- What is a dental filling?
- Are Amalgams the only dental filling material that contains Mercury?
- I already have amalgam fillings. Can I have them replaced?
- Do I have to have amalgam fillings replaced?
- Aren’t mercury amalgam fillings cheaper and faster?
- Do Teeth get more brittle over time?
- If a tooth is heavily damaged by decay or wear and is more “filling” than “tooth” wouldn’t it make sense to repair it in a stronger way than trying to fill it?
Dental Health and Overall Health
Medical research has observed a connection between poor oral health and other health conditions such as heart disease, stroke, and bacterial respiratory infections. Your dental health can affect your general health as oral bacteria can enter the blood stream. There are health conditions such as diabetes and osteoporosis which may mean a patient is more at risk for dental problems such as tooth decay, gum disease, and tooth loss.
Medical researchers have found that people with gum disease are nearly twice as likely to have coronary artery disease. The links continue to be researched.
It is important for your dentist to know your medical history as some conditions can have an effect on the outcome of your treatment and some treatments need to be discussed and adapted to best manage health risks. You will be asked to fill out a medical history form prior to your first appointment and any changes to your health should be communicated to us at subsequent visits. Inform us if you are diabetic, have allergies, heart murmurs, have had any joint replacements, heart surgeries, have any other medical conditions or are taking any medications, such as blood thinners including baby aspirin, or if you have taken bisphosphonate medication for osteoporosis even if it was in the past. Your confidentiality is strictly protected in our office.
Check ups, Cleaning and Oral Cancer Screenings
We generally recommend scheduling an appointment to have your teeth checked by the dentist and professionally cleaned by the hygienist every 6 months. This will help us to detect changes to the condition of your teeth and gums and keep them healthy. For some, who have signs and symptoms of gum disease, dental cleanings are recommended every 3 months. For those with a very low risk of gum disease and a very low risk for cavities an annual check-up and cleaning is suitable. If you have concerns arise between check-up visits call us to schedule an appointment for a specific exam by the dentist.
Our patients often comment that our hygienists are both extremely gentle and thorough. They are informative and offers practical homecare advice to patients who are interested in knowing more about how to properly care for their teeth.
Some people do experience sensitivity with teeth cleaning so we offer the option of a local anesthetic to keep the appointment comfortable. Following cleanings there are desensitizing treatments available and toothpastes designed for sensitivity which we recommend to patients with sensitive teeth. While sensitivity can be discouraging it is important to remember that gums are healthier after the trapped toxins in the tartar are removed. In terms of dental health it is well worth it to have your teeth cleaned. Please bring it to our attention if your teeth are sensitive.
When we do a new patient exam or a check-up exam we do a head and neck exam and a visual exam of all the mucosal surfaces of the mouth including the top part of the back of the throat and a palpation of the underside of your chin and neck. In addition, we can also use an instrument called a VELscope to screen for mucosal abnormalities which can be early indicators of oral cancer. The examination usually takes less than 5 minutes without any discomfort. We screen every new patient at their comprehensive exam with the VELscope and recommend re-screening every 12 months.
Only 33% of oral cancer is detected while it is still confined to the primary site*. The initial appearance of cancer can be easily camouflaged in the mucosa With the use of the safe blue light of the VELscope and with its green viewing filter, it is now possible to discover more information on whether abnormalities are present in the oral mucosa. With the use of this simple non evasive screening which has no rinses or dyes, it takes only a few minutes and is relatively inexpensive. That is exciting new technology!
It may be possible to improve the statistics on oral cancer including less invasive treatments with better outcomes due to earlier detection.
*Statistic from the National Cancer Institute. 1999-2000
Dental Radiographs or X-Rays
Crown Isle Dental uses the latest in digital x-ray technology to see how healthy a tooth is on the inside. Dental x-rays reveal the dental issues that aren’t visible to the eye, such as decay between the teeth, under the gum line or around old fillings, as well as gum disease and infections in, below, or around the roots.
In young patients two to four bitewing or check-up x-rays are often recommended once a year to show where new teeth will be coming in, spot any problems, and foresee any dental issues that could occur. In adults full mouth specific x-rays are often recommended at your initial exam to evaluate all areas in detail, including the deeper root areas. After that, for adults, two to four bitewing x-rays are generally recommended every two years. These are general guidelines. X-rays are always prescribed on an individual basis after assessing the risk/benefit factors. If you have current x-rays within two years for bitewings and five years for full specific x-rays please let us contact your previous dentist so that we can use these instead of taking more x-rays.
X-rays are safe when exposure is properly limited. We keep x-ray exposure as minimal as possible and when we feel they are required we use several precautions to ensure that our patients’ safety concerns are met:
- We prescribe x-rays based on the risk-benefit assessment for each individual.
- We use digital x-rays which require a significantly lower amount of radiation.
- We cover the patient’s torso with a lead apron and neck with a thyroid collar to minimize possible exposure to these areas.
- The x-ray is targeted so that it is directed to the area needed.
- Filters shorten the length of time that you’re exposed to radiation.
- The x-ray equipment is checked regularly and our dental staff is well trained.
We offer nitrous oxide and Ativan in addition to gentle but thorough local anesthetic.
Nitrous oxide is a very safe and gentle distraction for patients that can make longer appointment times seem shorter, ease tense jaw muscles, and reduce the occurrence of gagging for those patients with a stronger gag reflex. Nitrous is short acting; after 3-5 minutes of oxygen following nitrous use and a 10-15 minute delay to assess your alertness, if you feel comfortable you may resume normal activity.
Mild oral sedations are sometimes prescribed an hour before a dental appointment to help patients stay calm and relax. Patients who are prescribed an oral sedative need to have an adult drive them to and from their appointment and should not return to work or activities requiring their attention and coordination until the effects have worn off. Please ask us in advance of your appointment if you want to consider this oral sedation option for yourself.
Most people consider white teeth to be important for a beautiful smile. Dental whitening uses a gel formulation which can be a very effective way of lightening the natural colour of your teeth. It is a simple, comfortable procedure and noticeable results can usually be obtained in one to three 15 minute office sessions. The number of sessions will be determined by your individual results and preference. Teeth darken naturally over time, especially with exposure to beverages, foods, and activities that discolour teeth such as coffee, tea, red wine, fruits such as blueberries, and smoking. It is best to avoid these staining types of food for 24 hours after a whitening session so that your whitening results will last longer. Results vary for different individuals and will fade somewhat over time. Touch ups can be done every 3-12 months.
We have been wonderfully pleased with the new system introduced to our office in the spring of 2012. We now offer a spa-like whitening system that offers comfort, faster and better results, and less sensitivity than previous whitening methods available. Our patients report that the increased hot and cold sensitivity from older whitening systems is now virtually non-existent. Sometimes patients note a mild tingling during the process but report that the procedure itself is quite comfortable and relaxing.
Our office whitening system uses a more concentrated formulation and a light to enhance the results. This allows for faster treatments and whiter results.
There is no evidence of harm to enamel based on our tooth whitening protocol and gel formulations.
Teeth whitening gel will not harm or whiten crowns. They will stay the same colour. Teeth whitening gel will not harm or whiten fillings, though sometimes light stains may reduce very slightly. If you have dark crowns or fillings, replacing them is the only option to lightening them. If your crown work used to match your teeth and your teeth have darkened, whitening may be a great option to return your smile to its more youthful appearance.
Dental Fillings, Material and Mercury
Non-metal filling placement is a common procedure that is used to repair teeth that have damage that is relatively small. The decayed area of the tooth is removed and replaced with a material that will fill the space. Small, carefully placed composite fillings are tooth coloured and look the most natural. In choosing our filling material we look for the one that will last the longest and offer the safest and healthiest result. Mercury-free fillings are an important consideration for patients and healthcare providers. Our dental office has been placing only mercury free fillings since 1996. Our dental filling materials are also BPA (Bisphenol A) free.
Yes, you can have amalgam fillings replaced with composite (white) fillings. Amalgam fillings contain mercury. Here is what we want our patients to know about mercury fillings: The highest peak exposure to mercury in dental work is on the day the filling goes in and on the day the filling is removed. Some of our patients, who want to minimize their exposure to mercury, choose to work with a naturopathic doctor and take dietary supplements such as chlorella for a few days at and after amalgam filling removal. This will help to remove the mercury from their body during and following this peak mercury exposure. Our dental office uses careful procedures to minimize a patient’s exposure to mercury during amalgam removal:
- Use of a rubber dam as much as possible during the removal of fillings.
- Thoroughly rinsing above and below the dam following removal.
- Directing the removed amalgam particles to a mercury trap.
- Having a high quality air exchanger in our office and for very concerned patients there is the option of using an alternate air source to breathe through their nose during the mercury removal process.
That is an individual choice. The Canadian Dental Association still supports the placement of new mercury amalgams for adults. Many of our patients choose not to remove their amalgam fillings unless it is necessary due to decay. Some of our patients choose to remove them for cosmetic reasons. There are many opinions on the subject and Dr. Clancy encourages patients to be as informed as possible so that they can make knowledgeable choices for themselves.
Yes, mercury fillings are less expensive. To place a composite (white) filling to last well it is important to take more care and attention to detail in technique of managing moisture and depth of cure. White filling materials have been well researched in the industry for over 30 years. The slightly higher expense of composite fillings is due to the higher cost of the materials and the time they require to be placed well.
Crowns for Worn Teeth and Larger Fillings
Question: Do Teeth get more brittle over time?
Yes. As we age teeth continue to function. The ‘nerve’ or pulp and the ligament and gums continue to be living and renewed by our body but the enamel and dental work is static or inert without the capacity to heal itself. Depending on the forces the teeth are subjected to, which can be significant for some people, wear cracks and fractures may begin in enamel and dental work.
Yes. If the tooth will be solid enough to last with a filling, then that is all that is needed and makes the most sense. If structurally the tooth is weak, then an onlay or crown will offer better long term results. You are offered the choice so you can plan what is best for you short and long term.
There are several options for replacing missing teeth which include implants, fixed bridges, or partial dentures.
Implants are the closest substitute to replacing a natural tooth. Dental implants are placed into the bone. The implant integrates in place stimulating the body’s natural bone turnover and renewal process which allows the bone to be preserved, instead of shrinking over time. Dental work is then attached to the integrated implant. A single implant can be used when a single tooth is missing, with a single implant crown restoration attached to the placed implant. When multiple teeth side by side are missing, two or more implants may be placed with a multiple tooth implant bridge restoration attached to the implants.
When all of the teeth in the upper or lower jaw are missing, implants can be placed with either a fixed implant bridge attached that is not removed by the patient, or a removable denture that attaches to the fittings on implant. Implants are not susceptible to decay but the area around the implant needs to be cared for to resist gum disease just as a natural tooth requires that care.
Bridges are a cemented tooth replacement that involves crowns on the teeth on either side of the missing teeth with a connected artificial tooth in the middle. A bridge is a very solid and functional restoration solution and is the traditional way to replace missing teeth.
Partial dentures are removable appliances that are taken out on a regular basis for cleaning by the patient. Partial dentures are a cost effective option for those with a limited budget.
Full dentures – at times people choose to have full upper and lower dentures. These can be done with the benefit of implants to support them for improved function.
There two reasons why Crown Isle Dental recommends tooth replacement:
- Replacing missing teeth prevents other teeth from tipping over or growing into the space left by the missing tooth. This kind of bite collapse can lead to other tooth disease and loss over time.
- Replacing missing teeth distributes chewing forces evenly around the mouth. Over time, chewing without replacement teeth can lead to other tooth disease and tooth loss, splaying of anterior teeth, bite collapse, and other jaw problems such as jaw joint pain or TMD.
Cosmetic Dentistry and Smile Makeovers
Our job is to understand what you want and then to discuss what is possible. We start with a vision of the end result and then plan out the steps to accomplish the result.
We like to keep surprises out of the equation and to make sure we are meeting the objectives at each step. Once you decide what treatment option is best suited to you it is our job to use that information to communicate the objectives with the dental lab. In some cases the dental lab can supply wax pattern mock-ups before we begin the work so that we can clearly envision the outcome. In these cases we use the mock-up to build provisional dental work so the patient can literally test drive the result before the permanent work is done at the lab. The end result of this thorough and collaborative process is very rewarding for both our patients and our dental team because we can confirm or, if necessary, make minor adjustments for improvements prior to final placement of the finished work.
Cost, Insurance and Payment
Dental insurance plan coverage varies greatly and we encourage clients to be familiar with their plan coverage to eliminate disappointment with payments and reimbursement. Upon request we can submit a predetermination to the plan in advance of treatment, to enable patients to prepare their finances accordingly.
As a courtesy to our clients, we accept assignment of insurance benefits toward the payment of dental treatment. We do ask you to pay for your portion of the treatment at the completion of each appointment. Our payment options include cash, debit, Visa or MasterCard.
Our fees are based on the quality of materials we use and our clinical expertise in performing your needed treatment. After Dr. Clancy has examined you and determined what treatment is needed, she will recommend and discuss options with you. The treatment plan and an estimate for treatment options will be provided.