Archive for September, 2010

My son’s front teeth are a mess!

Wednesday, September 29th, 2010

My 10-year-old son was jumping on the neighbor’s trampoline, and came down on his face on the frame (no safety net). Half of his left front tooth broke off, and there is a horizontal crack in the right one. We took him to the ER to make sure he did not have any other injuries, which thank God he doesn’t. This morning, I took him to our family dentist and couldn’t believe it when he told us we will have to wait nearly three weeks for his schedule to allow him to fix it! Are you kidding me?? When I asked him if he could recommend someone who could fix it right away, he said we need to wait anyway, to let the root desensitize. I’ve never heard of this before.

Is it medically necessary to wait? I want this fixed right away.

Thank you in advance,

Jennifer in Portland, OR

Dear Jennifer,

Medically, there is no reason to wait. I’m not sure why your dentist won’t recommend someone else if he is too busy to take care of this right now. Your letter kind of implies that there is not much a trusting relationship with this dentist, which is a good indicator that you may want to consider finding a new dentist.

You don’t mention whether or not you have the piece that broke off the tooth, and hopefully you do. An experienced and talented cosmetic dentist may be able to reattach the broken piece of tooth. If you do not have the missing piece of tooth, the most likely fix for a child this age is direct dental bonding. When he is older, he will likely need porcelain crowns on one or both front teeth.

Direct dental bonding is a very demanding procedure, both technically and artistically. Keep this in mind when you choose a dentist to do the repair. You should look for an expert cosmetic dentist with demonstrated skills in direct dental bonding, and one who is sensitive to self-esteem issues in kids. If you talk to a dentist and he or she seems to be dismissing the importance of the appearance of those front teeth in a child, seek another opinion.

Best of luck to you.

Tags: , ,
Posted in Dental Bonding, Porcelain Crowns | Comments Off

White fillings OK for wisdom teeth?

Friday, September 17th, 2010

Some years ago I had three molars that required fillings, and the dentist I saw at the time talked me into white fillings. While he was at it, he also talked me into getting white fillings in my two lower wisdom teeth, to protect them against future cavities, because I guess they had very deep pits and fissures in them.

Soon after the fillings were placed in the molars with cavities, I had to have those fillings replaced by a different dentist. My teeth were so sensitive after the fillings that I could hardly stand to eat anything! The white fillings in my wisdom teeth didn’t bother me at that time, but I kind of figured that was because there were not any cavities under them. Now, though, the white filling material in my wisdom teeth has worn almost completely away. The parts of the teeth that were covered with filling material before look just awful–yellow and gross.

What kind of filling should I get to have these fixed? I don’t want a repeat of the fiasco I had before, but my current dentist does not even place the regular kind of fillings anymore. She only does white fillings, which kind of shocked me. Could it be that she does not know how to place the more traditional kind of fillings? If that is what I want for my teeth, will I have to go to a new dentist again?

Thanks for your help and advice with this,

Ryan in New Hampshire

Dear Ryan,

It wasn’t the kind of filling you had that caused your problems. It was the technique used to place those fillings.

If your dentist graduated from dental school, then she does know how to place an amalgam filling. But many dentists these days are choosing NOT to place amalgam fillings, because so few patients want them if offered the choice between white fillings and traditional amalgam fillings.

There are several disadvantages to amalgam fillings. The amalgam material is more than 50% mercury by weight, and there are ongoing concerns about safety that are currently being investigated by researchers. Many people chose to err on the side of caution and opt for white fillings. Also, the amalgam material weakens the surrounding tooth material, making the overall structure of the tooth weaker. Amalgam fillings also corrode over time and tend to make your teeth more sensitive. Finally, they are just plain ugly. There is nothing that can be done to make an amalgam filling look natural in your mouth.

By contrast, white fillings can look like a natural part of your tooth. If done properly, your teeth will be less sensitive to temperature changes, and the white composite material bonds to the tooth structure, creating a stronger end result. The disadvantages of white fillings is that they are usually more expensive, and require more skill and expertise to place.

If your dentist ONLY places white fillings, then it is a safe bet that she is an expert in doing this procedure. If you need more reassurance, question her about where she did her training, and ask to see before and after pictures of her work. Most dentists will want you to feel safe and comfortable with the treatment plan, and if she can’t reassure you, it might be time to find a dentist you can really trust.

Posted in Sensitive Teeth, White Fillings | Comments Off