Amalgam Fillings

Dental amalgam is a blend of metals such as silver, copper and tin. Mercury binds these metals together, providing a strong, hard, durable 'silver' filling for your teeth. Dental amalgam is less expensive than other materials

Do amalgam fillings release mercury?

If you have amalgam fillings, mercury vapour may be released when you chew vigorously or grind your teeth. The amount of vapour released from fillings is extremely small. There is no valid scientific evidence that associates this tiny amount of mercury vapour with any health problems

Is the mercury in my amalgam fillings safe?

The mercury used in fillings is safe for most people. Authorities such as the British Dental Association, US Public Health Service, FDI World Dental Federation and World Health Organisation state that amalgam has been used for more than 150 years in millions of patients and no controlled studies have shown adverse health effects, except for rare cases of mercury allergy.

I've heard that people are cured from illness when amalgam fillings are removed - is this true?

Stories of overnight cures from serious diseases have never been supported by sound scientific evaluation. If you are concerned about your amalgam fillings your dentist will be happy to discuss the benefits and risks of replacing them.

What are the alternatives to amalgam fillings?

Composite fillings are tooth coloured and have been used for front fillings for many years.Modern composite filling materials are now available for back teeth.They generally don't wear as well as amalgam, but this should be weighed up against their excellent appearance and any concerns you may have about mercury release. Composites are effective if the cavities are not very wide, and only involve one or two surfaces of the tooth. Gold or porcelain inlays, overlays and crowns are very effective for treating very broken down teeth due to their strength and long - term durability. They are more expensive than other materials but generally last a decade or more. To find out which treatment is best for you, and the costs involved, talk to your dentist.

Bridges

A bridge is an artificial tooth supported by the teeth on either side of the space. Your dentist shapes the teeth on either side of the gap, and takes a mould which is sent to a dental technician. The dental technician to make the bridge. In the meantime you have some plastic tooth-like temporary covers on the teeth. The dental technician makes the complete structure, using porcelain (for appearance) and a metal core (for strength). Your dentist then removes the temporary covers and checks the fit and bite then cements the bridge onto the teeth. Bonded bridges that do not require shaping of the neighbouring teeth are sometimes used. These have advantages and disadvantages which you and your dentist can discuss. Stronger materials are sometimes necessary for bridges used in back teeth. Your dentist may use an all-metal, gold bridge for this. A bridge is a long term, very attractive way of helping you fill the gap.

Crowns

Crowns for front teeth are natural looking porcelain caps, which fit over teeth that have been specially shaped by your dentist. They are usually made of porcelain, and may have a gold or metal core for added strength.

Why have front teeth crowned?Teeth with large fillings (and/or root fillings) are weakened, and can break when you bite. A crown can protect these teeth against further damage. Crowns are also the best choice for teeth that are very misshapen or darkly stained. Well made crowns will enhance your smile and enable you to chew and speak with confidence.

How are crowns fitted?

Your dentist reduces the size of the existing filling and tooth to make room for the new crown, and takes a mould which is sent to a dental technician. While the technician makes your permanent crown, your dentist will fit a temporary crown to cover your tooth. Once your permanent crown is ready, your dentist will try it in your mouth to check the fit and appearance before cementing it in place.

Dental Implants

Dental implants are used to replace a missing tooth or teeth. An implant is like an artificial tooth root, and is placed into the jawbone where a tooth has been lost. One or more implants can be used, depending on how many teeth have been lost and the size of the space.

After a time of healing (usually a few months) an artificial tooth is attached to the implant. This can be an excellent way of replacing a missing tooth or teeth, because other teeth are not involved in the treatment. Implants can also be used to make dentures more stable and stay in the mouth better so that they behave more little natural teeth. Treatment takes between six to twelve months to complete.
Not everyone has the right jaw structure for implants, and you will need to be checked by your dentist to see if this is the right option for you.

How much do implants cost?

Because of the variety of options available there are also considerable variations in price. Your dentist will be happy to discuss the options with you. Although they are expensive ($4-5,000) there are now hundreds of thousands of implants that have been in place for 25 years, and techniques are improving all the time to increase the lifespan.

Dentures

There are several types of partial dentures suitable as a short or medium term tooth replacement. The plastic partial denture fits on the gum and sometimes has wire clasps to hold it in place. The metal precision partial denture fits exactly with clasps and rests on existing teeth. Both types of denture are removable and you take them out to clean.Full dentures are the traditional replacement when all teeth in the jaw have been lost. These are held in by muscle function and sunction onto the gum but are often unstable and loose. As mentioned above, dental implant and supported dentures are available now.

Fissure Sealants

Fissure sealants are a protective plastic coating, which your dentist applies to the chewing surfaces and sides of teeth at risk of decay. The chewing surfaces of back teeth have small grooves or fissures, which often extend right down into the tooth itself. However well the teeth are brushed, these fissures are very difficult to clean thoroughly. Bacteria and food particles stick in them and eventually cause decay. Even fluoride in drinking water or toothpaste, which helps protect the smooth sides of the teeth, can't fully protect these high - risk areas against decay. Fissure sealants completely seal off these grooves, preventing any food particles or bacteria from getting in, and avoid having any of the tooth removed and a filling placed.

How is the treatment done?

First the fissure is checked for decay. Then the process simply involves cleaning the tooth surface, preparing it with a special solution, applying the coating and setting it in place with a curing light. The new smooth surface is now easy to keep clean and healthy with a toothbrush. Fissure sealants do not affect the normal chewing function of teeth.

Will it hurt?

No injections or drilling are needed, and the entire process is pain free. When should it be done? It's best to get the permanent back molar teeth sealed as soon as they start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear, which can be any time between 11 and 14 years of age.

Do the teeth need special care afterwards?

No special care is needed, but the back teeth still need to be brushed regularly with a good toothbrush, preferably using fluoride toothpaste. It's also important to keep going to your dentist for regular check-ups because other teeth might need attention.

Gum Disease

Gum or periodontal disease affects the gums and supporting structures of the teeth. Gingivitis is an early stage of periodontal disease, where the gums may become red, swollen and bleed easily. It may begin in early childhood and increases in prevalence and severity in the early teenage years. In New Zealand, approximately 80% of those over the age of 15 have this disease. Gingivitis is usually painless and easily treated in dental practice along with changes in your home care. If not treated gingivitis can advance to the next stage of periodontal disease which is difficult to treat. As the bone and tissues surrounding the teeth become damaged by this disease, periodontitis, a gum pocket forms around the tooth. This pocket becomes infected, which permanently destroys more bone and tissue. Eventually, the tooth becomes loose and falls out or needs to be extracted.

Periodontal disease is a bacterial infection caused by bacteria present in plaque ( the flurry film of debris, which clings to the teeth). If not removed carefully each day by brushing and flossing, plaque hardens into a rough, porous substance called calculus (also known as tartar). Toxins, produced by bacteria in plaque, irritate the gums. Left in place, the toxins cause the gums to pull away from the teeth and periodontal pockets are formed which fill with more toxins and bacteria. As the disease progresses, pockets extend deeper and the plaque moves farther and farther down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.

Warning Signs

  • Red, swollen or tender gums
  • Bleeding while brushing or flossing
  • Gums that pull away from the teeth
  • Loose or separating teeth
  • Pus between the gum and a tooth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures.

    Sometimes gum disease can progress without any symptoms or pain.

    Diagnosis and Prevention

    Proper brushing twice a day and flossing daily will help prevent periodontal disease. During a regular dental examination, the dentist or hygienist will inspect the gums and probe between the tooth and gum to check for periodontal disease so undetected disease can be treated before it can advance. A professional cleaning every three to six months by a dentist or dental hygienist will remove plaque and calculus from hard-to-reach areas that might otherwise be susceptible to periodontal disease. If signs of disease have progressed to a certain point, the dentist may suggest the patient see a periodontist, a dentist who specialises in the treatment of periodontal disease.

Missing Tooth

A missing tooth or teeth can spoil your smile, and make eating and speaking difficult. Teeth on eiher side of the space and the tooth that used to bite on the missing toothcan move resulting in tipping teeth and the creation of spaces that are difficult to clean. This may lead to decay or gum problems. Today there are many options available to help you fill the gap.

Root Canals

Inside a tooth is a fine space called the root canal. This contains the dental pulp, which consists of nerves and blood vessels. If the dental pulp becomes diseased,infected or dies, a toothache or an abscess may occur. In the past these problem teeth were extracted but now your dentist can offer you root canal treatment to care for these teeth.

Is root canal treatment painful?

Local anaesthetic and modern painkillers are used to provide comfortable treatment. Usually painful symptoms improve once treatment is started.During treatment a rubber dam ( a protective thin film of flexible sheeting) is used tp prevent saliva and other contaminants getting inside the tooth as the root canal is being cleaned and shaped.

How is a tooth restored following root canal treatment?

It is very important that any restoration adequately seals the root filling from infection by bacteria from the mouth. Teeth requiring root canal treatment often have large fillings or extensive damage and they are brittle due to the loss of blood supply. After a period of time to ensure the root canal treatment is sucessful it is wise to protect the remaining weak tooth with a crown.

How successful is root canal treatment?

There may be up to 4 root canals in a tooth. If all the root canals are able to be fully cleaned and sealed and the tooth properly restored then treatment has a very high success rate. The treatment may take several visits to complete with temporary fillings and dressings placed in the tooth between visits. Antibiotics are sometimes prescribed when an infection is present.

What complications can occur during root canal treatment

Because the root canals are very fine and curved in some teeth it may be difficult to find and clean all the canals completely so the infection returns. Occasionally a piece of a file may break off in the root canal due to the strain placed on these fine instruments. if the segment is not retrievable it may be sealed in the root canal as part of the filling. Pain or discomfort may occur between appointments due to ongoing tenderness of the tissues around the tooth or a flare up of an abscess, or a hairline crack in the root, which is extremely difficult to detect. An abscess or ongoing pain will rarely persist following root canal treatment. If this occurs the tooth will require some further treatment, usually by a specialist called an endodontist. Occasionally a surgical procedure may be required if discomfort persists.

Sensitive Teeth

People whose teeth are sensitive feel pain when they eat or drink things which are very cold ( most usually), hot or sweet and when brushing. The classic example is eating ice cream, but simply being out in the cold weather breathing on a frosty morning can be enough to set off the probloem.

Sensitive teeth are a common complaint, mainly in the winter. Studies show that one in four people suffer from sensitive teeth, however, this is greater in the 25-45 age group and in women. People most likely to suffer from this marginal tooth sensitivity are those who over- enthusiastically brush their teeth, consume more than usual amounts of wine or citrus drinks, have had treatment for gum disease or who have special medical problems - like bulimia.

Typically pain from sensitivity is sudden, sharp, and stabbing but subsides very quickly. If left untreated, the pain of sensitivity can lead to poor oral hygiene - it can become quite painful for the sufferer to brush their teeth so they stop doing a thorough job, which only makes the sensitivity problem worse. The problem usually has a simple cause but it can be complicated to treat. It most commomly occurs on the part of the tooth where it joins the gum. The enamel thins out and finishes in this area, so the sensitive part of the tooth (dentine) is exposed. Normally the gum covers the dentine, but with gum recession and abrasion or erosion the senstivity occurs.

The tooth can be treated with solutions that block the thousands of microscopic tubes in the dentine that conduct the stimulus to the nerve inside the tooth. Concentrated fluoride gels and high concentration fluoride toothpastes are also usefuland the dentist may recommend desentsitising toothpaste that contains the active ingredients to block the tubules. This treatment may take 4-6 weeks to completely eliminate the problem.

Dentists also advise people to use the right type of toothbrush, especially as a lot of teeth sensitivity comes from over- brushing with a hard brush. Soft brushes are recommended. If you are experiencing continued problems with tooth sensitivity, it is probably a good idea to visit your dentist. No one needs to suffer from this problem when there is often a simple solution

Teenage Dental Treatment

In 2001, the Ministry of Health introduced a new contract for dentists providing dental care for teenagers up to the age of 18 years. Dentists could choose to work under the new contract (the Adolescent Oral Health Service Agreement), or remain working under the old regime. The Ministry of Health website, nzhis.govt.nz provides further information about the new system for adolescent care.

The services provided under each scheme are similar, however dentists working under the new contract can provide some additional treatments at no cost. Details of the no charge treatments available, are given on the web site of the New Zealand Dental Association www.nzda.org.nz

Contact Info

Auckland Dental Association

Manager: Margie Ecroyd
ADA Head Office
1/195 Main Highway
Ellerslie
Auckland
P.O. Box 28-084
Remuera
Auckland 1541
Phone: 09 580 0081
Fax: 09 580 0010
Email: admin@ada.co.nz
Contact Us
Auckland Dental Association 1/195 Main Highway, Ellerslie, Auckland. Phone: 09 580 0081 Email: admin@ada.co.nz