Composite Resin YES - Silver-Mercury NO

One of the most common questions asked in our practice concerns our choice of the material that we use to restore cavities.

Silver-mercury (amalgam) fillings were introduced to dentistry over 100 years ago. At the time, this mixture of silver and mercury was considered a miracle material (of course, at that time, so was indoor plumbing). Today, amalgam fillings are made of a mixture of silver/tin/copper alloy and mercury in about 50/50 proportions. And as of today the American Dental Association believes that amalgam is a safe and effective material for use in the human mouth. They are entitled to their opinion. Here is my personal opinion about amalgam:

It is possible that the mercury in amalgam is not harmful to us. However, mercury is a toxic substance and according to the EPA, must be disposed of in a Toxic Waste Disposal Site. In my opinion, anything that must be disposed of in a Toxic Waste Disposal Site should maybe not be placed in our mouths. But this may simply be an over-cautious position on my part. I do not actually know what the long term outcome of on-going research will be. I do know that some European countries and a couple of states in the U.S. have regulated amalgam use, mostly because of environmental contamination reasons. Some European countries have banned the use of amalgam in pregnant women and young children.

I want to be clear on this. I have not used amalgam since April of 1982. And the reason has nothing to do with its safety or non-safety. The jury is still out on that.

The reason I do not use amalgam is that, in my opinion, it is a poor restorative material compared to newer materials we have now. Like everything else, improvements have been constant over the last 100 years. It took science until the 70’s to develop an alternative to amalgam, and into the early 90’s to perfect it to its current level.

The material I favor and use as my first choice is bonded composite resin. This material is extremely biocompatible and flexes and wears like natural teeth. A silver-mercury restoration has no bond to tooth structure. Expansion and contraction of this material over the years causes cracks in teeth and eventually, many teeth will fracture. You may have had this happen to you, even when you were eating something soft. Amalgam tends to leak after five or ten years, causing recurrent decay. Amalgam corrodes and turns black.

There is no way I will ever place amalgam in a patient’s mouth again.

When aging amalgam restorations are replaced by bonded composite resin restorations, the strength of the tooth is increased and underlining tooth structure is sealed.

Plus, of course, composite resin restorations are tooth colored and are so much more attractive and natural looking than metal fillings.

Now let me talk with you about the economics of composite resin. Composite resin restorations are more technique sensitive and are more time consuming to place. Special care must be exercised to operate in a controlled environment that can be moist when desired and dry when desired. Composite resin is more sensitive to moisture control procedures than amalgam. When placing composite resin fillings, we seal the dentin against bacterial infiltration and protect the dental pulp from irritation. As a result of this necessary expertise and the increased time associated with composite placement, the cost of restoring teeth with composite resin is a little higher than with amalgam.

Insurance companies are slow to embrace new techniques, especially when it could cost them money to provide state-of-the-art care to their insured. Many insurance companies will only cover the cheapest material to restore teeth. That’s amalgam, and many will pay their amalgam benefit even when composite resin is used. Yes, they are allowed to do that.

My patients have mostly learned about the ways insurance carriers pay benefits. For example, they have learned not to be fooled by the “usual and customary fee” jive and they know that this is bogus and is intended to drive a wedge between patient and doctor. If you are concerned about anything you read in an Explanation of Benefits you receive, just call. We’ll explain it with straight, honest talk. You don't have to be my patient to get advice; we'll be glad to help you.

Composite resin is one of a wonderful list of modern, state-of-the-art beautiful materials dentists use to help you have the strong, functional teeth and great smile you have always wanted.

You can post a comment or ask a question by clicking on the word "comments" right below this post.

Sensitive Teeth: Ouch!

Does ice cream or hot coffee, or even brushing your teeth make you wince? Do you get a twinge of pain – or even worse – from hot or cold or sweet foods?

You may have a common dental problem called sensitive teeth.

There are a number of causes of this uncomfortable condition. Some of them include worn tooth enamel, decay, tooth roots that are exposed at the gumline from aggressive brushing or gum disease, worn or leaky fillings or crowns, or cracks in teeth.

Teeth are protected by enamel above the gumline and by cementum on the roots. Under enamel or cementum is the basic structure of teeth, called dentin. Dentin has tiny channels called tubules that run from the inner pulp of the tooth to the place where the dentin joins the enamel or cementum.

In these tubules is fluid and also some very fine nerve fibers.

When the enamel or cementum is worn or damaged, these little nerve fibers can get stimulated and that causes the "ouch".

Sorry. Sensitive teeth can really take them pleasure out of eating some foods we really like.

So what to do? Here are some things to think about:

1. Good oral hygiene tools and techniques are very important. Aggressive equipment and aggressive technique can cause the damage that makes teeth sensitive, as well as damaging tooth surfaces and making them need repair. In our office we definitely spend plenty of time helping our patients get equipped with terrific tools and learn how to use them so they not only prevent disease but also do not cause harm. What you use and how you use it matters.

2. Grinding your teeth, especially in sleep, can cause amazing tooth wear. If you do this and are not aware of it (most people are not), there are effective ways we can help you with to prevent damage. This kind of grinding is also an important cause of severe headaches, sometimes diagnosed as migraine (there is a blog on this here if you are interested). If you have worn down your teeth (hint: lower front teeth are not supposed to be flat on top) have that taken care of.

3. Get worn out fillings and crowns and bridges replaced. If a tooth is cracked internally dentists can detect this and take care of it. This also helps prevent other problems.

4. Prevent gum disease, or if you have it, get it taken care of. Periodontal disease is very treatable. Take a look at our blog on periodontal disease. Gum disease is the reason that most adult teeth are lost. Gum disease can cause gum recession and exposed roots, which wear and become (you guessed it) sensitive.

For minor sensitivity, all that may be needed is for you to use a special toothpaste that helps some people. These toothpastes work by helping to block sensations from moving from the surface of the teeth to the nerve fibers inside. Sometimes they take a while to work.

Fluoride gels or rinses can sometimes help with mild sensitivity. Again, dentists know how to recommend what's right for you.

Dentists can protect sensitive surfaces with bonding resins that block the tooth surface and reduce sensitivity.

If you have lost a lot of gum tissue and have exposed roots, gum tissue grafting can often replace that coverage.

A last resort might be to remove the nerve tissues from the inside of the tooth ( root canal therapy).

But the bottom line is that you do not have to live with this kind of sensitivity. Get help. Dentists know what to do to help you enjoy eating again.

Don’t live with pain.

If you would like more information, or would like us to take a look at your situation, all you have to do is call or send an e-mail. We'll be glad to advise you.

Bon Appetit!

Ten Good Things To Remember To Make Your Life Work Better

General Colin Powell has a list of things he lives his professional life by.

They are good rules for everyone. Here they are:

1. It’s not as bad as you think. It will look better later.

2. Get mad, then get over it.

3. Avoid attaching your ego to your position,

so when your position falls you won’t fall with it.

4. Never let style overpower substance.

5. Don’t let adverse facts stand in the way of a good decision.

6. Triple-check the small things.

7. Share credit.

8. Remain calm. Be kind.

9. Don’t let your fears be your only counsellor.

10. Optimism and enthusiasm are force multipliers.

Straight Teeth Without Braces - Clear Aligner Ortho

Many of our patients wish their teeth were straighter but some of them do not want to wear braces or have their teeth capped.

Well, there is very good news. It is now possible to get your teeth straightened without the appearance, hassle and discomfort of metal wires.

It's called Clear Aligner Orthodontics and it is comfortable, easy and best of all, just about invisible. There is no interference with eating, no sore lips, no rubber bands and pretty near no discomfort.

Not only that, but it normally takes much less time than with traditional metal braces.

There are two methods of aligner ortho we are Certified in: ClearCorrect and Invisalign. You can visit their web sites: ClearCorrect.com and Invisalign.com. We definitely favor ClearCorrect because they have become a much friendlier company to work with.

Why not have straight teeth? They are better looking, easier to clean, less likely to trap food, fit together better and today, it's comfortable and fast.

Find out if straighter teeth are possible for you. Call us at 845-297-6206 or just send e-mail to DrSteveRoss@aol.com. We'll bring you in for a no-charge evaluation.

Just another way today's dentistry can help you be all you can be.

Come visit our web site at DrSteveRoss.com and check out what we're about and how we can help you.