Knowledge Base - Real Answers About Dental Safety
Although we do not use silver fillings here (usually referred to as "Amalgam"), they have been around in dentistry for more than two hundred years. They work very well, and can last a very long time (30-40+ years!). They are not used as much today because of the demand for tooth-colored fillings.
Amalgam is a metal alloy composed of silver, tin, copper, zinc, and mercury. It is the presence of the mercury in the amalgam that has caused the most controversy amongst the public, even though amalgam is considered safe by most dental researchers and public-health officials worldwide. Regardless of whether there is scientific evidence to support the claims of mercury toxicity from amalgam or not, we do not use amalgam because we have modern alternatives that look better. In fact, at Inman Park Dentistry we ONLY use metal-free fillings and crowns.
What people dislike most about amalgam is the appearance. Because it is mostly silver, amalgam does tarnish over time and can look dark, even black sometimes. While mild staining is often purely cosmetic, dark staining can sometimes indicate that a cavity is forming around the old filling.
Tooth enamel is made of calcium crystals. But those calcium crystals are weakened and broken down by anything acidic. Cavity-causing bacteria are the main culprits, but even acidic foods and drinks will dissolve a microscopic layer of enamel at each and every sip.
When fluoride combines with the weakened enamel surface of your tooth, a new crystal is formed. That new surface is harder than your original enamel and more resistant to the effects of acidic foods and drinks, thus your tooth is less susceptible to develop a cavity.
As a child (when your adult teeth are forming), ingesting fluoride through drinking water or supplements enables your body to build that fluoride into the structure of the teeth, making your teeth more cavity-resistant, from the inside out. But after your adult teeth are fully-formed your body can no longer build the fluoride into your teeth. So for anyone over the age of 12, fluoride can only be added to the outer surface of your teeth (via drinking water, toothpaste, etc.).
Fluoride is a naturally occurring part of drinking water, and in some places of the country it is found in very high concentrations in well water and reservoirs. Many years ago, dentists and doctors noticed that children in those areas tended to have lower levels of cavities, and eventually they discovered that it was the fluoride that made the difference. But too much fluoride as a child can lead to Fluorosis, which is a permanent, but usually slight, discoloration of the teeth. Although purely cosmetic, it can lead to patchy white or brown spots on the tooth enamel. This is because the fluoride crystal reflects light differently than the normal enamel crystal, leading to the discoloration. Most municipal drinking water supplies (including Atlanta's) are regulated to provide people the benefits of fluoride, but in a concentration low enough to not cause Fluorosis.
Yes, tooth whitening is safe, but it can also irritate the teeth and gums.
People ask us all the time if they should whiten their teeth. We usually tell them, "if you think you should whiten your teeth, than do it". Tooth whitening works. But there are some things you need to know:
- Most whitening toothpaste does not whiten your teeth! Read the back of the tube and you'll see that it says "removes surface stains". There is no bleaching agent in the toothpaste; rather it is simply more abrasive than normal toothpaste. That extra abrasiveness often causes sensitivity and receding gums when used for years. Most people should not use a whitening toothpaste!
- You can use over-the-counter products (like WhiteStrips®, etc.). They are not as strong as the bleaching products we use in the office, so they can take 2-3 weeks (or more) of regular use to get the final results. But they do work.
- Dentist-prescribed "take-home", or "in-office" products are generally stronger, and thus work quicker, than over-the-counter products. The fastest way to whiten your teeth is to do the one-appointment whitening procedure, which can be done in about 1-2 hours in the dental office. But the most thorough whitening is done with custom-fitted whitening trays, with prescription strength gel, and used at home for 90 minutes a day for 1-2 weeks.
- All tooth bleaching products can cause some sensitivity in your teeth. It will go away, but for some people it can be painful. We generally advise bleaching with a slower or less-concentrated method if you have very sensitive teeth.
Ideally, everyone would brush and floss their teeth after every meal, first thing in the morning, and right before bed. But that is a lot of effort that most people aren't willing to do for their own oral health. At the very least, everyone should brush every morning and evening, and floss (or use another "inter-dental cleaner") at least once a day.
Brushing your teeth:
When you brush, take your time! It should take you at least two minutes. That may not seem like much, but two minutes can feel like an eternity when brushing, and you'd be amazed how much of a difference an extra 30 seconds can make, each and every time you brush, on your long term oral health.
And don't brush too hard either! Perhaps people feel brushing harder will make up for not flossing, but aggressive brushing is an absolute epidemic! We see it all the time… receding gums & sensitive roots, all from brushing too hard. Tooth paste is extremely abrasive, and after years of brushing and thousands of brush strokes, you can really cause some damage. The key is to use soft bristled tooth brushes, and don't push too hard (you only need to remove the soft plaque). Once the plaque hardens into calculus (tartar), no amount of tooth brushing will clean it off. That's what a cleaning with the dental hygienist is for.
Get yourself an electric toothbrush:
Any electric toothbrush, from a $10 Spin-Brush to a $150 Sonicare, will clean better than a manual toothbrush. We tell patients all the time, "It's the 21st century, stop brushing your teeth with centuries old technology, use a power tool!"
Flossing (and other inter-dental cleaners):
Most people think flossing is simply intended to get stuck bits of food out from between your teeth. That is a great use of floss, but that's not really what daily flossing is about. The purpose behind regular flossing is to wipe the sides of the teeth where the toothbrush can't reach. You need to get something in-between your teeth regularly, whether floss, or dental toothpicks, Water-Pik® type things, etc.
If you spend a few moments in the tooth brush aisle at the grocery store, you'll find that there are many different kinds of floss, as well as other disposable tools designed to help you floss. I don't care what you use, just use something!
Chewing Gum:
Sugar-free chewing gum, especially after a meal or snacks, has been proven to keep your mouth healthier. Chewing sugar-free gum, (such as Orbit®, Trident®, etc.) after meals has been proven to reduce the amount of plaque buildup on teeth and increase saliva flow, which reduces the effect of acids produced by the bacteria in your mouth.
Mouthwash:
Once a day, or more, you should use a mouthwash. I'm not talking about something to just "freshen your breath", but rather something to actually improve the health of your mouth. A fluoride containing mouthwash (like ACT®), used daily, can slow and even reverse some early cavities. Aside from brushing and flossing, using a fluoride-containing mouthwash regularly is one of the best preventative measures you can do for your teeth.
It depends on what kind of pain and how bad it is. It is very common for people to have occasional tooth sensitivity, especially to cold water and drinks. As long as it is only occasional, and minor in both severity and duration, then it likely may be nothing to get worried about. But if the sensitivity persists, worsens, or starts being painful, then come in for an evaluation.
There are some symptoms that should get checked out right away:
- If a large piece of a tooth breaks (regardless whether it hurts or not).
- If you have swelling around the tooth or gums.
- If you experience spontaneous pain (i.e. it starts hurting "out-of-the-blue", or wakes you up at night).
- Regular sensitivity to sweets on a specific tooth.
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