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Out With The Old, Fill With The New?

March 1, 2016

I often am asked if older silver fillings should be replaced with newer white fillings. Sometimes the concern is cosmetic and other times it is regarding health. The health issue revolves around whether the mercury in silver fillings is a risk. Our office no longer places silver fillings, and hasn’t for years. There was a time in the past where silver fillings significantly outlasted white fillings. We don’t believe that is the case anymore, so we have eliminated mercury entirely from our practice. The question remains when to replace them if a patient already has them. The answer is yes to replace for the following reasons: If you have a known allergy or sensitivity to any of the components of silver fillings, if they are breaking down or have a cavity starting underneath them or if they are presenting a cosmetic issue. If they are holding up and not causing any issues, in general, we tend to watch them until one of the other criteria arises. If it ain’t broke, don’t fix it. Of course, if you are concerned about the mercury content and want them removed, we would be happy to discuss the pros and cons of their removal and help you make an educated decision as well as discuss methods of reducing ingestion if we do decide to take them out. Dr. Jay Rabinovich

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February 15, 2016

One of my earliest childhood memories is that of my father talking to me about an extraction he just had done at the dentist. I remember he complained for long after that the pain he had in the area did not get better from the treatment. It turned out that all he really needed was a night guard to control his clenching habit. I have a feeling he was not the only patient of his generation to be misdiagnosed. Clenching and/or grinding must always be considered if there is no obvious other cause for what the patient is experiencing. There may be nothing wrong with the tooth itself, but the nerves that surround tooth are being compressed by the habit. This could potentially lead to temperature sensitivity and/or discomfort to chewing, among other symptoms. Stop compressing the tooth in it’s socket and the issues resolve themselves. That’s what night guards are designed to do (not to mention protecting your jaw joints, potentially relieve morning headaches, etc., which I will touch on another time). Clenching or grinding might not be the reason for your problem(s), but it must be considered part of the thought process. Dr. Jay Rabinovich

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February 1, 2016

Why do some people get cavities and others do not? There are many factors involved, but the three main ones are genetics, oral hygiene and of course, sugar consumption. A lot of people don’t understand that it’s not just about how much sugar (whether it’s refined like in candy or pop or natural like in fruits) you consume but also how you consume it. By that I mean, it is much better to eat a package of candy in one quick sitting as opposed to having a little all day long. To understand why, you need to understand why a cavity forms in the first place. The sugar you eat is also consumed by the bacteria in your mouth. When they do so, they produce acid as a byproduct, which in turn increases the acidity of your mouth. You’ll only get a cavity if the acidity in your mouth stays high for a critical amount of time. If you eat all your sweets quickly, you give your mouth a chance to buffer the acid. If you have a small amount of sugar all day long, your mouth never gets a chance to recover, the acidity stays high for that critical amount of time, and a cavity may form. Dr. Jay Rabinovich

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January 28, 2016

Can you brush your teeth too much? I get this question all the time. I don’t think you can brush or floss too much, but you can definitely do yourself harm if you brush or floss INCORRECTLY too much.  The main thing you want to avoid is creating recession by being too aggressive. We will all get ‘long in the tooth’ over time, but scrubbing the sides of your teeth will cause your gumline to recede quicker than mother nature intended. So you must brush properly. Scrub the biting surfaces of your teeth all you want. They are covered in enamel and you will do no harm. But on the sides, brush away from the gumline only as if you’re trying to bring the gum tissue up towards the biting surface. As far as floss is concerned, gently saw the floss through the contact, slide the floss between the gum and tooth (there are two teeth to clean at each spot), and gently wipe the soft plaque off the tooth surface. You can’t be too clean, but you can be too aggressive. Dr. Jay Rabinovich

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January 7, 2016
On occasion I am asked why x rays are necessary if “I’m not feeling any problems”. The answer is simple. While often times sensitivity (such as that to sweet, temperature changes or chewing) can present itself, just as often one can have a problem with absolutely no signs or symptoms. For example, a small cavity can create sweet sensitivity for one individual while a large cavity or even an abscessed tooth can cause no issues for someone else. I also like to tell people that when you start to know you have a problem, chances are it’s already a big problem. Best to catch things small and create less necessary dental work. Of course, x rays can also catch non-tooth issues such as cysts and tumours that may be growing quietly in the bone. Finally, how often we should take routine x rays really is a decision we make on a case by case basis. It’s always best to minimize  exposure and weigh the risks and benefits.

  Dr. Jay Rabinovich

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