The Most Asked Questions

  

 1) About Silver Fillings and White Fillings
2) About X-Rays
3) Do Root Canals Hurt?
4) When Do I Need A Crown?
5) What Is A Bridge?
6) What are Sealants?
7) When Should Wisdom Teeth Be Removed?

  1) About Silver Fillings and White Fillings
Silver fillings that are mixed with mercury and silver into an amalgam have been used successfully to fill teeth for the past 140 years. In the early 1970's, small amounts of copper spheres were added into the amalgam alloy. This highly improved the quality and durability of amalgam thereby substantially reducing the replacement rate. Around 1990, bonding technology developed to the point that even silver fillings could now be bonded to teeth thus increasing tooth strength. The two drawbacks are the silver colour and the necessity of using mercury. Many scientific studies have been carried out over the last three decades to see if the mercury posed a danger or caused other diseases. All of the studies showed that this mercury never rose above safe levels in the bloodstream. Mercury analysis studies indicate that most blood mercury originates from the food we eat, especially fish, and not from inorganic mercury such as in fillings. The one study that was publicized in the program, 60-Minutes, that was done in Calgary by Dr. Vimy, and that showed high levels of ingested mercury in one sheep is considered by the scientific dental community as having been poorly done. Silver amalgam is still the most versatile, economical, and easy to place filling material that we have for molar teeth today. Nevertheless, some people might be allergic to mercury, or still might be fearful of having silver amalgam used for their fillings. They might also be concerned with the aestheitcs. White fillings made of composite acrylic, have improved to the point that they are reliable enough to be used regularly in back teeth. Because of this and their beauty, our office is using them for almost every situation and we will inform you if there is a reason that we must use silver amalgam.

  2) About X-Rays
X-rays are an essential diagnostic tool that we use to detect the presence of dental disease at an early, treatable stage. With the development of high speed film, lead aprons with collars and lead-lined collimator cylinders, the levels of radiation delivered to the patient have been significantly decreased from even 15 years ago. Even so, because the incidence of decay today is reduced, we no longer take updated x-rays as often as we used to. At the initial examination, we first do a complete comprehensive examination. If there is gum disease, missing teeth, or any other dental problems, we will need a full mouth series of x-rays. Sometimes, a full set of x-rays will be available from a previous dentist. As long as it is current, it would be very helpful for us to use it. If there are impacted wisdom teeth, we may also need a panorex. For patients on our regular recall system, we will usually take a set of four cavity checking x-rays anywhere from one to two years apart, depending on how prone they are to gum disease and tooth decay. Please inform us if you are PREGNANT or have had a lot of radiation recently. We will usually delay taking x-rays in these cases. By following the above guidelines, you will never receive excessive doses of dental radiation in our office. Finally, all our x-ray equipment is checked for exposure levels annually. Each of our machines has met the required standards with above average results and displays the appropriate, government-approved stickers.

  3) Do Root Canals Hurt?
The answer is an emphatic no, even though more horror stories are heard about this procedure than anything else. In fact, in most cases, the tooth neither hurts before, during, nor after the appointment. The main problem arises with an acute abscess or acute pulpitis where there is severe pain to begin with. In these cases, the pain is from the problem tooth which is sometimes hard to freeze, not the procedure, and even here, the pain is almost always relieved by a practitioner who does the procedure well. We have a lot of expertise in this area.

  4) When Do I Need A Crown? A crown is a cap that fits over a tooth. The tooth is first made smaller so that the cemented crown will restore it to its original shape and size. For this to last, the remaining core of the tooth must be cleaned out of old fillings and decay so that it is certain it will not break down underneath the crown after cementation. Then the crown, which surrounds the core tooth from all sides, can serve to support and strengthen the tooth and restore it to proper function. There are many reasons why crowns are needed. The most common ones are:

    A) A back tooth that has had a root canal, or a front tooth in the same situation where a lot of it is missing.
    B) Any tooth that is already restored with less than a quarter of its tooth structure remaining.
    C) Any heavily restored tooth that has sustained an additional fracture.
    D) A bicuspid or molar that has a confirmed vertical fracture threatening to split it.
Crowns can be made of gold, porcelain or a combination of porcelain bonded to gold. The last type is the most common.

  5) What Is A Bridge?
A bridge is simply two or more crowns connected in one piece by at least one false tooth in between. The two crowns anchor the bridge permanently to the teeth, while the false crowns in between serve to replace the missing teeth. Whenever teeth are lost, a bridge should be placed if the remaining teeth are healthy. Leaving gaps results in adjacent teeth collapsing into the space and opposing teeth overerupting. The result is a disastrous alteration in the bite leading to stress on the teeth, jaw muscles and joints. Placing a bridge in timely fashion will prevent these problems.

 6) What are Sealants? The permanent teeth often develop with deep pits and fissures on the chewing surfaces. These teeth are very prone to developing cavities, because many times these deep fissures remain unfused and are inaccessible to the tooth brush. We recommend that these pits and fissures be sealed as a proven preventive measure to reduce decay. This is done by bonding a thin acrylic coating to the fissured surface, just like polyurethane seals hardwood floors. The sealants of course need to be checked regularly, and occasionally may need repair if worn, but generally have proven their worth in preventing decay.

  7) When Should Wisdom Teeth Be Removed?
Wisdom teeth are often impacted or stuck in the jaws because of insufficient room for them to erupt. Usually, they will have partially erupted through the bone but not the soft tissue, or sometimes their cusp tips may be showing through the gum. We recommend that in these situations, the wisdom teeth usually be extracted to prevent possible serious problems. If left alone, increased crowding, especially in the lower jaw, may occur in the late teens and early twenties. Also, bouts of pericoronitis, or infection and inflammation of the tissue covering the wisdom teeth, may crop up on an intermittent basis. Sometimes, the second molars in front may be severely damaged from improperly positioned wisdom teeth. We have also found in a few cases, large cysts in the jaws surrounding them. Finally, there is potential of tumors arising from retained wisdom teeth. Each situation would have to be assessed individually, but for those who have impacted wisdom teeth remaining, we recommend at the least that a panorex x-ray be taken to assess their condition and that it be repeated once every three years.

Dr. Paul Jesin©

5 Park Home Ave., Suite 130
Willowdale, Ont. M2N 6L4
Telephone: (416) 221-6333