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.
Major league baseball player Aaron Judge made news in July by breaking Joe DiMaggio's record for most home runs scored by a New York Yankees rookie. Then he made news again, this time for breaking something else. Following their game-winning home run against the Tampa Bay Rays in the 11th inning, the Yanks met for a spontaneous victory celebration at home plate. It was all fun and games… until an errant helmet accidentally slammed into Judge's mouth, breaking off half his left front tooth. Ouch!
Even if you're not playing big-league baseball, accidents sometimes happen. So what's the best dental treatment if you chip or break a tooth? It all depends on how much is broken off.
When a tooth has a small chip in it, dental bonding may be sufficient. Layering on tooth-colored bonding material results in a natural look, and it can be completed in one dental visit. However, bonding material in time will discolor, and it is not as strong as real tooth structure, so eventually it may need re-treatment.
Dental veneers or crowns may be used to restore more seriously damaged teeth. Veneers, thin porcelain shells that cover the front surface of teeth, can be used to restore minor to moderate chips. A crown (“cap”) is used when the damage is greater and more structural support is required. A crown replaces the visible part of the tooth above the gum line.
When the soft pulp tissue inside the tooth is damaged, root canal treatment will be needed to save the tooth. Despite the outdated rumors some people have heard, root canal procedures don't cause pain — they actually relieve it. During the procedure, exposed or infected pulp is removed and the inside of the tooth is sealed. Then a lifelike crown is placed so the tooth looks as good as new.
If the tooth cannot be saved — for example, it breaks off below the gum line — a dental implant may be your best option. Dental implants are small titanium posts that are surgically inserted and then capped with an artificial crown. Implant-supported teeth can last a lifetime and are usually indistinguishable from natural teeth.
So what happened with Judge's tooth? Thanks to a Friday morning visit to the dentist, he was smiling again with a temporary crown — and smiling over the fact that his tooth garnered more attention than the Yankees' dramatic 11th inning win.
If you have questions about cosmetically-pleasing tooth restorations, please contact our office or schedule a consultation. (If you have a dental injury, call us immediately!) You can learn more in the Dear Doctor magazine articles “Dental Implants” and “A Step-by-Step Guide to Root Canal Treatment.”
Your best insurance against oral health problems is prevention. The Centers for Disease Control in Atlanta say that the chances for tooth decay and gum disease dramatically decrease when people routinely care for their teeth and gums. What do good oral hygiene habits involve? Find out from your dentists, Dr. Gregory Cox and Dr. Sherri Wilkerson-Cox at Cox Family Dentistry & Orthodontics in Fredericksburg, VA. They desire to keep your smile healthy and strong for a lifetime.
It's not rocket science
Dentists understand that oral bacteria--specifically, Streptococcus mutans--causes cavities and gum disease in its various forms (gingivitis and periodontitis). So how can you avoid a build-up of germs in your mouth? Eliminate as much sticky plaque and hard tartar as possible, says your dentist in Fredericksburg and here's how: have a regular routine of oral hygiene. Done correctly, and combined with a tooth-friendly diet, disciplined oral hygiene habits will keep your mouth healthy for a lifetime.
Recommendations for good oral hygiene
First of all, brush your teeth twice a day with a fluoride toothpaste and a soft brush, says the American Dental Association. Fluoride remineralizes your tooth enamel, keeping it strong. Soft bristles ensure you don't abrade your gums or wear down tooth surfaces prematurely. Also, the ADA says to brush for two minutes. Time yourself and your kids.
Next, floss around your teeth each day. If you don't, that sticky plaque, coming from food residues, collects and hardens into tartar. The bacteria in plaque secretes acids that corrode teeth, and tartar actually pushes your gums away from your teeth. Deep gum pockets are characteristic of gum disease, says the National Institute of Dental and Craniofacial Research, and they require treatment to avoid gum, bone and tooth loss.
In addition, a healthy diet is part of good oral hygiene. Make sure you drink plenty of water to rinse your teeth and gums, and avoid sugar and starches, and substitute with lean proteins, fruits and vegetables and calcium-rich foods such as milk, cheese and yogurt. Yes, what you put in your mouth makes or breaks your dental health. So avoiding tobacco--both cigarettes and smokeless tobacco--is a must.
Finally, see your dentist in Fredericksburg every six months. He or she will check your teeth for dental decay and gum disease, and you'll receive a thorough cleaning to remove plaque and tartar. Your children will benefit from semi-annual appointments at Cox Family Dentistry & Orthodontics, too, as the friendly hygienists show them proper brushing and flossing techniques and encourage them to limit unhealthy snacks.
Do you have questions?
If you desire to improve your oral hygiene habits but are unsure of what may be lacking in your routine, ask Dr. Cox or Dr. Wilkerson-Cox when you come in for your semi-annual check-up in Fredericksburg, VA. After all, they're all about preventive dentistry and how you can keep your smile healthy and bright. Call for an appointment today: (540) 373-5825.
Treating advanced periodontal (gum) disease takes time. If you have this destructive disease, it wouldn’t be uncommon for you to undergo several cleaning sessions to remove plaque from tooth and gum surfaces. This built-up film of bacteria and food particles is primarily responsible for triggering and fueling gum disease.
These cleaning sessions, which might also involve surgery and other advanced techniques to access deep pockets of infection, are necessary not only to heal your gums but to preserve the teeth they support. With these intense efforts, however, we can help rescue your teeth and return your reddened and swollen gums to a healthy, pink hue.
But what then — is your gum disease a thing of the past?
The hard reality is that once you’ve experienced gum disease your risk of another occurrence remains. From now on, you must remain vigilant and disciplined with your oral hygiene regimen to minimize the chances of another infection. You can’t afford to slack in this area.
Besides daily brushing and flossing as often as your dentist directs, you should also visit your dentist for periodontal maintenance (PM) on a regular basis. For people who’ve experienced gum disease, PM visits are more than a routine teeth cleaning. For one, your dentist may recommend more than the typical two visits a year: depending on the severity of your disease or your genetic vulnerability, you may need to increase the frequency of maintenance appointments by visiting the dentist every two to three months.
Besides plaque and calculus (tartar) removal, these visits could include applications of topical antibiotics or other anti-bacterial substances to curb the growth of disease-causing bacteria in your mouth. You may also need to undergo surgical procedures to make particular areas prone to plaque buildup easier to clean.
The main point, though, is that although you’ve won your battle with gum disease, the war isn’t over. But with your own daily hygiene maintenance coupled with your dentist’s professional attention, you’ll have a much better chance of avoiding a future infection.
If you would like more information on preventing and treating gum disease, 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 “Periodontal Cleanings.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
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