Dental Care Questions and Answers
Do I need to have dental x-rays?
What are dental sealants, who should get them, and how long do they last?
What's the latest word on the safety of amalgam-type fillings?
I'm interested in changing the shape of my teeth. What options are available?
What is the difference between silver fillings and white fillings?
When should I take my child to the dentist for the first check-up?
Are baby teeth really that important to my child?
What should I do if my child has a toothache?
Toothpaste: when should we begin using it and how much should we use?
According to the Environmental Protection Agency, approximately 100 MILLION dental x-rays are done each year in the United States. These x–rays provide your dentist with a vital tool that shows the condition of your teeth including roots, jaw placements, and the overall composition of your facial bones. X-ray machines only produce radiation during operation and the amount of radiation used is small.
Dental x-rays allow dentists to:
- Detect problems in the mouth such as tooth decay, damage to the bones supporting the teeth, and dental injuries (such as broken tooth roots).
- Detect teeth that are abnormally placed or don't break through the gums properly.
- Evaluate the presence and location of permanent teeth growing in the jaw of a child who still has baby teeth.
- Plan treatment for large or extensive cavities, root canal surgery, placement of dental implants, and difficult tooth removals.
- Plan for orthodontic treatment, like braces.
Sealants are a thin, plastic coating that are painted on the chewing surfaces of teeth -- usually the back teeth (the premolars, and molars) – to prevent tooth decay. The painted on liquid sealant quickly bonds into the depressions and grooves of the teeth forming a protective shield over the enamel of each tooth. Typically, children are most cavity prone from ages 6 to 14 so the American Dental Association (ADA) recommends they should get sealants on the permanent molars and premolars as these teeth come in. Dental sealants can protect their teeth from decay for up to 10 years.
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FDA Rules Mercury Amalgam Fillings Safe. The U.S. Food and Drug Administration's long-awaited final regulation on the use of mercury amalgam for dental fillings deems the material safe, while at the same time moving the material from the Class I (low risk) medical-device category to Class II (moderate risk). This allows for tighter control over its manufacture and use. Mercury amalgam, or "silver," fillings have been used for decades to repair cavities. It's the cheapest filling material available, and the American Dental Association (which supports the new regulation) has long warned that restricting its use would deprive dentists of an important tool and likely move needed dental work beyond the reach of low-income patients. But many people have raised concerns about the potential for mercury to "leak" from fillings into the body and cause neurological damage or diseases such as multiple sclerosis. An FDA press release announcing the decision reports: "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." Still, the agency suggests that amalgam package labels feature a warning to patients about the risk of mercury allergy, a reminder to dental professionals about the risk of working with mercury amalgam without proper ventilation, and "a statement discussing the scientific evidence on the benefits and risk of dental amalgam, including the risks of inhaled mercury vapor. The statement will help dentists and patients make informed decisions about the use of dental amalgam," according to the press release.
1. Dental bonding is a procedure in which a tooth-colored resin material (a durable plastic material) is applied to the tooth surface and hardened with a special light, which ultimately "bonds" the material to the tooth.
2. Dental crowns are tooth-shaped "caps" that are placed over teeth. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.
3. Veneers (also sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials that are designed to cover the front surface of teeth. These shells are bonded to the front of the teeth.
4.Recontouring or reshaping of the teeth (also called odontoplasty, enameloplasty, stripping or slenderizing) is a procedure in which small amounts of tooth enamel are removed to change a tooth's length, shape or surface.
Each of these options differ with regard to cost, durability, "chair time" necessary to complete the procedure, stain resistant qualities, and best cosmetic approach to resolving a specific problem. Talk to your dentist to see if one is right for you.
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1. Amalgam (silver filling) is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.
While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institute of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.
Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. They are also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line. Amalgam fillings, like other filling materials, are considered biocompatible—they are well tolerated by patients with only rare occurrences of allergic response.
Disadvantages of amalgam include possible short-term sensitivity to hot or cold after the filling is placed. The silver-colored filling is not as natural looking as one that is tooth-colored, especially when the restoration is near the front of the mouth, and shows when the patient laughs or speaks. And to prepare the tooth, the dentist may need to remove more tooth structure to accommodate an amalgam filling than for other types of fillings.
2. Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.
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According to the American Academy of Pediatric Dentistry – your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child’s smile now and in the future.
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A child's primary teeth, sometimes called "baby teeth," are as important as the permanent adult teeth. Primary teeth typically begin to appear when a baby is between age six months and one year and help children chew and speak. They also hold space in the jaws for permanent teeth that are developing under the gums. The ADA recommends that a dentist examine a child within six months of the eruption of the first tooth and no later than the first birthday. A dental visit at an early age is a "well baby checkup" for the teeth. Besides checking for tooth decay and other problems, the dentist can demonstrate how to clean the child's teeth properly and how to evaluate any adverse habits such as thumbsucking.
Have your child rinse their mouth with warm water to clean it out. Gently use dental floss or an interdental cleaner to ensure that there is no food or other debris caught between the teeth. In addition, the ADA recommends to place a cold compress on the face if it is swollen. If the pain persists, contact your dentist.
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The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. Then, according to the American Adacemy of Pediatric Dentistry,as soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively. Children should spit out and not swallow excess toothpaste after brushing.
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