O'Fallon Family & Cosmetic Dentist

                People often ask me, “How long will these fillings last, Doc?”  While there is no right answer to this question, there are a number of factors that influence a filling’s longevity.  The most important predictor of the lifespan of a filling is the degree of tooth structure missing that is being replaced.  The larger the filling, the greater the likelihood that a crown will be necessary at some point in the future.  In fact, dental health professionals often refer to large fillings as “baby crowns.”  Though patients often hope any dental problem can be solved with a filling, it frequently makes more sense to simply crown the tooth requiring a large filling in the first place.

                The particular material used to fill the tooth plays a role in the equation as well.  Though dental amalgam, or silver fillings, has been used for over 200 years and is still backed by the American Dental Association, I have not placed an amalgam filling in over a decade.  This material is currently banned in many European countries and the packaging in which it comes outlines various health risks that may be associated with the mercury it contains.  My concern about dental amalgam is more related to the cracks that it tends to place in teeth.  When mercury expands and contracts with thermal changes, similar to what happens with a thermometer, craze lines and cracks can develop in teeth.  The larger the filling and the more stress a patient puts on the teeth, the higher incidence of cracked tooth syndrome we see.  This syndrome necessitates a crown and at times root canal therapy, and is characterized by biting pain and cold sensitivity.

                Another factor contributing to a filling’s longevity is the dentist’s ability to meticulously apply the attention to detail necessary when placing the fillings.  Varying materials demand different protocol which must be followed precisely in order to extend the lifespan of a filling. The tooth-colored materials are particularly technique sensitive.

                An obvious contributor to early breakdown of any dental restoration is poor oral hygiene and heavy forces placed on these restorations, mainly in the form of clenching or grinding.  Though the majority of adults grind their teeth at night, most people are completely unaware of it.  It is very obvious to a dentist when a patient grinds, however.  A night guard made at the dentist can be a highly effective, inexpensive and conservative solution to this problem.  Ask the dentist if a night guard is right for you and help extend the life of your dental work.

Oral, head and neck cancer awareness week is from April 12 – April 18th.  The Head and Neck Cancer Alliance has coordinated with hospitals and cancer centers throughout the United States to provide free screenings.  Their website provides a map of participating centers and educational information on symptoms and causes of oral cancer.  Oral, head and neck cancer is the 6th most common type of cancer in the United States.

WebMD outlines the following signs and symptoms of oral cancer which should be investigated further by your dentist or doctor: 

Unexplained bleeding in the mouth,

Persistent sores in the mouth that bleed easily and do not heal within two weeks,

Velvety white, red or speckled patches in the mouth,

Swelling, bumps and rough spots in the mouth or on the lips,

Unexplained numbness or discomfort in any part of the mouth,

Difficulty chewing, swallowing, talking or moving the jaw or tongue,

Soreness or feeling like something is caught in the back of your throat,

Dramatic weight loss,

Change in the way your teeth or dentures fit together.

Some of these symptoms have other more common causes like decay and gum disease.  Regular checkups with a dentist can help recognize unusual symptoms which may indicate oral cancer.  As with any cancer, early diagnosis and treatment is best.

The following sources contain more information on common signs and symptoms of oral cancer.

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.ohancaw.com/hanca-education/

http://www.oralcancerfoundation.org/facts/

http://www.livestrong.com/article/10332-spot-signs-oral-cancer/

     For millions of people, sensitive teeth can make life miserable.  The pain and discomfort make even favorite cold drinks and foods impossible to enjoy.  Pain is often felt more acutely in winter when cold air can cause problems in already sensitive spots.  Tooth sensitivity typically first presents as temporary discomfort when eating cold food or drinks or breathing cold air.  If decay is ruled out as the culprit of sensitive teeth, many people believe there are no good options for treating their pain.  However, in many cases tooth sensitivity can be treated quickly and successfully.

     When tooth decay is not leading to tooth sensitivity, gum recession is often the cause of the problem.  The gums cover the roots of teeth like a protective blanket, but when gums recede the underlying roots may be exposed.  The three most common causes of gum recession are brushing teeth too hard, poor dental hygiene and the aging process.  It has been estimated that over half of people brush their teeth with too much pressure which can remove significant gum tissue, thereby exposing the tooth roots.  We recommend using a soft bristled toothbrush and brushing gently at the gum line.

      If gum recession is due to brushing too hard, a small amount of the same material used in tooth colored fillings can be placed to fill in areas where the gum has receded.  These bonding agents close the pores of the tooth root.  This simple treatment effectively eliminates sensitivity to cold or hot liquids immediately, pain-free and without the need for anesthetic or the dental drill.  If you have been plagued by tooth sensitivity with no underlying decay issues, this simple bonding procedure may end your discomfort.

     Poor oral hygiene can lead to plaque build-up around teeth and gums.  Over time this plaque hardens into tartar.  Bacteria in this tartar is responsible for gingivitis and periodontal disease that causes gum recession.  The exposed roots contain small pores which lead directly to the nerve of the tooth.  Pain, pressure and cold stimuli can travel down the pores and trigger pain in the tooth nerve.  Often this pain makes it uncomfortable to brush or floss this area of the mouth which can exarcerbate the problem.  When oral hygiene is the cause of sensitivity, a person may need a more frequent schedule of thorough cleanings and periodontal health check-ups.  Often this can relieve pain and sensitivity that have caused problems for years.

Tooth color is effected by many factors, including your genes and the aging process.  While you cannot control your genetic make-up or stop yourself from aging, there are several steps you can take to keep your teeth their whitest.

1.  Eliminate tobacco use.

2.  Limit your intake of coffee, tea and soda.  It is common for people to sip these beverages throughout their entire day exposing teeth to these stain causing agents for hours at a time.  A better practice is to drink one or two servings and then brush afterwards rather than exposing your teeth to these beverages throughout the day.  Cold liquids can be sipped through a straw to better protect teeth’s exposure.

3.  Brush after eating dark berries, soy sauce and curry.  Dark berries like blueberries are wonderful for your overall health so I would not advise eliminating these foods. 

4.  Limit your intake of wine.  Red wine is a known culprit of teeth staining, but recent studies have shown that white wine can also effect tooth color by wearing down the enamel.

5.  Brush your teeth after every meal and after consuming stain causing foods.

6.  Floss your teeth daily.  Teeth can display a great deal of staining at their edges where teeth meet.  This is due to a build-up of plaque that can be avoided by flossing between teeth.

7.  Have your teeth professionally cleaned at least twice a year.

8.  If you are concerned about the color of your teeth, talk to your dentist about safe and effective teeth whitening options.

We all know that sugary foods like candy, cookies and cake can cause tooth decay, but some foods that cause problems may surprise you.  Parents who limit dessert consumption are surprised to learn that some snacks that they consider healthy may be causing decay problems.  Starchy foods like bread, chips, cereal bars, some cereals and granola bars can cause problems too.  These foods tend to stick to teeth and mix with an enzyme in saliva to cause an acidic reaction.  Dried fruit also tends to stick to teeth and is acidic in nature.   

Acidic drinks like fruit juice and soda, even diet soda, can also cause problems.  Many of my patients assume that diet soda will not harm their teeth because it is sugar free, but the acidic nature of it can cause damage.  I recommend keeping these drinks to a minimum, but if you are a serious soda addict who can’t kick the habit, try using a straw to help the liquid bypass the teeth more effectively.  A recent study in the Journal of Periodontology, demonstrated that green tea may have a beneficial effect on teeth and gums. 

Another sometimes surprising problem is tooth decay in children’s front teeth when a sippy cup is used for a prolonged time, especially when the child drinks a considerable amount of juice or sugary substances.  With the design of a sippy cup, children often purse their lips around the cup but do not open their teeth around it.  This can cause the front teeth to be directly exposed to the acids in the juice on a regular basis.  Some sippy cups are being designed with straws now which causes children to open their teeth to take a sip.  As an aside, open cups or cups with straws are better for speech development in young children as well. 

Young children often have more snacks throughout their day as their bodies require this frequent refueling.  Frequent snacking can set teeth up for constant exposure to decay causing substances.   While brushing teeth each time a snack is eaten may not be a reasonable expectation, drinking or swishing water in the mouth to dislodge and remove decay causing substances is a good habit to establish for children and adults.