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What new methods are under development to treat and prevent tooth decay?

Several new treatments are under development. One experimental technique uses fluorescent light to detect the development of cavities long before they can be detected by traditional means, such as X-rays or dental examination. In many cases, if cavities can be detected early, the decay process can be stopped or reversed.

Researchers are also working on a “smart filling” to prevent further tooth decay by slowly releasing fluoride over time around fillings and in adjacent teeth.

New ways to prevent tooth decay are also being studied. A study showed that a chewing gum containing the sweetener xylitol temporarily retarded the growth of bacteria that cause tooth decay. Also under research are several materials that slowly release fluoride over time to help prevent further decay. These materials would be placed between teeth or in pits and fissures of teeth. Toothpastes and mouth rinses that can reverse and “heal” early cavities are also being studied.

What are dental sealants?

Sealants are a thin, plastic coating that is painted on the chewing surfaces of the teeth to prevent tooth decay. The painted-on liquid sealant bonds into the depressions and groves of the teeth, forming a protective shield over the enamel of each tooth.

Typically, children should get sealants on their permanent molars and premolars as soon as these teeth come in. These dental sealants can then protect the teeth through the cavity-prone years of ages 6 to 14. Adults without decay or fillings in their molars can also benefit from sealants.

Sealants can protect the teeth from decay for up to 10 years, but they need to be checked for chipping or wearing at regular dental check-ups.

Are amalgam-type fillings safe?

Over the past several years, concerns have been raised about silver-coloured fillings, otherwise called amalgams. Our practice follows and accepts the research-based guidelines and information provided by the New Zealand Dental Association (NZDA), which states:

“Dental amalgam is a safe and durable material that has been used by dentists to restore teeth for well over 100 years. It is a mixture of metals including silver, copper and tin, to which mercury is added. The mercury binds these components to form an alloy which has a long established record of safety and durability as a dental filling.

Many scientific studies have shown that the very small amounts of mercury released from an amalgam filling during its placement or removal, and in fact over the whole life of that restoration, do not cause any adverse health effects.

NZDA affirms the safety of dental amalgam as a restorative material. Patients are assured that the current extensive scientific evidence shows amalgam fillings, whether old or new, do not constitute a threat to their health. Numerous scientific studies have demonstrated that there is no evidence of any association linking amalgam fillings with chronic degenerative diseases, kidney disease, autoimmune  disease, cognitive function, adverse pregnancy outcomes, or any non-specific symptoms. Also, the studies have failed to demonstrate that removal of amalgam fillings will improve patients’ health, or result in the remission of any symptoms of illnesses.

There has been concern over the release of a small amount of mercury vapour from these fillings. According to the various researches all around the globe however, there is no scientific evidence that this small amount results in adverse health effects.”

This link is to an interesting article

Can you have an allergic reaction to amalgam?

It is possible, but fewer than 100 cases have ever been reported so far. In these rare circumstances, mercury or one of the metals used in an amalgam restoration is thought to trigger an allergic response. Symptoms of amalgam allergy are similar to those experienced in a typical skin allergy, and include skin rashes and itching. Patients who suffer amalgam allergies typically have a medical or family history of allergies to metals. Once an allergy is confirmed, another restorative material can be used.

What role are lasers playing in the field of dentistry?

Lasers have been used in dentistry since 1995 to treat a number of dental problems.

 Lasers to treat:

  • Tooth decay — Lasers are used to remove decay within a tooth and prepare the surrounding enamel for receipt of the filling.
  • Gum disease — Lasers are used to reshape gums.
  • Biopsy or lesion removal — Lasers can be used to remove a small piece of tissue (called a biopsy) and send it for testing to determine if it is cancerous. It can also be used to remove lesions in the mouth and relieve the pain of canker sores.

How do whitening toothpastes work and how effective are they at whitening teeth?

All toothpastes help remove surface stains through the action of mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach. Over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface, as well as stains deep in the tooth.

None of the home use whitening toothpastes can come even close to producing the bleaching effect you get from your dentist’s office through chair-side bleaching or power bleaching. Whitening toothpastes can lighten your tooth’s colour by about one shade. In contrast, light-activated whitening conducted in your dentist’s office can make your teeth three to eight shades lighter.

What about whitening strips and whitening gels? What’s the opinion on these products?

Both of these products contain peroxide in a concentration that is much lower than the peroxide-based products used in your dentist’s office. Although some teeth lightening will be achieved, the degree of whitening is much lower than results achieved with in-office or dentist-supervised whitening systems. Additionally, use of over-the-counter products do not benefit from the close supervision of your dentist – to determine what whitening process might be best for you, to check on the progress of the teeth whitening, and to look for signs of gum irritation.

Over-the-counter gels and strips are however considerably less expense (ranging from $10 to about $55) than the top-of-the line in-office whitening procedures, which can cost nearly $800 – $1000

Beyond simply changing the color of my teeth, I’m interested in changing the shape of my teeth. What options are available?

Several different options are available to change the shape of teeth, make teeth look longer, close spaces between teeth, or repair chipped or cracked teeth. Among the options are bonding, crowns, veneers, and re-contouring.

Dental bonding is a procedure in which a tooth-coloured resin material (a durable plastic material) is applied to the tooth surface and hardened with a special light, which ultimately “bonds” the material to the tooth. A dental crown is a tooth-shaped “cap” placed over a tooth. The crown, when cemented into place, fully encases the entire visible portion of the tooth that lies at and above the gum line. Veneers (also sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-coloured materials designed to cover the front surface of teeth. These shells are bonded to the front of the teeth. Recontouring or reshaping of the teeth (also called odontoplasty, enameloplasty, stripping, or slenderizing) is a procedure in which small amounts of tooth enamel are removed to change a tooth’s length, shape, or surface.

Each of these options differ with regard to cost, durability, “chair time” necessary to complete the procedure, stain resistant qualities, and best cosmetic approach to resolving a specific problem.

I have a terrible fear of going to the dentist yet I recognize the importance of seeing the dentist to maintain good oral health. What should I do?

If you fear going to the dentist, you are not alone. Every day we see many patients who state they try to avoid going to the dentist because of anxiety or fear. The first thing you should do is talk with us by phone, so the dentist is aware of your fears and can deal with them. We believe that treatment will only be successful if we can effectively address your fears prior to the initiation of any treatment The key to coping with dental anxiety is to discuss your fears with your dentist. Once we know what your fears are, we are better able to work with you to determine how to make you less anxious and more comfortable.

The good news is that today there are a number of strategies that can be tailored to the individual to reduce fear, anxiety, and pain. These strategies include use of medicines (to either numb the treatment area, or sedatives or anaesthesia to help you relax), use of lasers instead of the traditional drill for removing decay, application of a variety of mind/body pain and anxiety-reducing techniques, and perhaps even visits to a dentophobia clinic or a support group.

I’ve been a cigarette smoker for a number of years and am concerned about the possibility of developing oral cancer. What are the signs and symptoms of oral cancer?

First, it’s important to note that more than 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally. To answer your question, the following are the common signs and symptoms of oral cancer:

  • Swellings/thickenings, lumps, bumps, rough spots/crusts or eroded areas on the lips, gums, or other areas inside the mouth
  • The development of velvety white, red, or speckled (white and red) patches in the mouth
  • Unexplained bleeding in the mouth
  • Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
  • Persistent sores on the face, neck, or mouth that bleed easily and do not heal within two weeks
  • A soreness or feeling that something is caught in the back of the throat
  • Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
  • Hoarseness, chronic sore throat, or changes in the voice
  • Ear pain
  • A change in the way your teeth or dentures fit together – a change in your “bite”
  • Dramatic weight loss.

If you notice any of these changes, contact our office immediately for a professional examination.

How safe are dental X-rays?

Exposure to all sources of radiation — including the sun, minerals in the soil, appliances in your home, and dental X-rays — can damage the body’s tissues and cells, and can lead to the development of cancer in some instances. Fortunately, the dose of radiation you are exposed to during the taking of X-rays is extremely small.

Advances in dentistry over the years have led to the low radiation levels emitted by today’s X-rays. Some of the improvements are new X-ray machines that limit the radiation beam to the small area being X-rayed, higher speed X-ray films that require shorter exposure time to get the same results compared with older film speeds, and the use of film holders that keep the film in place in the mouth (which prevents the film from slipping and the need for repeat X-rays and additional radiation exposure). Also, the use of lead-lined, full-body aprons protects the body from stray radiation (though this is almost non-existent with the modern dental X-ray machines).

As per the law, our X-ray machines are regularly checked for accuracy and safety.

With so many toothpastes in the market today, can you offer any tips to help make a wise choice?

Here’s some advice. First, when purchasing a toothpaste for you or your child, select one that contains fluoride. Toothpastes with fluoride have been shown to prevent cavities. One word of caution: check the manufacturer’s label. Some toothpastes are not recommended in children under age 6. This is because young children swallow toothpaste, and swallowing too much fluoride can lead to tooth discoloration in permanent teeth.

Brushing twice daily with fluoride toothpaste is an effective method of reducing dental caries. In areas where the water supply is fluoridated it gives extra protection to teeth. For children under six years of age only a smear of fluoride toothpaste should be used and children should be discouraged from swallowing or eating fluoride toothpaste.

Finally, some degree of personal preference comes into play. Choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint all work alike. If you find that certain ingredients are irritating to your teeth, cheeks, or lips, or if your teeth have become more sensitive, or if your mouth is irritated after brushing, try changing toothpastes. If the problem continues, come to us.

Since the introduction of fluoride and other advances in dental care and dental products, is it still necessary to visit the dentist twice a year?

The standard recommendation still is to visit your dentist twice a year for check-ups and cleanings. The three best arguments that can still be made to support the twice-yearly visitation schedule are:

  • So that your dentist can check for problems that you might not see or feel.
  • To allow your dentist to find early signs of decay (Decay doesn’t become visible or cause pain until it reaches more advanced stages.)
  • To treat any other oral health problems found. (Generally, the earlier a problem is found, the more manageable it is.)

That being said however, people who have taken great care of their teeth and gums, and have gone years without any problems whatsoever might choose to lengthen the time between visits.

At the other extreme, it should be kept in mind that some people — such as those with gum disease, a genetic predisposition for plaque build-up or cavities, or a weakened immune system — might need to visit the dentist even more frequently than twice a year for optimal care.

Ask us what visitation schedule works best for your state of dental health.

What do you think I should look for when choosing a dentist?

You and your dentist will be long-term oral health care partners; therefore you need to find someone with whom you can be comfortable. To find a suitable dentist to meet your needs, consider asking the following questions as a starting point:

  • What are the office hours? Are they convenient to meet your schedule?
  • Is the office easy to get to from work or home?
  • Where was the dentist educated and trained?
  • What’s the dentist’s approach to preventive dentistry?
  • How often does the dentist attend conferences and continuing education workshops?
  • What type of anesthesia is the dentist certified to administer to help you relax and feel more comfortable during any necessary dental treatment?
  • Is information provided about all fees and payment plans before treatment is scheduled? (If you are comparison shopping, ask for estimates on some common procedures such as full-mouth X-rays, oral exam and cleaning, and filling a cavity.)
  • Does the dentist participate in your dental health plan?
  • What is the dentist’s office policy on missed appointments?