We’ve compiled a list of our most frequently-asked questions to inform you on important dental health care processes and procedures. Don’t see what you’re looking for? Call or visit our Cambridge dentistry today to learn more about how we can help you find your best smile.
Q: Are amalgam (silver) fillings safe?
A: Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapour and minute particles from the mercury can cause a variety of health problems.
According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.
The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost-effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades.
Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.
There are numerous options outside of silver fillings, including composite (tooth-coloured), porcelain and gold fillings. We encourage you to discuss these options with your dentist so you can determine which is the best option for you.
Q: How often should I have a dental exam and cleaning?
A: You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.
Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, many other things are checked and monitored to help detect, prevent and maintain your dental health. These include:
Medical history review – Knowing the status of any current medical conditions, new medications and illnesses, gives us insight to your overall health and also your dental health.
Examination of diagnostic x-rays (radiographs) – Essential for detection of decay, tumours, cysts and bone loss. X-rays also help determine tooth and root positions.
Oral cancer screening – Examination of the face, neck, lips, tongue, throat, tissues and gums for any signs of oral cancer.
Gum disease evaluation – Examination of the gums and bone around the teeth for any signs of periodontal disease.
Examination of tooth decay – All tooth surfaces will be checked for decay with special dental instruments.
Examination of existing restorations – Check current fillings, crowns, etc.
Removal of calculus (tartar) – Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
Removal of plaque – Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing – Removes stains and plaque that is not otherwise removed during tooth brushing and scaling.
Oral hygiene recommendations – Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
Review dietary habits – Your eating habits play a very important role in your dental health.
As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.
Q: Why is it important to use dental floss?
A: Brushing your teeth removes food particles, plaque and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, your toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.
Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gum line, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.
How to floss properly:
1. Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
2. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
3. Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss. Daily flossing will help you keep a healthy, beautiful smile for life!
Q: What can I do about stained or discoloured teeth?
A: Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.
Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).
As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The colour of our teeth also comes from the inside of the tooth, which may become darker over time. Smoking, drinking coffee, tea, and wine may also contribute to tooth discolouration, making our teeth yellow and dull. Sometimes, teeth can become discoloured from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discoloured.
It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach, and your dentist may offer other options, such as veneers or crowns to cover up such stains. Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth. Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.
The most widely used professional teeth whitening systems:
Home teeth whitening systems – At-home products usually come in a gel form that is placed in a custom-fitted mouth guard (tray), created from a mould of your teeth. The trays are worn either twice a day for approximately 30 minutes or overnight while you sleep. It usually takes several weeks to achieve the desired results, depending on the degree of staining and the desired level of whitening.
In-office teeth whitening – This treatment is done in the dental office, and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.
Some patients may experience tooth sensitivity after having their teeth whitened. This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week. Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!
Q: What are my options if I have missing teeth?
A: With many state-of-the-art dental treatments and prevention options available today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience, and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future. When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth and TMJ (jaw joint) problems. These problems and movements do not result immediately but will eventually appear, compromising your chewing abilities, the health of your bite and the beauty of your smile.
Options for replacement of missing teeth:
Removable bridges – This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-coloured, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges – This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures – This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.
Implants – These are an effective way to replace one or more missing teeth. They may also be great to support ill-fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment are always less involved and less costly than delaying treatment and allowing a serious problem to develop.