When a tooth is missing, the underlying bone no longer has a purpose and begins to shrink. That’s what causes a sunken look around the mouth and jaw. Missing teeth also shift the burden of chewing to remaining teeth, causing them to wear down faster.

2. How does the cost of a dental implants procedure compare to other tooth replacement options?

When comparing tooth replacement options over a span of twenty years, dental implants are often the most cost effective. They last well over 20 years, while a bridge lasts 7-10 years and partials and dentures last an average of 5 years.

3. Am I too old for dental implants?

Age is not a factor. Dental implants are a lifestyle choice, as they affect appearance, eating, confidence, smiling and overall health. Last year, an 80+ year old patient got his dental implants before moving to Florida to continue his active lifestyle.

DENTAL IMPLANT FACT: 90% of all dental implants replace just a single missing tooth.

For more information on dental implants, visit our St Louis Dental Implants website.

If you’re over the age of thirty and have had your fillings for quite some time, schedule an appointment and let me examine them. They could need replacement if there are signs of cracking.

Cracking or decay festering underneath won’t be apparent until you find yourself in pain one day. Or, you bite down on something and feel the final crack give way beneath the old filling.

Also, as fillings get old they sometimes leak. In your exam, I’ll see if they’re worn around the edges and pulled away from the tooth enamel. When this happens, bacteria can enter and once inside the tooth it can’t be removed, so decay begins. There may be no symptoms until the decay reaches the nerve of your tooth, creating the need for a root canal.

If the decay gets far enough for you to be in pain, the remedy will require more treatment and more expense.

Every time you bite down you’re applying one hundred pounds of pressure to your teeth. If your fillings are weakening and there’s unseen cracking and decay underneath, every bite, is causing stress.

Last year I removed the silver fillings from a forty-five year old patient who has had regular dental care elsewhere and whose teeth and gums were in relatively good shape. She wanted the silver amalgam replaced with white fillings for cosmetic reasons. When we removed her silver fillings we discovered her molars were cracked and had to be restored. They are not only functioning great, but she no longer has dark fillings detracting from her beautiful smile.

When fillings are worn or broken down they need to be replaced as soon as possible to prevent the spread of decay throughout the tooth and any unseen cracking lurking underneath. In the process, you’ll get a smile update.

Source: Journal of the American Dental Association March 2001

your son, daughter or grandkid wants to join the growing number of young adults with pierced tongues, they should be aware of the risks to their dental health.

These can cause tooth chipping and breakage and lead gums to recede due to rubbing and irritation.

The practice of replacing silver fillings with white, tooth-colored material for health reasons has been promoted by “biological” dentists who believe silver fillings are detrimental to your health. You may have heard these referred to as “silver”, “mercury”, or “amalgam.” These three terms are used to refer to the silver material which contains more mercury than silver, along with other metals.

If you’re confused about whether mercury fillings are safe or not, you’re not alone: even the FDA has seemingly changed their opinion. On June 4, 2008, the agency issued this statement on their website:

“Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.” And: “When amalgam fillings are placed in teeth or removed from teeth, they release mercury vapor. Mercury vapor is also released during chewing.”

The FDA also agreed to release a new ruling in July 2009, and alert consumers about potential related hazards.

Instead, on July 28, 2009 the FDA issued the following statement, as reported by Reuter’s:

“While elemental mercury has been associated with adverse health effects at high exposures, the levels released by dental amalgam fillings are not high enough to cause harm in patients,’’ the FDA said, citing an agency review of roughly 200 scientific studies.

The American Dental Association stands behind mercury filling safety, stating:

“Dental amalgam has been studied and reviewed extensively, and has established a record of safety and effectiveness.”

For cosmetic reasons 90% of our patients prefer the white, tooth-colored material. If you’re among those of us who grew up when mercury fillings were the only option and you haven’t had these replaced, you can whiten and update your smile by replacing these with this new tooth-colored material.

I don’t see enough hard science confirming claims that mercury fillings are linked to such conditions as Chronic Fatigue Syndrome or Alzheimer’s. However, I’ve been using the white, tooth-colored non-metallic filling material since 1987, thereby eliminating the issue for my patients. That said, some people are allergic to this non-metal material.

A “biological dentist” would recommend you remove these fillings for health reasons, believing that the longer you leave these in your mouth, the longer you are exposing yourself to metal toxicity.

I recommend replacing decades-old mercury fillings for two reasons: one is cosmetic and the second is tooth preservation. You see, as a dentist, my primary role is to enable you to chew. Since mercury expands and contracts with temperature changes, over time the teeth underneath can crack, which has been the case with some patients. Sometimes, the tooth can crack so deeply it must be removed and replaced with an implant and crown.

Ok, let’s address some common questions.

1. Are white fillings weaker than amalgams?

Yes, however, if you take the total result—the filling plus the tooth—the composites are stronger

because they bond to the tooth, making the tooth more resistant to fracture.

2. Why don’t all dentists offer white fillings?

Many dentists don’t feel comfortable using white filling material on back teeth—it requires special

training to do so. The experience and training ensures the filling isn’t vulnerable to leakage and

new decay. The material has been around since the 70’s, but it wasn’t until the mid-80’s that technology was developed to bond it to your tooth.

With a deep cleaning …called a “scaling and root planing” you get all of that trapped bacteria, plaque and calcification cleaned out. The result is your gum tissue can reattach to the bone. A deep cleaning, when necessary, is one of the most therapeutic health treatments you can get. Good gum health is a foundation of good overall health.

1. Plaque Buildup. Cavities and tongues with deep grooves serve as prime reservoirs for bacteria we commonly call plaque – a sticky, colorless film that constantly forms on teeth. The bacteria produces volatile sulphur compounds that give bad breath, or halitosis.

2. Periodontal Disease. Gums that are puffy or bleed when you brush indicate infection.

3. Medications. According to the most recent research 7 out of the top 10 medications used in the US during 1998 had “dry mouth, bad breath, or taste disorders” as a side effect.

4. Tooth Decay. Tooth decay is just what the name implies–dead, decayed matter. Dead stuff smells bad by itself,and since the decay is fairly soft, it absorbs juices from the foods you eat, and that decays as well. Every area of decay is a potential source of bad breath. You cannot hope to eliminate bad breath permanently without first having the decay repaired.

5. Diseases. Some diseases are directly related to chronic bad breath such as diabetes, sinus and tonsil infections and lung, kidney and liver diseases.

Since chronic bad breath can be either medical or dental in origin, the first approach is improving oral hygiene. This includes the following:

•Scrape Your Tongue.

•Brush and Floss every day

•Get regular professional cleanings

•Treat gum disease with deep cleanings that eliminate bacteria that has penetrated into gum tissue that has pulled back from the teeth – called “pockets.” This allows the gums to heal and reattach to the teeth.

If the above treatments don’t address the situation, seek medical treatment for any chronic infections that are contributing to the condition.

The distance between your nose and chin is detemined by your back teeth. So your entire face, lips and smile is dependent on your back teeth.

The teeth in the back of your mouth serve a vital chewing function. If that function is compromised due to missing or broken down teeth that need to be capped or replaced, the entire chewing mechanism is compromised.

This sets the scene for more tooth loss in the future. Besides, it reduces the ability to chew up your food and puts the brunt of digestion on your stomach. This often results in gastointestinal problems.

So, replacing missing teeth or getting crowns in the back of your mouth is not a cosmetic decision — but a decision in favor of maintaining overall health.

Research and polls done in the last few decades repeatedly show that your smile influences how you are perceived and treated by others in every situation in life.

A survey done by the American Academy of Cosmetic Dentistry found that 74% of American adults believe an unattractive smile can harm a person’s chances of career success. Julia Roberts was at one time the highest paid actress in Hollywood. She also was voted as having the best smile in the business. Think there’s a connection?

People see your smile or teeth as the first or second thing they notice when they look at you. Some studies say it’s the eyes – others say the smile. Either way, when you come into contact with other people they will notice your teeth and smile no matter what, since the mouth and eyes are the chief vehicles for communication.

This is not a recognized specialty in dentistry. Rather, it’s a term we use in our office to describe the Pagano Protocol – the sequence in which your teeth, gums and structure are treated which results in a dazzling smile that sits in a structurally sound foundation.

What do we mean by “orthopedic cosmetic dentistry?” Think of your teeth and gums as the inside of a house and your jaw and head bones as the structure and foundation. Once Doc ensures that the structure is balanced and stable – which often includes treatment that eliminates headaches,

teeth grinding and other unwanted conditions – then the restorative and cosmetic treatments on your teeth and gums can be performed on a stable foundation. This results in cosmetic treatment that lasts, a bite that feels natural, and eliminates redoing your work.

One patient with lifelong headaches experienced complete relief. Her treatment included straightening her teeth and getting a gorgeous smile.

You can read more about orthopedic dentistry in Doc’s free downloadable ebook: Lifetime Smile at www.stlouisdentistdrpete.com.