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Dental Fillings

White Fillings in Children

I have a question about white fillings. My son needs his first filling. I am really uncomfortable with the silver fillings because of the mercury in them. I asked my dentist about getting him a white filling but he said they don’t work well in children. Why is that? Will the silver ones be dangerous for him?

Mallory

Dear Mallory,

Let’s start with your last question first. Are the silver fillings dangerous? The American Dental Association still says that silver amalgam fillings are safe. Understandably, though, many patients and parents are uncomfortable with the high mercury content.

While composite (white) fillings are a tad trickier with children, that doesn’t mean they are not able to have white fillings. The struggle is because the composite material has to stay completely dry while it is being placed. That can be tricky for wiggly little ones.

If having a composite filling is important to you, I have found that using some nitrous oxide allows the children to completely relax if their nerves are making them figity. Most of the time they end up sleeping through the procedure.

That being said, I wouldn’t push your current dentist into this. The technique for placing composite fillings is completely different from placing amalgam fillings. I have often found that dentists who try to steer you to a different procedure are actually doing that to keep from admitting they can’t do the one you want. If you pressure him into the other procedure, he will likely not do it correctly.

I suggest that you look for a dentist who advertises as a mercury-free dentist and then see if they are also a pediatric dentist. They don’t have to be a pediatric specialist. Instead, they can be a general dentist who enjoys treating children. They are qualified and do a pediatric rotation so your children will be in good hands.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry, Uncategorized

Two Sets of Teeth in Youth

I have two sets of teeth for some of my teeth. I mean that I have both the baby teeth and the adult teeth in my mouth at the same time. How do I fix this? I’m 16 and want a pretty smile before I leave for college.

Kaycie

Dear Kaycie,

teenager smiling with braces

If you have been under the care of a dentist this whole time, you need a new dentist. This should have been addressed a long time ago. You don’t have to see a pediatric dentist. It can also be a general dentist, especially at your age. Though, I would look for a general dentist who also treats children. They tend to be more patient.

To get your mouth in proper alignment, the first thing you will need to do is have every baby tooth that has an adult tooth erupted also extracted. Make sure whoever you end up with does a full set of x-rays so you are sure which teeth have the adult teeth.

From there you have three possible scenarios.

Scenario 1: All Your Adult Teeth Have Erupted

In this situation, you have all of your adult teeth and they have all erupted. If that is the case, the solution is fairly simple and can be done in two steps. Step one is for you to have your baby teeth extracted.

Once that is completed, step two is to have your teeth straightened with orthodontics. You are not limited to metal wires and brackets and more. These days, Invisalign can handle most cases. If you’re unfamiliar with Invisalign, they use clear aligners to straighten your teeth.

Scenario 2: Not All Your Adult Teeth Have Erupted

If you have the adult teeth, but they still haven’t erupted, your dentist can open the area to make it a bit easier. In most cases, they’ll come in after that.

Then, once they are in, you can then get orthodontics done as suggested in the previous scenario.

Scenario 3: You Don’t Have All Your Adult Teeth

In some cases, a patient will have genetically missing teeth. That means there never was an adult tooth to replace the baby one. When this happens, you will still need orthodontics to open up the space where all the teeth are in their proper positions. Once that happens, you will start with a temporary tooth replacement, such as a dental flipper, in order to keep the opening in the right place.

When you are older and your jaw is fully developed, it will be time to get a more permanent replacement. The ideal tooth replacement is a dental implant, so that is what I’d recommend. Though, your dentist can give you all the options.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Affordable Dentist

Can’t Afford Next Treatment

I had a Maryland Bridge, but ended up being allergic to part of it. I can’t use that anymore and my dentist is inisisting my only option now is a dental implant. I priced that originally and couldn’t afford it. Surely there is another option, but my dentist is insisting this is it.

Carol.

Dear Carol,

A dollar sign hatching out of an egg

I’m sorry that you have had such a hard time with this tooth replacement. It is unfair of your dentist to insist on the most expensive treatment. While everyone wants the best option, sometimes our budget precludes that. What disappoints me is your dentist is ethically bound to at least make you aware of all your options, even if he won’t do them.

You will have more success with a dentist that understands budgetary limitations. If your dentist doesn’t look for someone who advertises as an affordable dentist. They’ll be more willing to offer you the options that work for your pocketbook. Most are even willing to accept payment plans.

Affordable Options to a Dental Implant

The first thing I would suggest to you is a zirconia or porcelain bridge. This is a false tooth suspended between two dental crowns. These are metal-free and won’t give you the same allergy issues that you faced with your last treatment.

If that doesn’t work for you financially, there are allso removable partial dentures. You’ll just need to make certain your dentist knows you will want metal free clasps.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Dental Fillings

Do Amalgam Fillings Stain Teeth?

I have two amalgam fillings that cover about 70% of my tooth. I want to remove them and replace them with composite fillings. He said the amalgam stains teeth and they won’t look nearly as good. Is that true? Should I leave the amalgam fillings on?

Meredith

Dear Meredith,

While there is some staining of teeth with amalgam fillings, they will always look better with composite fillings. Always. In addition, while amalgam fillings simply rest on the tooth, composite fillings are bonded directly to the tooth which strengthens the tooth and puts it at less of a risk for fracture.

I suspect your dentist said that to disuade you from switching. This is likely because he is uncomfortable placing composite fillings. They are placed with a completely different technique than he or she is used to placing the old amalgam fillings.

I don’t recommend you push him into doing it though. There are horror stories of patients who ended up needing a root canal treatment after a dentist placed them incorrectly. Even if it isn’t that bad, you could end up with other issues.

If you want this done right, I suggest going to a dentist who is familiar with placing them. You can do an internet search using the term mercury-free dentist. These dentists only place composite fillings and have the technique down pat.

I have one other concern I’d like to address. You mentioned your current fillings cover 70% of your tooth. In that case, your dentist really should have done a dental crown to adequately protect your tooth. This additional information puts me more in doubt of his abilities. You may want to start looking for another dentist, who can better meet your needs.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Affordable Dentist

I think I was conned by an “affordable dentist”

I needed a couple of teeth replaced. The quote my dentist gave me for implants was higher than I could afford, especially because he said I’d need some bone grafting done first.  I called around to several dentists and they all said the same thing.  I was about to give up and settle on a removable partial denture, which was heart-rending for me.  Right before I scheduled the procedure, a friend recommended her dentist who didn’t require bone grafting.  I talked with him and he said he could do the procedure without the grafting and at half the price the other dentists quoted. I was so excited!!  Now, here I am many thousands of dollars later and both my implants have fallen out!! The whole thing, right out of my mouth.  Was I taken in? Are there no affordable dental implants and he was just trying to get my money?

Bella B. – Cincinnati

Bella,

The problem isn’t looking for an affordable dentist. There are affordable dentists out there who do great, quality work. Then, there are those who do just about anything to draw in business, yet keep their profits up. Those aren’t affordable dentists as much as cheap. 

 It sounds to me like the one you chose, said what you wanted to hear in order to get your business.  Mind you, I say that without having examined you, which may be unfair.

However, if both implants just fell out of your mouth, that hints to me one of two things.  1. You DID need bone grafting surgery.  Your teeth are held in your jaw by the bone that surrounds the root.  Without enough jawbone, your implant procedure was doomed to fail. 2. If you did have enough jawbone to begin with, then it is likely your dentist didn’t leave enough time for osseointegration (Time for the bone to form around your implant).

If I were in your place, I would go to a skilled implant dentist and have them look at your case.  They can likely tell you what is going on.  If your dentist was negligent, you may be able to get some money back in order to have the procedure done correctly.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Affordable Dentist

One Dentist is $500 Less

I need a dental crown so I started calling around. I’ve called three dentists. One of them is significantly less than the others, by like $500! It seems like a great deal but I’m wondering how he can be so much less. Are the other two just hiking their price up?

Fran

Dear Fran,

We all want a good deal, don’t we? The thing to be aware of is there is a difference between affordable dentistry and cheap dentistry. You didn’t mention the two different prices, just that they were $500 apart. Let’s say for argument’s sake the less expensive dentist is $400 for a dental crown but the other dentists you called are $900.

You asked a great question earlier about how he could afford to charge so much less for their dental crowns. Usually, when one dentist is significantly less expensive than other dentists in the area there are usually one of three reasons:

They are a Brand New Practice

Maybe this dentist is fresh out of dental school and he needs experience. He lowers his prices to barely above cost to draw in patients. We all start somewhere and if you are willing to give the new guy a chance with the hope of saving money, then go for it.

They Have Trouble Keeping Patients

Like in every field, you will have some dentists who are terrible at their job. Maybe they barely passed dental school and don’t apply themselves to improving. Maybe they have a terrible chairside manner and patients just don’t enjoy being around them.

When you keep losing patients, you have to find ways to constantly draw in new ones. You can certainly do that by having your prices several hundred dollars less than everybody else.

If they’re not a new dentist, I would certainly check their reviews to see what type of experience other patients have had with them.

They Use Cheap Materials

It is hard for a dentist to pay for their overhead if their prices are barely above cost. Do make up profits, some dentists will purchase cheaper materials in order to make money. The one who suffers in those cases are the patients.

Is It Really Cheaper?

Let’s say you go with one of the last two dentists to save money. You get a dental crown for $400. It seems like a good deal, but only lasts you three years before you have to replace it. You get another one for $400, plus the cost of time off work. It only lasts you another three years. Again, $400. You’ve now paid $1200 and lost work three times.

Compare that will a dentist who initially charges $900 but his crowns last you $15 years. In this case, you have actually saved $600 by originally going to the dentist who costs more.

I’m not saying you have to go with a more expensive dentist to get quality. I am just saying do your homework on the dentist to make sure you are getting affordable and not cheap.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Dental Flipper for a Toddler

My son, who is 3 years old fell and lost his two front teeth as a result. I spoke with my pediatric dentist about getting him a dental flipper and he refused. I looked online for the do it yourself kind, but they only make those for adults. What would you recommend for me to get him a flipper? I am worried about his teeth shifting.

Morgan

Dear Morgan,

young boy smiling with toothbrush

I wish your pediatric dentist would have explained things rather than just refuse. Parents are always better off knowing the reasoning behind the recommendations and decisions their child’s caregiver is putting forth.

Reasons Children Can’t Have a Dental Flipper

You noticed that there were only DIY flippers for adults. That is because it is dangerous for children to use a Dental Flipper.

First, they are removable. Just as we are careful with the size of toys we let our children play with, we try to do the same thing with any type of removable device. Otherwise, it is a choking hazard.

Second, they are removable. No, I didn’t make a mistake typing that twice. It is a rare toddler or even older child who will keep in an orthotic device. It is much more likely it will be removed and lost in a short period of time.

Third, they stay in by clasping onto other teeth. Your son’s jaws and teeth are in a constant state of growth right now. This means he will outgrow the flipper quickly and often.

The Really Good News

I know you are worried about your son’s teeth shifting which can lead to overcrowding of his adult teeth. That shows you pay attention to your son’s dental health. The good news is, with his front teeth that won’t be an issue.

When we talk about the importance of tooth retention in children, it is with their baby molars. This is because the adult molars don’t come in until the child is around 12-years-old. In that amount of time and given the placement, the teeth will shift.

If it ever happens that a child of yours does need to have a molar removed, getting a space maintainer will be important.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Uncategorized

Bleaching Non-Veneered TEeth

I just had four porcelain veneers placed and while I do like them, they are much whiter than my natural teeth. The difference is pretty obvious when I smile. I think I need to whiten my natural teeth but don’t know if that will damage my brand new veneers.

Cathey

Dear Cathey,

tooth bleaching trays

While any teeth whitening you do will not affect your porcelain veneers, I am a bit surprised your dentist didn’t have you do the whitening beforehand.

When you have porcelain veneers done, unless you have enough veneers to cover each tooth that is visible when you smile, which is almost always more than four teeth, it is standard operating procedure to whiten the teeth ahead of time.

One of the reasons we do the whitening first is because it is much easier to match porcelain veneers to teeth than it is to match your whitening to already established porcelain veneers.

This does give me some concern about your dentist’s knowledge of cosmetic work. One thing that will be especially important is when you go in for your next cleaning that they do not use anything like a power prophy jet or acidulated fluoride on your teeth.

This will completely remove the protective glazing from the veneers which will ruin them.

Best of luck and feel free to get your teeth whitened without the worry of damaging the veneers.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Dental implants

She’s PLaying with Fire with This Tooth Infection

I have an impacted wisdom tooth that is slightly infected. My ears hurt as a result. My dentist wants to take it out, which I’m fine with but I want him to take out that tooth and a tooth next to it that had a root canal treatment. He is refusing to take out the tooth with the root canal. I am likely going to wait until he changes his mind because I don’t want to go back and have the second procedure later, as I’m sure I will have to. I’d rather do them both at the same time. Is there any advice you can give me in the meantime?

Pamela

Dear Pamela,

I haven’t seen your x-rays, but I can’t imagine a dentist leaving an infected tooth in your mouth. He’d get to charge you for two extractions instead of one which could only bring him money. The only reason for him not to do that is because he has integrity. That is something to be thankful for.

My guess is nothing is wrong with the adjacent tooth so he doesn’t want to extract it unnecessarily.

Let’s say he did extract it, though. Unlike your wisdom tooth, the adjacent tooth would need to be replaced. Then, you are talking about needing to get a dental implant, something else your dentist could make money off of.

Don’t Wait on This Extraction

Unless there is something you haven’t mentioned to me, this tooth isn’t infected. If you continue to wait on the wisdom tooth extraction, you are putting yourself in danger.

Dental infections are considered dental emergencies because of their tendency to spread when left untreated. Think about how close your jaw is to your lungs, heart, and brain. You wouldn’t want an infection to end up there.

The fact that your ear is already hurting means it has started to spread. Please don’t put this off any longer.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Emergency Dentist

Antibiotics for a Tooth Infection

I’ve had a tooth infection and went to see a dentist. He prescribed me antibiotics that I’ve been taking antibiotics for 11 days. I was fine for a while, but now it seems to have started acting up again. Do I just need to refill the prescription or do I need another visit to the dentist?

Kevin

Dear Kevin,

A man holding his jaw in pain.

I’m hoping there was some miscommunication between you and your dentist. While the antibiotic is useful until the infection can be dealt with by a dentist, it does not eliminate the infection, as you have discovered. Once the antibiotic is completed, it doesn’t take long for the infection to rear its ugly head.

With a tooth infection, a dentist has to get in there and physically remove the infected pulp. This is typically done with either a root canal treatment or by extracting the whole tooth.

It is always better to save any tooth you can, so a root canal treatment would be the better choice if it is still possible.

If the Tooth Cannot be Saved

In the case that it has been too long and the tooth cannot be saved, it is important that you replace the tooth as quickly as possible. The longer that spot is left open, the more you will be dealing with the adjacent teeth shifting or tipping into that spot. This will throw off your bite leading to jaw pain, headaches, and even TMJ problems.

Ideally, you’ll want to have a dental implant for your replacement. It is the closest thing to having a natural tooth again. This will help you preserve the underlying bone. If that is not possible, there are other options such as a dental bridge or a removable partial denture.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.