it’s important to let your surgeon know about any drugs you are currently taking, including over-the-counter drugs like aspirin. The oral surgeon will then be able to take the necessary steps, including working with your medical doctor, to ensure your surgical procedure is safe and uneventful.

If you would like more information on oral surgery precautions while taking blood thinners and other medication, 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 “Oral Surgery & Blood Thinners.”