Archive for April, 2011

Can you get stained teeth from silver fillings?

Saturday, April 30th, 2011

I have two fillings that I want taken out and replaced with white fillings, both because of how they look and because of the mercury. I’ve been trying to lead a more healthy lifestyle, and a lot of the holistic magazines I read now mention removal of silver (mercury) fillings as part of reducing your “toxic load”.

Anyway, my dentist said that maybe those teeth won’t look very good when we are done, because the silver fillings might have stained my teeth? They are molars, but are visible when I laugh or talk.

Is this right? What makes the stain? That kind of freaks me out, because what if the toxins are now soaked into my teeth. I am also kind of worried about how strong these teeth will be after the procedure. About seventy percent of the teeth are filling, and my dentist said that the material in the composite is not as strong as the silver filling material (he will never call it mercury). Are these teeth going to be at risk for breaking or cracking?

Maggie in Colorado Springs

Dear Maggie,

Over the years our practice has removed many amalgam fillings and replaced them with white fillings, and we have never seen a case where they did not look significantly better. It is true that the amalgam fillings can cause some discoloration in your teeth, but it is usually very minimal, and in back teeth or molars should be barely noticeable.

The real issue at hand is that it sounds like your dentist is not comfortable with this procedure, and is kind of trying to talk you out of it. Putting white composite fillings in the back teeth is very different and more challenging than placing amalgam fillings, and if your dentist has not had training in this procedure, he may not be comfortable doing it. Most dental schools do not teach placement of composite fillings, so unless your dentist has pursued training beyond dental school, he may not be comfortable doing them, especially in the back of the mouth.

One point that should be made very clear: it is ALWAYS a bad idea to push a dentist out of his or her comfort zone. If you get the feeling that your dentist is not comfortable with a procedure you want, then it is best to seek the services of a different dentist.

One other thing–you state that more than half of the teeth in question are fillings, and in that case, we would strongly suggest porcelain crowns rather than fillings. For smaller fillings, replacing amalgam fillings with white composite fillings actually yields a stronger end result, because the composite bonds to the tooth. But removing and replacing fillings that large may well result in the cracking you are worrying about. Porcelain crowns are the safer option.

This blog post is provided as a courtesy of the dental office of Dr. Malone, Lafayette Louisiana cosmetic dentist.

Can I get bone grafting done?

Tuesday, April 19th, 2011

My general dentist has told me that I should consider getting some dental implants. I lost three teeth in a boating accident when I was a teenager. I am 40 now, and have had a dental bridge for all these years. The x-rays that my dentist takes show that there is a lot of bone loss where the teeth were, and my dentist does not want to let that situation continue.

He wants to do dental implants, and says he could do the work unless it requires bone grafting, in which case he would refer me to an oral surgeon for that. I think I would rather just go to a specialist for the whole procedure. How can you tell if you need bone grafting? My dentist did not say. Seems like you would be able to tell from the x-rays, but maybe there is more to it?

Also, how do I know if I even CAN get bone grafting done? I am not in good health. My regular doctor does not sound very excited about me undergoing surgery, though he did not say “don’t do it”. I guess all of this uncertainty is making me very nervous, and wondering if the procedure is worth the risk.

Thanks for any information you can give me,

Shelia in New Orleans, LA

Dear Shelia,

We would suggest a consultation with your dentist, the specialist you and your dentist choose to do the procedure, and your regular physician. You should be in good general health for the best chances of a successful bone grafting procedure, and you say that your health is not good. Is your general dentist fully aware of your health problems? He may change his recommendation if he has the full picture of your overall health.

The dentist who does the implants will consider your x-rays and CT scans, and then consider your case in light of all other health information. Like the field of cosmetic dentistry, dental implant dentistry is not recognized as an official speciality are by the American Dental Association, so you’ll have to be cautious about choosing the specialist. You’ll want someone who has demonstrated success with dental implants, and who has extensive training beyond dental school.

There is no one way to determine who is the best dental implant dentist in your area, but some techniques are to consult the websites of dentists in your area, and find one that advertises that he or she does dental implants. If they have pursued the extra training, chances are very good that they will mention this either on their home page or on the “About the Dentist” page. Look for training at facilities such as the International Congress of Oral Implantology, the Academy of Osseointegration, or the American Academy of Implant Dentistry.

This blog post is supported by the dental office of Lafayette Louisiana cosmetic dentist Dr. Malone.