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.

There IS a secret to getting your cosmetic work done for less. And it’s simple. It’s getting it done right the first time.

Even high quality crowns, veneers and dental implants can fail in your mouth. They can feel unnatural and make it uncomfortable to chew. Done incorrectly, they can lead to popping and clicking in your jaw or head, neck and back pain.

The secret to saving thousands on your crowns, porcelain veneers and dental implants is to ensure that the cosmetic dentistry actually “fits” your head, neck and jaw. Consider that dentistry is engineering on a very tiny scale. Everything must fit together to function correctly. Often, patients come to me with a jaw joint imbalance that has led to a deteriorated dental condition. Once this imbalance is corrected, cosmetic dental work can be placed on a sound structure.

This is called orthopedic cosmetic dentistry . This is not a recognized specialty in dentistry, but a protocol I’ve followed based on thirty-five years of experience, training and research into the best ways to ensure that cosmetic dental work lasts, does not interfere with natural chewing function, or create a structural imbalance leading to pain.

If you’re over the age of forty and have considered getting veneers, implants or crowns, I apply the principles of orthopedic cosmetic dentistry to Midlife Dentistry. That’s a sequence of treatment to restore the health of your teeth and gums and enhance your smile and usually entails some procedures that are common in the midlife mouth, such as:

* Your head, neck and jaw are balanced so that your cosmetic dental work is sitting on a sound structure. This ensures that your cosmetic work will last and save you from redoing procedures.
* As you age your teeth wear down, often causing an uneven bite. This can lead to unexplained pain in the head and neck area. If not addressed, you may have to redo cosmetic dental work. Worse, you may seek medical treatment for pain that has been caused by your cosmetic work.

But whether you’re midlife or not, your teeth and gums are part of the interrelated structure of your head, neck and jaw. A comprehensive program ensures the outcome of natural chewing as well as the expected aesthetic outcome. If your primary concern is just looks, then you may not get the work done correctly the first time.

I regularly have patients come to me to correct cosmetic work that was done over misalignment of the head, neck or jaw. This often leads to unexplained headaches due to a basic malfunction that was only made worse by veneers or crowns.

Some signs you may be ready for orthopedic dentistry are:
1. Thinning of your lips.
2. Wrinkles or sagging around your mouth and jaw.
3. A wearing down of your teeth causing your chin to get closer to your nose.
4. You avoid chewing on one side of your mouth.
5. You have missing or cracked teeth.
6. You don’t smile for pictures anymore.
7. You noticed facial pain with increased pressure in your head and sinuses.
8. You put your hand over your mouth when you smile.
9. You notice your smile is getting crooked as teeth wear down unevenly.
10. You’ve had an increase in root canals, especially on one side of your mouth.
11. You have neck and low back pain that creates inactivity.

The primary role of dentistry is chewing. Whether you are getting simple fillings or implants and crowns, your dental work needs to function naturally. With this approach to your cosmetic dentistry, your work is performed so that it’s in alignment with your structure. It is also done in the correct sequence, since all procedures are done in my office. This leads to work that doesn’t have to be redone. And that’s the secret to saving thousands on your cosmetic work.

You can learn more in my free downloadable ebook: Lifetime Smile.

If you are interested in a Consultation for Implants, Veneers, Crowns or Bridges,
call our St Louis dentist office 314 576 3000.

Midlife Dentistry is a service mark owned by Dr. Peter J. Pagano, DDS PC

1. Ignoring bleeding or swollen gums.
2. Skipping scheduled cleanings and exams.
3. Putting off getting an ache or pain in your tooth checked out.
4. Allowing impacted wisdom teeth or decayed teeth to remain.
5. Keeping old mercury fillings (these often have cracked teeth underneath).
6. Ignoring the fact that you have bad breath and not knowing why.
7. Tolerating neck or back pain that leads to inactivity.
8. Going through life with missing or cracked teeth.
9. Putting up with sensitivity to hot or cold food and drink.
10. Avoiding one side of your mouth while chewing.

Hi. I’m St Louis dentist Dr. Pete Pagano and once we treat any pre-existing dental conditions and get your teeth healthy (and believe me, this is so much easier than you might think), we can then give you the beautiful smile you’ve always wanted.

YOU DON’T HAVE TO BE WEALTHY TO GET A BEAUTIFUL SMILE.

My patients who have had smile makeovers not only include other dentists and professionals, but teachers, retirees and union workers. Today, cosmetic dentistry is affordable for nearly anyone.

TO CLAIM YOUR $197 TOWARD A CLEANING, X-RAYS AND
5 POINT DENTAL EXAM, CALL 314 576 3000.
MENTION THIS WEBSITE OFFER.

OFFER EXPIRES December 31st.

PS. I hope you take me up on my $197.00 offer. Frankly, an exam and x-rays are too costly for me to give away for very long. I can only extend the offer until May 31st.^th.

PPS. Oh … one more thing. When you explore my website you’ll find out I’m also known for accurate diagnosis. That’s why I’m the “Second Opinion Dentist.”

Source: Journal of the American Dental Association March 2001

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.

Correct the Problem and These Symptoms Go Away. That’s Done By Balancing Your Head, Neck and Jaw Before Doing Dental Work. That’s What Orthopedic Dentistry Is All About. It Also Ensures Your Cosmetic Enhancements Don’t Create An Imbalance.

In a perfectly constructed mouth, the teeth and jaw fit together to perform the function of chewing. The slightest adjustment to a tooth can throw this precise functioning off-balance. Even the replacement of a filling can make your bite feel different if it’s not balanced correctly and if not adjusted, can cause your jaw joints to move out of place.

If just a simple filling requires such precision, imagine the skill required in placing veneers or implants while ensuring they not only look great but are completely natural in their feel and fit.

Like a perfectly balanced bridge constructed to withstand the elements of weather and carry immense weight, your teeth and jaw are designed with a similar precision. The ability to work with the precision of an engineer and the talent of a master artisan ensures your dental outcome is both sound and beautiful.

Wisdom teeth, also known as third molars, are the last teeth to erupt. This normally occurs between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom.”

Anthropologists contend that the rough diet of early humans resulted in excessive wear of their teeth. The wear, it’s theorized, caused teeth to drift and by late adolescence there was space for wisdom teeth to erupt into. Modern diets don’t put the same demands on chewing and so teeth no longer shift to make room for wisdom teeth.

Do Wisdom Teeth Always Have to Be Extracted?

No. Dr. Pete believes that if wisdom teeth are well aligned, they can be very useful for chewing and may be left in place. However, in the majority of people they don’t completely erupt and remain “impacted” in the jaw. Therefore, Dr. Pete will advise extraction when he sees any of the following:

1. The width of the jaws does not allow wisdom teeth to erupt in an alignment that is beneficial for chewing.

2. Wisdom teeth are partially erupted, which may allow bacteria to penetrate the gum, causing infection.

3. Wisdom teeth are not properly aligned causing crowding or damage to the second molars. This condition makes good oral hygiene difficult and increases the likelihood of cavities and gum disease.

4. Development of an operculum, Latin for “little lid,” which is essentially an extension of the gum. This can occur when wisdom teeth have not fully erupted. In many such cases, chewing on food can irritate this operculum causing infection. This condition, called pericoronitis, can result in redness, intense pain, a bad smell and a difficulty of opening the mouth.

Is There a Benefit to Extracting Earlier Rather Than Later?

Possibly during adolescence, the roots of wisdom teeth may not be completely formed, making extraction less complicated.

What to Expect

Before removing a wisdom tooth, Doc will administer appropriate pain prevention to numb the area where the tooth will be removed. Even needle-phobes no longer need worry because Dr Pete’s dental procedure includes first putting a topical numbing agent on the area to be anaesthetized so the needle is never felt.

How soon afterward can you resume your normal activity?

Dr. Pete recommends up to four to five days, but the time varies depending on how impacted the teeth are. One patient returned to work immediately after surgery. Another took the full four days for recovery.

If you or your teen or college-aged student need wisdom tooth extractions, call as soon as possible to lock in a summer appointment.

See What Others Say About Their Wisdom Tooth Surgery With Dr Pagano:

After having 2 wisdom teeth pulled in one sitting, I am a happy camper. Dr. Pete was fast and efficient removing the two perpetrators. Afterward there was minimal discomfort in the affected areas, little swelling and complications that could only be attributed to the work done by a skilled professional. Thank you Dr. Pete and Staff.
Guy M.

Let me just first start off that I was freaking out about this dental procedure, especially because I was not going to be knocked out like everybody else I knew. I was shaking and crying before anything even happened but of course you heard all the horror stories and all I could think was the worst. Dr. Pete calmed me down and explained what he was going to do and why he wasn’t going to knock me out. His lovely assistant held my hand the whole time, poor girl, I thought for sure she would loose all circulation in it but she didn’t complain and smiled at me the whole time. After the 1st 4 shots, I really couldn’t feel much and the next million (I’m exaggerating, but I am very sensitive) nothing at all. Before I knew it, it was over. The very next day, I was walking over and running errands. My roommates couldn’t believe it. They said “you must have an awesome dentist”. I said, “I do, his name is Dr. Pete!”

EP posted on yahoo.com

When I first came to Dr. Pagano’s St Louis office, I was very apprehensive because he was a new dentist (to me). After my consultation and check-up Dr. Pagano informed me that I needed to pull my wisdom teeth, not 1, not 2 but all 3!! I was terrified because I had so many horrible experiences with dentists in the past. He assured me that everything would be fine. During the procedure he talked to me the whole time and kept letting me know what he was doing. This made me feel calm. He would ask me if I felt any pain and I did not. After my wisdom teeth were pulled I didn’t feel any pain nor did I need any pain medication! I’ve heard horror stories from people and their bad experiences with their wisdom teeth being pulled, but I had a good experience and that was due to Dr. Pagano’s skilled and talented hands. He knows what he’s doing and he’s the best! I recommend him to everyone I know and meet. Thank you Dr. Pagano.

Abby J.

To Schedule a Wisdom Tooth Surgery Consultation With Dr Peter J. Pagano please call Brenda at 314 576 3000

12334 Olive Boulevard, Creve Coeur, MO 63141
One Block West of I 270 Olive Boulevard Exit

Saturday hours available

Rather Than Dread Dentures, View Them as a Chance to Design Your Own Smile

Morton came in as a new patient asking for a new set of dentures. In collaborating with him so we

could make him dentures he would be proud to wear, I asked him questions such as:

Do you want spaces between your front teeth?

What type of smiles do you like?

Who do you want to look like?

Do you want big teeth, little teeth, long teeth, wide teeth?

Do you want personalization, such as little character flaws built into your teeth?

Do you want perfect alignment?

Morton told me he’d never been consulted to that degree like when getting dentures made previously.

He said for the first time ever, he was excited to get his new denture appliance.

According to the Center for Disease Control, 1 out of every 4 adults over 60 have lost all of their natural teeth due to gum disease and tooth decay. Another CDC report says 1 out of every 5 adults over 65 have lost all of their teeth. Once that occurs, your choices are dentures or implants.

Although dental implants are an excellent alternative to dentures, not everyone can get them. This doesn’t mean you have to dread dentures. The biggest reason denture wearers switch to implants is:

• Their dentures are ill-fitting and uncomfortable;

• They don’t like how their dentures look.

You can dread dentures or view them as an opportunity to design your smile. If you want to pay $99 and get “teeth-on-a-plate” then the old adage “you get what you pay for” applies.

On the other hand, if you want someone to craft an appliance that feels and looks natural, you can spend the money and get something that will make you feel confident.

As an Art Minor in college, I see beyond the science of dentistry. Although an appliance needs to be engineered perfectly, the aesthetic appeal must also be present.

If you need a denture, view it as an opportunity to design the smile you’ve always wanted.

The American Academy of Implant Dentistry reports, “As the Baby Boomers begin filing for Social Security, they’re replacing teeth weakened from periodontal disease with dental implants instead of bridgework and removable dentures. Further incentive is that highly precise computer-guided dental implant surgery has made the procedure faster, highly predicable and long-lasting with a success rate of 97 percent.”

Trend #2: Teeth straightening will increasingly become the first step in a cosmetic makeover. It’s been a common practice to place porcelain veneers on crooked teeth. While this gives the appearance of straight teeth, it does nothing to address the health conditions caused by uneven teeth. These create uneven bite pressure which can lead to health problems, including headaches and migraines. With more dentists understanding the connection between the bite and jaw joints and head, neck and back pain, concern for health will lead to correcting the uneven bite rather than covering it up with veneers.

Trend #3: Gum Contouring Will Become More Popular. Just like lip plumping or botox improve appearance without surgery, contouring gum lines will become popular as more dentists investing in acquiring and learning how to use laser dental equipment. With laser technology being used in everything from skin care to knee replacement surgery, it was only a matter of time before it would be more routinely employed in your dental care. In addition to gum contouring which, by the way, is also great for men, lasers can disinfect diseased gum tissue. They can also cut into the teeth, making it faster and more comfortable to get fillings.

Trend #4: 3D x-rays will enable more precise dental treatment. Technology called “cone beam” takes two dimensional x-rays and makes them 3D. This allows your dentist to provide more precise dental treatment. For example, with a 3d picture, your dentist can see the nerve tissue surrounding impacted wisdom teeth. This allows for a better surgery. With implants, we’re able to determine more exactly their correct placement.

Trend #5: Teeth whitening will become part of a daily makeup routine for women. Whitening pens like Liquid Smile will make a professional in-offce whitening last a lot longer. Instead of bulky whitening trays sitting in your mouth for an hour with saliva coming out the side of your mouth, pens allow you to touch up the teeth that are visible.