Get those ugly metal fillings out!!

This is patient E.

She didn't like the look of her old metal fillings.

She wanted them out.

So we got her hopped up on some happy gas.

Numbed her up.

And away we went.

All the teeth before.

Individual tooth before.

All the teeth after.

Individual tooth after.

Patient E was very excited to be done with her metal fillings.

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Metal Fillings (amalgam)

Fewer and fewer people are asking this question, but occasionally we still do get it.

Are metal fillings safe?

The answer to this is, yes.

There have been studies done by the American Dental Association

and the Centers for Disease Control that both state that metal fillings

are safe to use.

In fact in certain cases we still use this material.

It is rare however, do to the fact that most people do not want the metal look.

You can go on the internet and find sites that tell you the horrors of amalgam.

But you can find a lot of stuff on the internet that isn't necessarily true.

If you have questions ask your dentist.

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How long will it last?

When I inform people that they need a crown due to their

tooth cracking I usually get the same response.

How long will it last if I don't get the crown.

The answer to that is usually the same.

It depends.

Your tooth is cracking because of the pressure being placed upon it during chewing.

Therefore, if you went on an all liquid diet ( thus no longer chewing )

your tooth will last for a long time.

However, if you like to eat nuts, carrots, or anything else that is a

little hard then your tooth could fracture tonight.

There is no way to tell.

If all depends on how you use your teeth.

Cracks will not heal themselves.

They will continue to progress as you use the teeth to chew.

The eventual result will be a fracture.

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My Child Just Knocked Their Tooth Out!

Okay. First of all, as in most traumatic situations.

Do not panic.

Its likely that your child has never gone through this before.

Therefore, they are fairly unaware whether what just happened

to them is simply a minor thing or whether they will soon be in the hospital.

The way they will be able to tell how severe the situation

is is by looking at their parent.

If you are flipping out then they will too.

The first thing to do is to educate yourself BEFORE something like this happens.

It is very important to know when your child's baby teeth will come out naturally.

Here is a chart of, about, when that will happen.

This is important because if the tooth that was just knocked out was about to

come out anyway then there is much less to worry about.

If it's still a year or so away, or you know that its already the permanent tooth

that just got knocked out then there is much more to worry about.

So lets say your child is 8 or 9 years old and it is the adult tooth that just got knocked out.

First thing is to do is obviously check your child for signs of significant injury.

If they hit their face hard enough to knock a tooth out

you need to check for signs of a concussion.

If they seem to be alright except for the tooth then the next step is to find the tooth.

Once the tooth is found treat it very gently.

The tooth is attached to the bone by ligaments.

Parts of those ligaments will still be attached to the tooth and must not be damaged.

First carefully pick off any large pieces of debris.

Secondly the smaller pieces need to be rinsed off.

This is best accomplished by gently rubbing the tooth against the inside of your child's cheek.

This will get all the small particles off and still treat the tooth gently.

Then, are you ready for this..... you need to stick the tooth back in.

That's right, you need to gently place the tooth back into the socket from which it came.

Its pretty simple.

The Skinny part goes in first.

Just simply slide it back into place.

Don't force it. Simply get it as close as you can.

If it wont go or you don't have the stomach for it then place the tooth

into your child's mouth in the bottom jaw in between the cheek and gums.

Holding the tooth there will give it the best chance for survival.

Then finally, in all cases, get to a dentist ASAP.

The dentist will know what to do and will give you options depending on the

severity of the accident and the condition of the jaw and tooth.

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My Crown has a little black line near the gums. what's wrong?

Nothing is wrong.

What you are seeing is simply the metal that your crown is

made out of showing out from underneath.

I know I know, you thought that your crown was white and that

there wasn't any metal in it.

Well, there is. You have what is referred to as a porcelain

fused to metal crown of (PFM).

The crown is made of a metal substructure to give it it's strength and

then porcelainis layered over the top to make it look like a tooth.

The PFM has been used for years and has had remarkable success.

The only draw back to these types of crowns is the metal line showing through

and the fact that the porcelain layers can begin to separate from each other

and cause the pieces of porcelain to fall off the crowns.

Today there are new advances in crown technology that have

eliminated both of these problems.

There is a new material, to the world of dentistry that is, called zirconium.

Zirconium crowns are milled from a solid block and are very very strong.

This milling process means that they are not put together piece by piece.

Therefore there are no pieces to come apart. The crown is one solid unit.

Zirconium is also white so the color is that of most teeth and will never show a

metallic line because there is no metal.

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Progression of tooth decay

Cavities don't just get big all of a sudden.

If you go to your dentist with a toothache, chances are that your

tooth has been decaying for some time.

This picture shows a chart of how a cavity grows.

The top row shows an example of cavities that you get when you

don't floss as much as you should.

The next row shows the cavities that you would get if

you do not brush as often as you should.

The last row shows cavities that can happen underneath

older fillings.

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Teeth Whitening

Teeth whitening is a very hot topic these days.

It seems as though everybody and their dog is offering to have your

teeth whitened for life, by tomorrow.

So what is real and what is hype?

As a disclaimer let me just say that tooth whitening can be accomplished successfully with ANY of these methods and that the following is based on fact with my opinion thrown in for flavor.

There are basically 3 ways to whiten your teeth.

#1 With the whiteners you buy in the stores.

This includes strips, trays, paint on stuff, etc.

Couple of things to consider here. The strength of the bleach has to be over the counter strength which is going to be less then bleach you can get form your dentist. Its like buying Tylenol from the store vs getting Lortab from the dentist. Next is the way the bleach is delivered. Below is a picture of a bleaching strip. Since this strip is sold to everyone it then, by nature, fits no one. Administering bleach to the masses can be a very inexact science that could lead to burned gums or uneven bleaching of the teeth.

#2 Is custom trays made by your dentist and you do the bleaching at home.

This way of bleaching has a lot of up side.

First the strength of bleach is prescription strength which will allow you to bleach faster. Second while bleaching faster it is still slow enough to stop when you begin feeling too much sensitivity. Lastly the trays are made specifically for you. They will fit no one else and thus deliver the bleach right to where it is needed.

#3 In office light whitening.

This option is nice because it is the fastest. But there are some draw backs. The machines to do the bleaching are expensive so the cost must be passed on the the patient. Next, you can't stop bleaching when you begin to feel sensitive. You will lay back being one shade and be several shades lighter when you sit up. If you happen to have lightened up too much and your teeth are very sensitive to even breath you are kind of out of luck.

So again, there are probably many of you reading this that have gotten your teeth whitened by any of the ways just mentioned and it has worked well for you. And that is great. I personally have chosen to offer only the 2nd option in my office as I feel it is the best bang for the buck and offers the least chance of complications for my patients.

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My tooth just tipped over!!!

Most people think that its no big deal to get just one tooth taken out. they will say things like "its just one tooth" and "I've got a ton more". Well, you do have a lot more teeth then just that one but this does NOT mean that getting a tooth out will not create many other problems in the mouth.

Some of the problems that can occur are as follows.

#1 The tooth that chews against the tooth you just took out could move up, or down, into the spot just vacated by the extracted tooth.

This top tooth is moving down into the mouth because the one below it was removed.

#2 The teeth right next to the extracted one may begin to tip into the spot just vacated by the extracted tooth. These next two pictures were taken 5 years apart. The patients tooth tipped completely over and needed to be extracted.

Both of these can cause your bite to be thrown completely off and make chewing uncomfortable.

#3 As you chew hard and crunchy foods, they will pinch up against the gums where the tooth used to be.

Moral to the story is this.

If you can fix your teeth, then do it.

If you can't, then get the hole filled where the tooth used to be ASAP.

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What is your favorite myth?

There are lots of myths out there.

The Lochness Monster, Bigfoot, etc.etc.

Mine is the myth of the cosmetic dentist.

There is no such thing as a cosmetic dentist.

Here is a list of the specialties that are recognized by the ADA. Orthodontics and Dentofacial Orthopedics, Endodontics, Dental Public Health, Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology, Oral and Maxillofacial Surgery, Pediatric Dentistry, Periodontics, and Prosthodontics.

Each one of these specialties is strictly regulated. Each doctor that practices in one of these fields must go through advanced licensure requirements and advanced schooling even beyond dental school. These doctors carry with them advanced knowledge that is strictly regulated by the ADA.

If you noticed none of those specialties that I just mentioned was called the specialty of cosmetic dentistry. That's because it doesn't exist. And as a matter of fact it is illegal to advertise yourself as a cosmetic dentist.

The idea of being "cosmetic" simply means that you try to make things look better. Well, there isn't a dentist, or specialist, out there who DOESN'T do this. Everyone in the dental field has the goal to make things look better. Its what we do.

Now, is it true that a dental professional can go to courses, after dental school, that focus solely on cosmetic procedures? Absolutely. And I have been to many of them. But that does not mean that I am a specialist in cosmetic dentistry. Because, once again, no one can be. It doesn't exist.

If you have things that you would like to see changed about your teeth then ask around. Find a dentist that has a good reputation for that kind of thing. Then when you meet him/her ask to see some of their work. If it looks good then you are probably at the right place.

Here is one that we did just the other day.

Before

After

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What are dental implants?

The teeth that you see in your mouth are connected to you by the root of the tooth.

An implant is simply replacing the natural root with an artificial one and then attaching a tooth to the new artificial one.

Implants can replace single teeth, multiple teeth, or be the way of attaching a loose denture in the mouth with a more firm grip.

Almost anyone is a candidate for implants. Certain medical conditions and drugs that people are taking may present problems but other then that implants are getting to be a pretty universal from for replacing missing teeth.

Most insurances cover implants. Occasionally there are some insurances that are still in the dark ages and don't cover implants so you need to check with your particular company first.

There is no dental specialty that is in charge of placing implants. They are done by general dentists, periodontists, and oral surgeons. Just make sure that the person placing your implants can show you some before and after pictures of work they have done and then can adequately explain the procedure you will be going through so that you will fell comfortable with what will be happening in your mouth.

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I cracked my tooth, do I need a crown?

Okay so you, your child, your mom, your brother, etc. etc. just fell face first into something, over something, under something, etc. etc. and broke the corner of your/their front tooth off.

What do you do now?

Well, that depends. Lets break this down into 3 simplified categories.

The nerve of a tooth is in the middle of the tooth.

#1 If you just broke off a small corner of the tooth and it didn't reach the nerve then a simple filling is probably all you would need.

#2 If you broke off a larger corner but still didn't reach the nerve then you more then likely would need a crown.

#3 If you broke your tooth so severely that you got down into the nerve then you will need a root canal AND a crown.

And although all of this may be a traumatic experience don't worry. Your cracked and broken smile can be completely repaired and have you back to being the model you know you were born to be.

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Are pacifiers bad?

Well, like most things, the answer is ............ it depends.

Sucking is a very natural and calming thing for a baby to do.

I have given each and every one of my 5 kids a pacifier.

None of them are delayed in their teeth coming in, have any speech problems, or had any thumb sucking problems due to using a pacifier.

There are some obvious thing you should be concerned with.

If you use a clip and a cord to keep the pacifier attached to your child's clothes make sure the cord is short enough that can't choke the baby.

Once your child gets to kindergarten make sure that they only use the pacifier at home. Being known as the only kid that had a pacifier in kindergarten could seriously damage your child's chances at getting asked to junior prom.

Well, what about thumb sucking, you may ask.

That my friends, is a whole different story.

We will talk about that tomorrow.

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Switching from soda to sports drinks.

I have many patients who have developed bad oral habits over the years.

One of these bad habits is drinking lots of soda pop.

Soda is terrible on your teeth.

I try to get people to stop drinking the stuff as much as I can.

Some folks have decided that they will kick the soda habit by going to something

much more healthy for them.

The stuff they decide to drink instead is sports drinks (gatorade, poweraid, red bull, etc.)

They see the commercials and see professional athletes drinking this stuff and think that it must be good for them.

Not so fast. The following is a study from the university of Iowa. and the results may shock you.

“The University of Iowa researchers covered extracted teeth with nail polish. They left bare two patches on each tooth, one on the enamel and one on the root. Then they dunked the teeth in test tubes filled with regular Coke, Diet Coke, Gatorade, Red Bull, or 100% apple juice. Every five hours, the researchers refreshed the beverages. After 25 hours, they examined the teeth with a microscope. All of the beverages eroded the bare spots on the teeth. But different beverages had significantly different effects. On the enamel, Gatorade was significantly more corrosive than Red Bull and Coke. Red Bull and Coke, in turn, were significantly more corrosive than Diet Coke and apple juice. On the roots of the teeth, Gatorade was more corrosive than Red Bull. Coke, apple juice, and Diet Coke followed in that order.”

So there you have it. People switching from soda pop to sports drinks thinking that they are helping their teeth are actually doing MORE damage to their teeth then before. Be careful what people tell you is better for you. It just may be worse.

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People often ask about veneers. Their number one concern is what exactly happens to the teeth that the veneers will be placed on. This video will hopefully clear that up.

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1/2 off brain surgery!

Who in their right mind would answer an ad for 1/2 off of a brain surgery?

Probably no one.

Why?

Because you want it done right. Your brain is important.

Whenever people are getting major surgeries done, you always hear them say that they got the best doctor they could find. You never hear them say that they got the cheapest.

So why do people jump so quickly for a cut rate dentist?

Please do not misunderstand. I realize that your teeth are not as important as your brain. However, if you like having a nice smile and if you do not want to have problems down the road with the same teeth over and over again you may want to look for the quality instead of the freebie.

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Dental Implants

When we talk to people about implants there is a lot of hesitation because people really do not know what is involved in getting an implant. If your tooth is already gone then its really very simple. If you still have a tooth in the spot where the implant needs to go then things can be a bit more challenging but its still not too bad. Here is a little, 30 second, video that shows an implant procedure.

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When should may baby get his/her first tooth?

There is nothing much cuter then an infants big gummy smile. After a while however, parents start to ask the question, "When are my babies first teeth going to start coming in"?

Below is a chart showing not only when the first teeth will come in but when they will come out as well. The first tooth to come in, is typically, the lower central incisor. The last should be the back molars. A quick way to check and see that your youngster has all of their teeth in is to count them. A full set of baby teeth will equal out to be 10 teeth on the top and a matching 10 teeth on the bottom.

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Technology

It happens all the time.

Someone comes into my office that hasn't been for a long long time. I ask why it is that they have not come for so many years. They reply that they had a bad experience once and that they can't stand the noise of the drill or the feel of the novocaine or something similar to that.

I ask them how long its been and the response comes back that they haven't been in 20 or 30 years.

I then ask them what their cell phone looked like 25 years ago.

After a puzzled look they go on to describe a boxy bulky phone that weighed a ton. I then ask them to describe their personal computer. They go on to talk about floppy disks and commodore 64s.

I then explain that just like in every other area of their life, things move on. Technology advances and things improve. Dentistry of 30 years ago is NOT dentistry of today. I tell them of quieter drills and how we don't use metal fillings anymore and on and on. The real kicker comes in when I tell them that we haven't used novocaine in over 20 years! I don't even know if you can buy the stuff anymore. Even the stuff we use to numb people up with has evolved immensely.

Moral to the story is this. If you have had a bad dental experience in the past. But it was the past of the 80s or even 90s. Please give the dentist another try. Things are so much better now then they have ever been. Technology can be a wonderful thing.

Don't know why I included this one. Just love the 80s hair.

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Painless teeth replacement

"Painless tooth replacement"

"Teeth in a day"

We have all heard these claims and typically they are accompanied by promises that the doctor can, almost magically, take out all of your teeth, put implants in, and place crowns on the teeth

with little to no pain. They may even show the patient biting into an apple right after the procedure.

In very rare and unique circumstances this MAY be the case. But for the other 99.7% of us, its not. anytime you have surgery of ANY kind you need to heal. The picture below shows a site where a tooth was recently extracted. This site will be very tender for several days while the body heals. That's just the way it works. Blood will rush to the site of any injury thus creating inflammation (swelling) and moderate discomfort.

If implants are placed that too will cause some type of discomfort.

To say that teeth can be extracted and implants placed and that you can begin eating right away with no pain whatsoever is just not true. What is typically happening is that these people are trying to suck you in and then sell you on something else.

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Cosmetic Dentistry

These are the days that make it really fun to be a dentist.

She told me that she hated her smile but that she didn't have the money to get braces or crowns. 1 hour later without any shots, and for a lot less then the cost of braces or crowns, she got out of the chair, looked in the mirror and started to cry.

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