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Many of us have dental fillings in place for many years and the question becomes when should they be replaced? Dental fillings are man made materials used to replace tooth structure that has been damaged by tooth decay. The dental filling will allow your dentist to restore both function and shape of your tooth back to its natural form.

Types Of Dental Fillings

-Amalgam (Silver). Use of amalgam has seen some controversy over the years due to its mercury content. Amalgam is made up of a mixture of various metals. Use of amalgam has some drawbacks (beyond its mercury content) which include:

1. No Bonding Properties. Amalgam cannot be bonded to existing tooth structure. This means that a tooth must be over prepared removing more natural tooth structure than necessary to ensure the amalgam filling will hold in place.

2. Not A Cosmetic Restoration. Amalgam is a darker color and cannot be matched to your existing teeth.

3. Increased Risk Of Tooth Fracture. Another disadvantage to using a metal allow is that it can expand and contract over time based on your oral environment. If the metal allow expands too much it can cause your tooth to weaken and fracture over time.

-Composite Resin. This has become the preferred dental restoration for most dentists and patients. The advantages of composite resin include:

1. Cosmetic Restoration. Dental composite is a tooth colored material that can be matched to your existing teeth. If done properly a dental composite can match perfectly to your natural teeth.

2. Excellent Bonding Properties. Unlike dental amalgam restorations, a composite resin filling can be directly bonded to your natural tooth structure. This creates a stronger attachment to the teeth.

3. Conservative Restoration. Since a composite resin can be bonded directly to the tooth much less natural tooth structure needs to be removed. There is no need to take away any more tooth structure than is absolutely necessary to restore the tooth back to its natural form and function.

The main disadvantage to the use of composite resin is the presence of Bisphenol-A (BPA) in some dental composites. If this is a concern to you, ask your dentist if they are using BPA free dental composite.

Signs A Dental Filling Needs To Be Replaced

-Temperature Sensitivity. This can be quite uncomfortable but it is important to see your dentist when it arises. If the pain goes away after exposure to hot or cold after a few seconds, it is usually repairable but if the pain lingers for a longer time after removal of exposure, it may indicate damage to the nerve that cannot be repaired with a simple dental filling.

-Pain Upon Biting. This can indicate a fracture beginning in your tooth from an existing dental restoration.

-Throbbing, Constant Pain. If the tooth decay reaches the nerve of the tooth it will create a toothache pain. Root canal therapy may be required at this point.

-Fractured Dental Filling. If you notice a piece of your dental filling has broken off you need to see your dentist immediately to have it repaired or replaced.

Conclusion

Being aware of your signs and symptoms is key to knowing when to see your dentist. Regular dental examinations and dental x-rays are needed to fully evaluate your existing dental fillings and give your dentist all the information needed as to when your dental fillings need replacement. It is best to diagnose replacement as soon as possible to avoid more extensive dental work.

BPA? What is it? BPA is short for Bisphenol A. BPA is an organic compound  that is used throughout the manufacture of many consumer plastic products, and has been found in some dental composites and sealants.

BPA has been shown to have hormone-like (estrogen) properties that raise concern about its suitability in consumer products and food containers. Some laboratory testing has suggested that BPA may effect reproduction and development in animals by mimicking the effects of the female hormone estrogen. This testing is raising concerns about its safety. Recent scientific research has found links between BPA and serious health problems, from heart disease, diabetes and liver abnormalities in adults to developmental problems in the brains and hormonal systems of children.

BPA and Dentistry

There are three ways BPA can become a part of dental materials:

1. As a direct ingredient in dental composites or dental sealants.

2. As a by-product of degrading dental composites or dental sealants in saliva. Composite resins are formulated from a mixture of monomers that are commonly based on bisphenol A glycidyl methacrylate (bis-GMA). Some composite resins may contain other monomers, in addition to bis-GMA, that are added to modify the properties of the resin. An example is bisphenol A dimethacrylate (bis-DMA). Bis-GMA and Bis-DMA-containing materials can release  BPA because both  bis-DMA and Bis-GMA are subject to degradation by salivary enzymes. Bis-DMA releases more BPA than Bis-GMA.

3. As a trace material during manufacture of dental materials. BPA may be used in the production of other ingredients found in some dental composites and sealants. Bis-DMA and bis-GMA are both produced using BPA as a starting ingredient, so residual trace amounts of BPA may be present in the final product.

There are many products utilized for “white” fillings. You can ask if your dentist is BPA free. The products utilized should not contain BPA, and even better if there is also no Bis DMA.

What Can Be Done To Limit Dental Exposure To BPA?

The big concern first was the use of traditional dental materials like dental amalgam. Amalgam contains mercury and there has been vigorous debate regarding its health effects. While all dental amalgam fillings contain mercury, not all dental composites and dental sealants contain Bisphenol-A (BPA). It is important to choose a dentist who carefully selects dental composites and dental sealants that are BPA free.

What if you already have dental composites or dental sealants? Should you be concerned?

It is important to remember the amount of BPA released in dental composites and dental sealants is very small. Although, the effect of BPA accumulation may be small it is important to note that it is a cumulative effect. Over the course of a lifetime the BPA will build up like most environmental toxins. Still, if the dental work in question is not causing any immediate health problems that you experience, removing the dental composite can do more harm than good. The trauma each tooth would undergo through the removal process may do more substantial harm to the teeth.

Common Items Containing BPA

-Baby Bottle

-Water Bottles

-Sports Equipment

-Medical and Dental Devices

-Dental composite filling

-Dental Sealants

-Cd’s and DVD’s

-Lining of Water Pipes

-Lining of Soda cans

How To Reduce Overall Exposure To BPA?

Choosing products that are BPA free  is important. Make good choices in everyday products as well as dental materials. Below are some tips to reduce overall BPA exposure for you and your loved ones.

-Choose Cardboard Or Glass Containers Over Cans. Most cans used in food preparation today are lined with BPA. The food in these cans are in contact with this lining allowing the food to leach BPA from the lining. Highly acidic foods (like tomato sauce) tend to leach more BPA than lower acidic foods. Choosing cardboard or glass will be safer in the long run.

-Avoid Microwaving Plastic Food Containers. The packaging in many microwaveable foods can break down under the high temperatures of the microwave. This will release BPA into your food from the lining of the container. It is not required to report whether a container contains BPA but plastic containers that do are usually marked with a #7 recycling code on the bottom of the package.

-Choose BPA Free Baby Bottles. The general rule for plastics is hard and clear contains BPA while soft or cloudy does not. Luckily, most major manufacturers now tout BPA free bottles for our children.

-Use Powdered Infant Formula. Recent research has shown that liquid formulas contain more BPA than the powdered version.

Bisphenol-A (BPA) Conclusion

Research continues to mount regarding the health hazards of Bisphenol-A (BPA) so it would be wise to protect your family and be educated. While we can probably never live a BPA free life we can limit exposure by making smart choices in dental care as well as our lifestyle. Manufacturers are making their own choices, and moving towards many BPA free products. Hopefully, future research will continue with the evolution of even better products to keep us all healthier.

We, as a society have become more acutely aware of the ingredients in many products used for our health. This includes food, medications, and children’s products. Now we

Cosmetic Dentist Marielaina Perrone DDS

Educate Yourself On The Hazards Of Mercury, BPA, and Triclosan.

can include dental materials to the list. Controversies have developed recently surrounding the use of Bisphenol-A (commonly referred to as BPA) as well as mercury use in dentistry. What are the truths regarding dental materials and what can you do to keep you and your family healthy at the dentist?

Controversial Dental Materials

-Mercury – This has long been used to restore tooth decay in something called a dental amalgam. A dental amalgam is a metal based restorative dental material that is a mixture of liquid mercury and a powdered alloy (composed of silver, tin, and copper). A dental amalgam is the cheapest of all dental materials used for restoring tooth decay and was developed over 150 years ago. While controversial in it’s use, It has been and will continue to be utilized around the world as an economical choice in dental restoration.

The controversy that surrounds dental amalgam is the incorporation of mercury. There are some who are allergic to dental amalgams. This allergy could be due to the mercury or one of the other components. The main concern is the inhalation of mercury vapors into the lungs. The NIH, and FDA have been conducting and comparing dental mercury research for quite some time. The general rule of thumb for mercury exposure is, low levels have no statistically significant or reproducible harmful effects whereas much higher levels can cause issues like, fatigue, memory loss, irritability, and headaches. Most research addresses levels released in the mouth following placement. Studies have concluded that, as these dental amalgams wear in the mouth, mercury is released mainly while chewing. While the research concluded that the level of mercury release was low, it can still be a cause for concern for many patients.

The FDA has released a final study on this stating that, “the levels released by dental amalgam restorations are not high enough to cause harm in patients.” The bottom line for the use of dental amalgam should be a dental materials choice between patient and dentist. It is an effective dental material (both in cost and function) and will continue to be an option for most dental offices in the near future.

-Triclosan – This ingredient is found in many everyday products including soap, toothpaste, and many mouthwashes. It’s main use is to reduce or prevent bacterial contamination.  Since its main use is as an anti-bacterial, many wonder if its overuse in soaps and mouthwashes will cause new bacterial strains to develop that are able to resist triclosan’s effects. Other concerns are its effect on our immune and muscular systems. There have been small studies done that have shown an increased incidence of hay fever and allergies in general from over exposure to anti bacterial soaps.

The jury is still out on triclosan as the FDA has not given it a full vote of confidence. It has approved it for use in toothpastes as an effective aid in preventing the development of gingivitis. As of this writing, triclosan has not been determined to harm humans but studies are ongoing.

Dental Materials Marielaina Perrone DDS

Make Informed Decisions on Mercury, BPA, and Triclosan For Your Entire Family.

-Bisphenol-A (BPA) – BPA is used in a variety of products mainly for the use in production of polycarbonate plastics and epoxy type resins. Commonly household items include water bottles, baby bottles, and even compact discs. BPA is also found in many dental materials including dental sealants and dental composites.

The controversy surrounding BPA is the fact that BPA has been characterized as an endocrine disruptor. Studies have linked BPA to numerous diseases in humans including heart disease, diabetes, and fertility issues. One study followed almost 1,500 adult patients in the U.S. and associated higher levels of BPA in the urine to lead to a greater probability of being diagnosed with heart disease, diabetes, and liver enzyme abnormalities. Another concern is the effect it has on children, as dental sealants are predominantly placed on children. The jury is still out as there has been no definitive relationship to this point.  Ask your dentist if they know if they are BPA free?

Dental Materials Conclusion

There is continuing research looking into the effects of BPA use by the FDA. Nothing definitive has been stated yet but ask your dentist regarding products they use. Many dental companies in response have developed “BPA free” alternatives. Many products claim to be BPA free because they do not technically add BPA. However, all sealants and composite resins have Bis-GMA and/or Bis-DMA which are made from BPA and release BPA into the mouth as a by-product. Bis-DMA releases far more BPA, and some brands of composite or sealant release substantially higher amounts of BPA at normal ph levels.

There is countless information available on all of these products. The internet is full of truths and lies. It is important to look at these ingredients, and research studies objectively and make the right choices for you and your family. If there are any concerns about any dental materials, ask your dentist for more information to make an educated choice. An educated patient is an empowered patient who can make informed choices about their dental care.

BPA? What is it? BPA or Bisphenol A is an organic compound  that is widely used in the manufacture of many consumer plastic products, and has been found in some dental

BPA Free Marielaina Perrone DDS

Keep Your Family Healthy By Choosing A BPA Free Dentist

composites and sealants. BPA exhibits hormone-like (estrogen) properties that raise concern about its suitability in consumer products and food containers. Some laboratory testing has suggested that BPA may effect reproduction and development in animals by mimicking the effects of the female hormone estrogen. This testing is raising concerns about its safety.

Common Items Containing BPA

-Baby Bottle-Water Bottles

-Sports Equipment

-Medical and Dental Devices

-Dental composite filling

-Dental Sealants

-Cd’s and DVD’s

-Lining of Water Pipes

-Lining of Soda cans

Health Effects Of BPA

BPA is thought to  mimic a form of estrogen, called estradiol, and may lead to negative health effects. The earlier the exposure, greater the sensitivity to its effects. Some studies have linked prenatal exposure to later physical and neurological difficulties. The FDA have determined safety levels for humans, but those safety levels are currently being questioned or are under review as a result of newer, more in depth research  studies. A 2011 study that investigated the number of chemicals pregnant women are exposed to in the U.S. found BPA in 96% of women.

BPA Free Marielaina Perrone DDS

BPA Free Dentistry is Possible

BPA and Dentistry

There are three ways BPA can become a part of dental materials:

-As a direct component from manufacturing in dental composites or dental sealants.

-As a by product of degrading dental composites or dental sealants in the mouth. Composite resins are formulated from a mixture of monomers that are commonly based on bisphenol A glycidyl methacrylate (bis-GMA). Some composite resins may contain other monomers, in addition to bis-GMA, that are added to modify the properties of the resin. An example is bisphenol A dimethacrylate (bis-DMA). Bis-DMA-containing materials can release very small quantities of BPA because bis-DMA is subject to degradation by salivary enzymes.

-As a trace material during manufacture of dental materials. BPA may be used in the production of other ingredients found in some dental composites and sealants. Bis-DMA and bis-GMA are both produced using BPA as a starting ingredient, so residual trace amounts of BPA may be present in the final product.

There are many products utilized for “white” fillings. You can ask if your dentist is BPA free. The products utilized should not contain BPA, and even better if there is also no Bis DMA.

BPA Conclusion

There have been numerous studies conducted. One of the most recent ones linked BPA to children’s behavior a few years following placement of BPA containing dental restorations. The studies showed their was some effect but it was quite small and not known if it was a direct link or not. Further studies need to be completed over the long haul, but most dentists and manufacturers are moving away from dental materials containing BPA.

There are many articles on line about the effects of exposure to BPA, posing different levels of concern. Hopefully, future research will continue with the evolution of even better products to keep us all healthier.