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Serving Las Vegas and Henderson, Nevada since 1999.

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.

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.

A Bright and Shiny smile is a wish for the young and old. Your own teeth may be a little dull looking. You have clean, healthy teeth but you wish they were several shades whiter. A confident smile expresses capability and a belief in oneself.  A bright smile lights up a face. It makes a person look younger, with increased vitality. If you have a beautiful smile, everything about you seems positive. You can have such a smile with the help of teeth whitening.

Of all the cosmetic dentistry treatments offered by dentists, teeth whitening is by far the most popular.This is probably due to the lower cost of teeth whitening versus other cosmetic dentistry procedures. It is estimated that ten million Americans will spend  $1.7 billion on teeth whitening products and services this year. Teeth whitening is the most common cosmetic dentistry service provided by dentists, and there are also a growing number of over-the-counter teeth whitening products to choose from. For those with little or no other dental problems,  teeth whitening is one of the most successful cosmetic dentistry procedures that can be done. The results can be spectacular. Patients will see an increase in self esteem following a whitening procedure. Virtually everyone can have their natural teeth whitened no matter how dark they are. However, old fillings, whether old fashioned mercury-silver amalgams or more modern composites(tooth colored fillings), or porcelain do not whiten. These older restorations would need to be replaced and updated to the new color of your teeth if you were to opt for teeth whitening.

Types of Teeth Whitening

teeth whitening

Cosmetic Dentistry – Teeth Whitening

Teeth whitening products are available at the dentist’s office and also over-the-counter. Visiting a dentist for teeth whitening is the most effective and quickest way to whiten your teeth because the whitening materials are stronger than what is sold in the stores. That said, teeth whitening occurs at different levels for different patients.

What happens when you whiten your teeth? You are removing a lifetime of accumulated stains from food, candy, teas, sodas and wine. For smokers, the nicotine from tobacco leaves dark brown and yellow stains that will not just brush away. Tooth enamel is a crystal, like a diamond with many facets. Over time, stains collect between the facets and discolor the teeth. The peroxide cleans out the stains.  It is not an acid and does not damage the enamel. You can get as many teeth whitening treatments as you like.  This allows your teeth to return to a more natural state of whiteness and brightness. Teeth whitening is not a one time procedure. It will need to be repeated every so often if you want to maintain your whiter, brighter smile.

Generally, there are three types of teeth whitening:

1) In Office Teeth Whitening (also called Dentist supervised teeth whitening). In office teeth whitening involves the controlled use of carbamide or hydrogen peroxide, tailored to a particular patient. Most in-office systems use gels with 15-35%  carbamide peroxide.  The dentist can whiten your teeth in approximately one hour using this higher concentration gel that is activated by a special light. This is the best and most effective technique that gives you the fastest and most accurate result due to the precision of the dentist and materials used.

2) At Home Teeth Whitening. Impressions are taken of your teeth so custom whitening trays can be fabricated just for you. The dentist will give you tubes of tooth whitening gel, usually enough for about 2 weeks of application. At-home systems will use a lowered carbamide peroxide concentration gel. You will asked to wear the trays with the gel for a minimum of 2 hours per day. Most patients prefer to sleep with trays in so it works overnight as well. This treatment usually takes approximately 2 weeks but in difficult cases may take up to 6 weeks. The cost is usually about half the cost of the in-office method, but for many people, the additional time required and inconvenience make it less popular.

3) Over-the-counter Teeth Whitening Products. This is the least successful way and involves using products purchased from your local drug store. A few of these over-the-counter products can work very well in selected cases. Many of these products do not have FDA approval and most have only varying degrees of success. It can be very hard to get this method of teeth whitening to give optimal results.

Studies have confirmed that teeth whitening is safe and effective. Teeth Whitening gels that contain 10 percent carbamide peroxide have not been shown to cause any damage to the enamel of the tooth. Higher concentrations of carbamide and hydrogen peroxide available from the dentist may weaken the enamel, but most of these formulas also contain fluoride offsetting this potential side-effect. Patients who use higher concentrations of whitening agents can further protect their teeth thru the use of  prescription fluoride gel or rinse..

Tooth sensitivity and gum irritation can occur. If either occurs it is best to start using the whitening product less frequently (usually recommended to whiten every other day instead of every day) and reduce the amount of time spent whitening. Sensitivity is treated via a prescription fluoride. Irritation of the gums can occur from either the in-office, at-home or over-the-counter tooth whitening systems. Gum irritation is usually mild and reversible, but can be treated with over-the-counter products such as Orajel (to relieve the discomfort).

Teeth Whitening Conclusion

teeth whitening

cosmetic dentistry – teeth whitening

Bottom line, in teeth whitening, you trade money for time. The more you invest, the shorter the time and the more successful the result. It is important to have realistic expectations regarding what the results might be. Several treatments may be needed to achieve a whiter smile. Teeth Whitening results may not be permanent, as your teeth will naturally pick up stain from foods, drinks, or tobacco use. Remember to brush and floss daily, and visit your dentist for regular cleanings and examinations. Teeth whitening results will vary from patient to patient, so choose an option that will suit your budget and specific need.

A beautiful smile can open doors. Which one will open for you?

 

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