Composite resins, or tooth-colored fillings, provide good durability and resistance to fracture in small to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. They can be used on either front or back teeth. They are a good choice for people who prefer that their fillings look more natural.
Composites cost more than amalgam and occasionally are not covered by some insurance plans.
Dental amalgam is made from a combination of metals that include mercury, silver, tin, and copper. Sometimes described as “silver-colored” fillings, dental amalgam has been used by dentists for more than 100 years because it lasts a long time and is less expensive than other cavity-filling materials such as tooth-colored composites or gold fillings.
Because of their durability, these silver-colored fillings are often the best choice for large cavities or those that occur in the back teeth where a lot of force is needed to chew. Amalgam hardens quickly so it is useful in areas that are difficult to keep dry during placement, such as below the gum line. Because it takes less time to place than tooth-colored fillings, amalgam is also an effective material for children and special needs people who may have a difficult time staying still during treatment.
One disadvantage of amalgam is that these types of fillings are not natural looking, especially when the filling is near the front of the mouth, where it may show when you laugh or speak. Also, to prepare the tooth, the dentist may need to remove more tooth structure to place an amalgam filling than for other types of fillings.
Although dental amalgam is a safe, commonly used dental material, you may wonder about its mercury content. It’s important to know that when combined with the other metals, it forms a safe, stable material. Be assured that credible scientific studies affirm the safety of dental amalgam. Study after study shows amalgam is safe and effective for filling cavities. The American Dental Association, U.S. Centers for Disease Control and Prevention, U. S. Food and Drug Administration and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer’s Association, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society—all science-based organizations like the ADA—also say that amalgam poses no health risk.
If you are self-conscious because you have missing teeth, wear dentures that are uncomfortable or don't want to have good tooth structure removed to make a bridge, talk to your dentist to see if dental implants are an option for you.
Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years. Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth.
Most patients find that a dental implant is secure, stable and a good replacement for their own tooth. There are generally three phases to getting an implant.
First, the dentist surgically places the implant into the jawbone. Your dentist may recommend a diet of soft foods, cold foods and warm soup during the healing process.
Next, the bone around the implant heals in a process called osseointegration. What makes an implant so strong is that the bone actually grows around it and holds it in place. Osseointegration means “combines with the bone” and takes time. Some patients might need to wait until the implant is completely integrated, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.
Finally, it’s time for the placement of the artificial tooth/teeth. For a single tooth implant, your dentist will customize a new tooth for you, called a dental crown. The crown will be based on size, shape, color and fit, and will be designed to blend in with your other teeth. If you are replacing more than a single tooth, custom-made bridges or dentures will be made to fit your mouth and your implants. (Note: The replacement teeth usually take some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture to help you eat and speak normally until the permanent replacement is ready.)
If you are interested in dental implants, it's a good idea to discuss it carefully with your dentist first. If you are in good general health this treatment may be an option for you. In fact, your health is more of a factor than your age. You may be medically evaluated by a physician before any implant surgery is scheduled. Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing.
A crown is a cap that covers the whole tooth. It can be made of porcelain, gold, resin, or zirconium. Your dentist may recommend a specific material that will work best for your personal situation. A crown can help strengthen a tooth with a large filling when there isn’t enough tooth structure remaining to hold the filling. Crowns can also be used to attach bridges, protect a weak tooth from breaking or restore one that’s already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It’s also used to cover a dental implant.
Missing a tooth or teeth can be a daily embarrassment. It can also cause difficult in chewing or speaking. Bridges can help restore your smile.
Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth and literally “bridges” the gap where one or more teeth used to be. This is done by preparing the teeth immediately behind and in front of the open space for crowns. Then the lab creates the bridge which is a single prosthesis consisting of an anchor tooth on each side of the open space and a “dummy” tooth or teeth in between to span the gap. Bridges can be made from gold, alloys, porcelain or a combination of these materials and are attached to surrounding teeth for support. Unlike a partial or denture, which you can take out and clean, a bridge is cemented in place.
Dentures are removable appliances that can replace missing teeth and help restore your smile. If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. That’s because dentures make it easier to eat and speak better than you could without teeth—things that people often take for granted.
When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile.
Types of dentures:
Conventional. This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months.
Immediate. This removable denture is inserted on the same day that the remaining teeth are removed. Your dentist will take measurements and make models of your jaw during a preliminary visit. You don’t have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed.
Overdenture. Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Implants can serve the same function, too.
Screw Retained Denture. If someone without teeth chooses to have a few implants placed, the denture can actually screw into the implants. This would make the denture a fixed denture and only the dentist can unscrew and remove the denture. See the All-On-Four Dentures and Bridges section.
New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should go away. Follow-up appointments with the dentist are generally needed after a denture is inserted so the fit can be checked and adjusted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases. Depending on your needs, your dentist will design a partial denture for you. A partial denture may have a metal framework and clasps that connect to your teeth, or they can have other connectors that are more natural looking. In some cases, a removable partial denture is made to attach to your natural teeth with devices called precision attachments. Precision attachments are generally more esthetic than clasps.
Crowns on your natural teeth are sometimes needed to improve the fit of a removable partial denture and they are usually required with attachments. Partial dentures with precision attachments generally cost more than those with clasps. Consult with your dentist to find out which type is right for you.
What to expect:
In the beginning, your new partial denture may feel awkward or bulky. This is normal, and you will eventually become accustomed to wearing it.
Inserting and removing the partial denture will require some practice.
Follow all instructions given by your dentist. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps.
Your dentist will give you specific instruction about how long the denture should be worn and when it should be removed.
Initially, you may be asked to wear your partial denture all the time. Although this may be uncomfortable at first, it's the quickest way to identify areas that may need adjustment.
If the denture puts too much pressure on a particular area, that spot will become sore. Your dentist will adjust the partial denture to fit more comfortably. After making adjustments, your dentist will probably recommend that you take the partial denture out of your mouth before going to bed and replace it in the morning.
Eating should become a more pleasant experience with dentures. Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on both sides. Avoid foods that are extremely sticky or hard. You may want to avoid chewing gum during the adjustment period.
Partial denture can also help improve your speech. If you find it difficult to pronounce certain words, practice reading out loud. Repeat the words that give you trouble. With time, you will become accustomed to speaking properly with your partial denture.
Even though they are temporary, your child's baby teeth are important, and are still susceptible to cavities. Tooth decay in infants and toddlers is often referred to as Baby Bottle Tooth Decay, or Early Childhood Caries. Children need strong, healthy teeth to chew their food, speak and have a good-looking smile. Their first teeth also help make sure their adult teeth come in correctly. It’s important to start infants off with good oral care to help protect their teeth for decades to come.
What causes Baby Bottle Tooth Decay?
Baby Bottle Tooth Decay most often occurs in the upper front teeth, but other teeth may also be affected.
There are many factors which can cause tooth decay. One common cause is the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.
Tooth decay is a disease that can begin with cavity-causing bacteria being passed from the mother (or primary caregiver) to the infant. These bacteria are passed through the saliva. When the mother puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.
If your infant or toddler does not receive an adequate amount of fluoride, they may also have an increased risk for tooth decay. The good news is that decay is preventable.
Preventing Baby Bottle Tooth Decay
-Try not to share saliva with the baby through common use of feeding spoons or licking pacifiers. After each feeding, wipe your child’s gums with a clean, damp gauze pad or washcloth.
-When your child’s teeth come in, brush them gently with a child-size toothbrush and a smear (or grain of rice sized amount) of fluoride toothpaste until the age of 3.
-Brush the teeth with a pea-sized amount of fluoride toothpaste from the ages of 3 to 6.
-Supervise brushing until your child can be counted on to spit and not swallow toothpaste—usually not before he or she is 6 or 7.
-Place only formula, milk or breast milk in bottles. Avoid filling the bottle with liquids such as sugar water, juice or soft drinks.
-Infants should finish their bedtime and naptime bottles before going to bed.
-If your child uses a pacifier, provide one that is clean—don’t dip it in sugar or honey.
-Encourage your child to drink from a cup by his/her first birthday.
-Encourage healthy eating habits.
When your child’s first tooth appears, talk to your dentist about scheduling the first dental visit. Treat the first dental visit as you would a well-baby checkup with the child’s physician. Remember: starting early is the key to a lifetime of good dental health. For more information about nutrition and your baby, visit the Academy of Nutrition and Dietetics.
When your child’s teeth come in, brush them gently with a child-size toothbrush and a smear (or grain of rice sized amount) of fluoride toothpaste until the age of 3. Brush the teeth with a pea-sized amount of fluoride toothpaste from the ages of 3 to 6. Supervise brushing until your child can be counted on to spit and not swallow toothpaste—usually not before he or she is 6 or 7. Your child should also see the dentist twice a year.
The ADA recommends taking your child to the dentist within 6 months of eruption of their first tooth.
Fluoride is a mineral that helps fight tooth decay. It is found in public water supplies, toothpaste and many other dental products.
Often called, “nature’s cavity fighter,” fluoride helps repair the early stages of tooth decay even before the decay can be seen. Research shows that fluoride helps prevent cavities in children and adults by making teeth more resistant to the acid attacks that cause cavities. When you brush your teeth with fluoride toothpaste, or use other fluoride dental products, you are preventing cavities and strengthening your teeth’s enamel.
Your dentist may apply fluoride varnish or fluoride gel during your dental visit. Your dentist might also tell you to use a special fluoride rinse, paste or gel at home.
The American Dental Association recommends that children and adults use fluoride toothpaste displaying the ADA Seal of Acceptance. For children younger than 3 years, caregivers should begin brushing their children’s teeth as soon as they start to appear in the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. You should be brushing your children’s teeth thoroughly twice a day (morning and night) or as directed by your dentist or physician. For children 3 to 6 years of age, caregivers should dispense no more than a pea-sized amount of fluoride toothpaste and brush teeth thoroughly twice per day. Always supervise your child’s brushing to ensure that they use the appropriate amount of toothpaste and try and get your child to spit out most of the toothpaste.
The American Dental Association recommends your child see the dentist twice a year.
Thumb sucking is a natural reflex for children. Sucking on thumbs, fingers, pacifiers or other objects may make babies feel secure and happy and help them learn about their world. Young children may also suck to soothe themselves and help them fall asleep.
However, after the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. Pacifiers can affect the teeth essentially the same ways as sucking fingers and thumbs, but it is often an easier habit to break. The intensity of the sucking is a factor that determines whether or not dental problems may result. If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumb suckers may develop problems with their baby (primary) teeth.
Children usually stop sucking between the ages of two and four years old, or by the time the permanent front teeth are ready to erupt. If you notice changes in your child’s primary teeth, or are concerned about your child’s thumb sucking consult your dentist.
Tips for helping your child stop thumb sucking:
Praise your child for not sucking.
Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.
For an older child, involve him or her in choosing the method of stopping.
Your dentist can offer encouragement to your child and explain what could happen to their teeth if they do not stop sucking.
If the above tips don’t work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.
Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food.
Sealants are a thin, plastic coating that is 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 groves of the teeth, forming a protective shield over the enamel of each tooth. No anesthetic or numbing is needed when sealants are placed.
Typically, children are candidates for sealants on their permanent molars and premolars as soon as these teeth come in depending on how deep the grooves are in these teeth. In this way, the dental sealants can protect the teeth through the cavity-prone years of ages 6 to 14.
However, adults without decay or fillings in their molars can also benefit from sealants.
Sealants can protect the teeth from decay for many years, but they need to be checked for chipping or wear at regular dental check-ups.