DENTAL CARE

Jeffrey Gross, DDS, FAGD

The next statement revealed why she was sitting in my chair. She told me that she has pain on the left and right sides of her mouth whenever she chewed. She regretted that she ever did those procedures and wanted me to help. Before we get to her concerns, let’s talk a little bit about replacing silver fillings. We live in an age where cosmetics is king. I’m sure that there were other times in human history when this was also true. The difference today versus other times may be the media. We communicate not by writing or talking but with pictures. Take a picture and put it on the internet, and the whole world sees it. It is not hard to get caught up with the aesthetic craze. When it comes to dentistry, silver and gold fillings are out. On top of this, people talk about metal fillings causing all types of neurological problems. There is no hard data to back this up, and silver has stood the test of time.

Some dentists advocate replacing all types of silver with white fillings for some of those reasons. I am not an advocate of that approach. I believe in the dictum that if it’s not broken, then don’t fix it. There’s another reason not to take a tooth that has no symptoms and replace the silver filling. White fillings require a preparatory step to create a seal between the filling and the tooth. I place a particular solution on the tooth in preparation for the filling, and then it is coated with a sealer. Both the preparatory solution and the sealer may cause the tooth to become sensitive. The sensitivity is the downside of white fillings. I employ specific techniques to make the problem not occur. However, the problem is a real thing, and individual patients may experience it.

When the problem is related to one tooth, replacing the white filling and putting some calming material may alleviate the pain. For other teeth, it gets so bad that the only solution is a root canal procedure. My new patient complained about multiple teeth. I did not think that it was prudent to replace many fillings. Who’s to say that the problem would not repeat itself as I take a shotgun approach to her problem? All of this conversation occurred before I looked in her mouth.

We took some x-rays and sat down for a complete and thorough exam. I noticed evidence of hard brushing of the teeth. The patient wore away large sections of her teeth close to the gum. I touched these areas gently, and I duplicated her sensitivity. She did not have multiple fillings that were the cause of her pain. The exposed roots were the root of her problem (no pun intended.) I figured that I discovered the source of her discomfort and recommended an easy fix. Next, in my evaluation, I studied her x-rays. At the beginning of the appointment, she complained that the left side was more severe than the right. When she put food in her mouth, the pain radiated up to her temple. On her x-ray, I found a very significant cavity on an upper tooth. This tooth was the culprit. The decay is close to the nerve and the most likely cause of that level of pain.

I don’t know if she needed all of her silver filling removed and replaced. That procedure could cause problems when we do so many at one time. However, I don’t believe that all those fillings did cause the issues. A combination of root exposure from vigorous brushing and a large cavity resulted in a very unhappy patient. Not everything that we see or experience is what it appears at first. Often we need an objective view of the situation and digging down through the details to discover the underlying issue. If you have a stubborn issue that is causing you trouble, please call us at 440.951.7856. I look forward to helping you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine. The Healthy Smile 34586 Lakeshore Boulevard Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com