This video by O’Fallon dentist, Dr. Edward Logan, highlights steps you can take to save a tooth that has been chipped or knocked out.

         As the average lifespan of our nation’s population is increasing, so too is the need for maintaining proper oral health care.  The goal, of course, is to retain our teeth for all of these extended years.  Though aging can have some negative effects on our teeth, I am encouraged to report that many of my elderly clientele are even more diligent and knowledgeable in the area of oral hygiene than some of their younger cohorts.  While dentures are still available, their prevalence in the dental office is significantly reduced from years in the past.

            It is important for the aging population to pay attention to certain scenarios that may present in the oral environment with age.  The saying, “He’s a bit long in the tooth,” originates from the fact that gum recession over time tends to expose more and more of the root surfaces of one’s teeth.  Often associated with this root exposure is increased sensitivity to cold and hot liquids and air brought in through the mouth.  A simple solution to this problem is to have your dentist bond a desensitizing agent to the tooth or to place a filling on the exposed surface.  These treatments are incredibly effective at eliminating tooth sensitivity both painlessly and immediately.  Patients are thus free to enjoy ice cream, coffee and cold beverages that same day.

            Exposed roots are also more predisposed to cavities, or “root caries” as we call them.  This is because the tooth structure below the gum line consists of a softer mineral than the more resistant enamel on the outer portion of a tooth.  Routine cleanings and check-ups, sometimes with even greater regularity than the typical six-month recall, can serve to head off at the pass any cavities that may otherwise run amuck.

            Decreased salivary flow can result with age as well.  Our saliva contains a buffer against the acids that result when foods breakdown in our mouths.  The absence of this saliva leaves our teeth more susceptible to tooth decay.   Certain medications can interfere with normal salivary production as well.   A dentist may elect to counteract this decreased salivary flow with other medications.  The best defense against the harmful effects of low salivary flow is the same as that for most age-related dental challenges: immaculate oral hygiene and regular visits to the dentist!

            This is no longer the Dark Ages of Dentistry.  Gentle dentistry can now be performed through advances in technology and dental delivery techniques.  While most people are somewhat nervous when receiving dental treatment, there is much less to be worried about now than there was in the past.  A dentist can make patients comfortable during anesthetic injections by wiggling the cheek, pulling the tissue over the needle rather than actually putting the needle into the tissue and very slowly delivering the anesthetic.  Most often, my patients comment that they did not even feel the needle or any of the injection.

            Virtual reality glasses allow patients to watch movies during treatment, taking their mind and ears off the procedure being performed.  Headphones playing music are a great option as well.  For those who remain fearful, nitrous oxide, or “laughing gas” can be delivered.  Oral sedation medications allow the patient to maintain an airway and not go to sleep altogether, but to be very relaxed during treatment, almost forgetting the anything happened.  If that is not enough, sleep dentistry can be performed by practitioners with advanced licenses.

            Not only does the injection not need to be painful anymore, the anesthetic agents used are now much more profound.  I routinely administer less than half the dose that was once required to achieve numbness.  These anesthetics also provide an even deeper level of numbness and are considerably faster-acting.  So now that the shots do not hurt and you cannot feel the drill, what are you waiting for?  Go to the 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.