Metal amalgam fillings for dental caries have been used since the mid 19th Century. Although newer, “natural color” filling materials have become available, amalgam remains a standard choice among dentists.
Dental amalgam is a metal alloy created by carefully combining exact proportions of mercury, silver, tin and copper. Though quite pliable when first mixed, the alloy eventually sets into a very hard substance that stands up well against the forces produced by the mouth’s natural chewing function. The presence of mercury, however, has raised concerns for some that the metal’s toxic properties pose a risk to the patient’s health.
But after decades of research, the American Dental Association and other health organizations have concluded that dental amalgam “is a safe, reliable and effective restorative material.” Studies have determined that any free molecules of mercury that could potentially enter the bloodstream are trapped in the set amalgam. And although the amalgam can release mercury vapor during chewing, the amounts are well below the levels considered harmful.
Dental amalgam has proven to be versatile, effective and economical. It doesn’t create an allergic reaction, is quite durable, and doesn’t interfere with normal chewing function. It does, however, have its drawbacks. Its use can require more tooth material to be removed to keep the fillings in place, and they can increase temperature sensitivity during the initial four to six weeks. And, of course, their metallic appearance, especially when used in more visible front teeth, reduces their aesthetic appeal.
Other, more cosmetically appealing types of filling material have been developed over the years. These include composite resin fillings, a mixture of glass or quartz in a resin medium; glass ionomers, made of acrylic acids and fine glass powders and best used in areas not subject to heavy chewing; and resin ionomers, similar to glass ionomers but with the addition of acrylic resin. Each of these has their advantages and disadvantages (as well as cost considerations), but they’re main advantage over amalgam is their mimicry of natural tooth color.
The choice of either dental amalgam filling or one of the tooth-color alternatives depends on what you may need and can afford. Rest assured, though, that if the choice is dental amalgam, this restoration workhorse can provide you years of safe and effective service.
If you would like more information on your options for tooth fillings, 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 “Silver Fillings.”
Tooth decay and other oral diseases aren’t the only dangers your teeth face — accidental injuries also pose a risk. Fortunately, much can be done to save injured teeth, if you act quickly.
Dental injuries where part of the enamel crown has chipped off are the most common. Even if only one tooth appears damaged, adjacent teeth and bone might also have been damaged internally. Most chip injuries can be repaired either by reattaching the broken crown or with a tooth-colored filling or veneer. If the damage has extended into the inner tooth pulp then a root canal treatment might ultimately be necessary.
Teeth that have been knocked loose from normal alignment (dislodged) or where the entire tooth with its root has separated from the socket (avulsed) are rare but severe when they occur. It’s imperative to see a dentist as soon as possible — even more than five minutes’ of elapsed time can drastically reduce the tooth’s survivability. Dislodged teeth are usually splinted to adjacent teeth for several weeks; we would then carefully monitor the healing process and intervene with endodontic treatment (focused on the tooth’s interior) should something unfavorable occur.
With the possible exception of a primary (baby) tooth, an avulsed tooth should be placed back in the socket as soon as possible. This can be done by someone on scene, as long as the tooth is handled gently, the root not touched, and the tooth rinsed with cold, clean water if it has become dirty. If no one is available to do this, the tooth should be placed in milk to avoid drying out the root, and the patient and tooth transported to a dentist immediately. Once in the socket, the treatment is similar as for a dislodged tooth with splinting and careful watching.
The damaged tooth should be checked regularly. Your body’s defense mechanism could still reject it, so there’s a danger the root could be eaten away, or resorbed. Some forms of resorption can’t be treated — the aim then is to preserve the natural tooth for as long as possible, and then replace it with a life-like restoration to regain form and function.
If you would like more information on the treatment of injured teeth, 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 “Trauma & Nerve Damage to Teeth.”
Can having a great smile help land you a high-level business position, a TV show, and a bride? Maybe — at least if you go by the example of Bill Rancic.
The 42-year-old Chicago native is well known as the first winner of NBC-TV's The Apprentice, a reality show where contestants vied for a job with Donald Trump's organization. Shortly after his selection as Trump's newest hire, Rancic met his future wife, Giuliana, when she interviewed him for E! News. Flash forward a few years, and the couple is now hosting their own reality TV show on Style network.
So how much has Bill's winning smile helped?
“I think a great smile says a lot about a person — especially in our professions,” Bill recently said in an interview with Dear Doctor magazine. He also mentioned that having a few cosmetic dental treatments helped him close the deal.
As a child, Bill wore braces to correct an overbite. For both kids and adults, orthodontic treatment is often the first step toward getting the smile of your dreams. The practice of orthodontics has changed dramatically in the past 20 years and there are now a number of choices available in lieu of traditional metal braces.
Not Your Father's Braces
For those who need to maintain a “professional” image, tooth-colored braces offer a less noticeable way to straighten your teeth. Lingual braces are another option that's suitable in some situations. These are truly invisible: bonded on the tongue side of the teeth, they can't be seen from the front.
Or, you may be able to forego braces altogether and use a series of clear plastic aligners to gradually bring your teeth into alignment. Not only are these difficult to notice, but they can be completely removed for short periods of time — at important board meetings, for example.
Red-Carpet Tooth Whitening
More recently, Rancic had tooth whitening treatments. Depending on the degree of lightening needed, these can range from custom-fitted bleaching trays that you wear at home under the supervision of a dentist, to in-office whitening treatments that work in far less time. Both can be effective in lightening your teeth by six shades or more.
But if you need the ultimate in whitening, veneers may be the best option. These are fingernail-thin coatings, made of pearly-white porcelain or composite material, that are placed directly on the tooth surfaces. Realistic and durable, they can provide a “Hollywood white” smile that's ready for the red carpet.
Did Bill's cosmetic dental work really improve his life? We can't say for sure — but as his wife Giuliana recently told Dear Doctor, “First impressions are very important, and having a beautiful smile will help anyone make a great impact on others.” So perhaps it worked on her!
If you would like more information on how cosmetic dental treatments can improve your smile, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Important Teeth Whitening Questions Answered.”
The Pankey Institute
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Once upon a time, when you had a cavity, you went to the dentist and came back with a tooth filled with metal: the common silver (or, technically speaking, “dental amalgam”) filling. But today — driven by dental researchers' quest to find a better filling material, and by the desire of many people to avoid a mouth full of dull gray metal — there are other choices.
In recent years, metal-free, tooth-colored fillings have evolved into a well-established treatment method that's finding increasing use — not just in the front of the mouth, where it's most visible, but in the back too. To help understand the benefits of these new materials, let's start by looking at the structure of the tooth.
We usually think of teeth as being hard, sturdy and durable. But did you know that their crowns, or top surfaces above the gums, actually flex under the force of the bite? Understanding the composition and behavior of teeth has led researchers to develop newer and better materials for restoration. These include improved dental porcelains and composite resins which more closely mimic the natural teeth in both function and form: That is, they're strong and good-looking too.
What's more, using these materials for fillings may mean that you can get the same result with a more conservative treatment. How? It all comes down to tooth structure. To secure a traditional amalgam (silver) filling, a tooth often had to be shaped with “undercuts,” which helped hold the material in place. This meant the removal of a greater amount of tooth structure, potentially leading to chipping or cracking of the tooth down the road.
Enter composite resins. Bonding these materials to the underlying tooth doesn't require undercutting, so less of the healthy tooth is removed. That makes for a more robust tooth structure, with potentially greater longevity. Combine that advantage with the aesthetic appeal of a restoration that's hard to tell apart from natural teeth, and you've got a winning combination.
There are different options available for restorations with tooth-colored materials. These range from quick, single-visit fillings for small cavities, to the fabrication of more extensive replicas of the tooth for complicated restorations. Exactly which treatment is needed will depend on an individual's particular dental issue and the kind of results they desire. Whatever the case may be, we can listen to your concerns, answer your questions, and offer the best advice regarding your treatment options.
If you would like more information about tooth-colored fillings, 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 “The Natural Beauty of Tooth-Colored Fillings.”
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