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.

It is estimated that 10-15 percent of Americans moderately or severely grind their teeth. Normally, we exert about 20 to 30 pounds per square inch on our back molars when we chew. but teeth grinders, especially at night without restraint, can exert up to as much as 200 pounds per square inch on their teeth.

The relentless wear and tear at night from grinding can quickly erode enamel, fracture teeth, affect bite and damage the temporomandibular joint at the hinge of the jaw, and the masseter muscle, which controls the jaws. Jaw and face pain as well as earaches and headaches may also occur.

Having treated this condition for over thirty years, I’ve helped many night grinders eliminate their problems.

*Some information for this article was taken from NY Times article of October 2009: When Stress Takes a Toll on Your Teeth.

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.

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.

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.

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.