Why do I need a crown when I?m only replacing a filling?

Once you get a cavity you will be “maintaining” that tooth for life. Similar to a car getting bald tires, over time, fillings break down and need to be replaced. Fillings need to be replaced for a number of reasons. These reasons could include things such as cavities, broken teeth, open margins, or cracks in the tooth.

Once a tooth gets a filling, that tooth can get another cavity. Some people think they can’t get another cavity in a tooth once it’s been filled. Unfortunately, this is not true. It’s important to keep your teeth clean and visit your dentist regularly so you can catch cavities early, before they cause you pain. Pain in a tooth is bad; it means the nerve is inflamed and you may need a root canal.

When you see your dentist, they will check your teeth for cavities and also breakdown and wear of your fillings. Your fillings should seal your tooth 360 degree’s around the entire filling. If you get a gap between your tooth and filling, or an open margin, then bacteria can hide inside that gap and can form a cavity. If your dentist sees fillings that are breaking down, they will recommend replacing them so you can reseal the area and avoid from getting another cavity.

Your teeth are under constant pressure from the bite forces in your mouth. Some people’s bite forces are so strong that they can, over time, break their teeth. If your tooth is broken into the second layer of your tooth, or the dentin layer, you must restore the tooth to avoid from nerve exposure or getting a cavity.

Amalgam, or silver fillings, are constantly expanding. This expansion of the material pushes on the tooth and can cause cracks or splitting of the teeth. Like a crack in a car windshield, these cracks will continue to grow and can result in a tooth needing a root canal or extraction. To avoid this, you would need to have your filling replaced.

So why would replacing a filling require a crown? Your tooth is designed with area’s that are built to crush and grind your food. They withstand a lot of pressure and force with day to day wear. If this area of the tooth is compromised for any reason, then placing a filling would not be a wise decision. This is because the forces will break down the filling very fast and it would not be worth doing a filling. Your teeth need a certain amount of tooth structure to hold the filling and to stand up to the pressures your mouth exhibits onto the teeth. A crown will cover your tooth and protect it all the way around from such pressures so you have a long lasting, esthetic, comfortable restoration.

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Why do my white fillings hurt?

Post operative sensitivity is very common after getting white fillings placed, but why? A lot has to do with the chemistry and physics of the filling material itself. Composite resins, or white fillings, are made of a plastic material that will expand and contract with temperature changes. This expansion and contraction is felt within the tooth and results in sensitivity. Most commonly, the sensitivity is within the first couple of weeks after getting a white filling replaced. After a couple of weeks, the tooth will get used to this movement and the sensitivity will go away. There are occasions when a white filling is too large for a tooth and the filling will need to be replaced with a crown.

White fillings are the material of choice for most dentists. This is because white fillings are chemically bonded to the tooth structure, enabling the dentist to do a more conservative preparation of the tooth structure. White fillings are also advantageous because they are esthetic. Dentist’s can place a filling that will be the same shade as your tooth so you can smile with confidence and no one will know that you have a filling.

Amalgam, or silver fillings, are the old standard fillings. They are not as commonly used because of the poor esthetic quality, the mercury controversy surrounding the material, and the cracking of the teeth that results after years of wear. Amalgam fillings are held into the tooth by mechanical preparation. The dentist prepares the tooth so that the filling is held into the tooth with the walls of the preparation. Because of this mechanical preparation, the tooth preparation is not as conservative as a white filling. Amalgam fillings are strong materials and can be used for larger fillings that composite resin materials aren’t designed to withstand. Where are white fillings are expanding and contracting, amalgams are constantly expanding. This expansion will push on the walls of the filling preparation and will result in cracks and splitting of the teeth. Like a crack in a windshield, the crack will continue to grow. You want to have your silver fillings replaced when the cracking begins because the cracks could go into the nerve, resulting in a root canal, or could split the tooth below the bone level which results in needing to have the tooth extracted.

White fillings are the new generation material in dentistry replacing the old amalgam fillings. It is a trustworthy, esthetic, and consistent material of choice for most dentists. Once you understand what the filling composition is doing inside your tooth, it’s easier to understand why you can have sensitivity with the material but also see the advantages of such material.

Dr. Ryanne Hazen Gilliland is owner of Smile Expressions Family Dentistry and a dentist in Mt. Dora and a dentist in leesburg fl.

DENTAL CARE & DIABETES

The importance of taking care of your teeth while you are diabetic.

Making regular dental appointments if you have diabetes is very important, as your chances of having dental problems increase prevalence of dental problems, including periodontitis.

Periodontitis is bacterial destruction of the bone and tissue supporting the teeth, abscesses, gingivitis (inflamed gums), dry mouth and soft tissue lesions.

The cause of periodontitis is associated with oxidative stress(build up of toxins in your blood
caused by high glucose levels). These toxins damage blood vessels, collagen, and other
tissues and thus compromise the health of the gum and teeth.

Oxidative stress also increases the risk of infection and impairs the healing of sensitive gum tissue.

Long term blood sugar elevation weakens your immune system and makes you more usceptible to infection.

Studies also show that poor dental health itself has a negative impact on the ability to control blood glucose levels. In addition, poor oral and dental health is associated with increased risk of other diabetic complications.

To help prevent periodontal disease you need TO KEEP YOUR BLOOD SUGARS IN CHECK and make regular visits to your dentist (two times or more per year). This will ensure proper plaque control and scaling.

The take home message is simple: you can prevent complications associated with diabetes and greatly reduce there impact.

regular use of tooth brush and paste with gental pressure and tradiational tooth powers are effective.

Health is yours, what you do today will impact your future.



B.Sc.(Med.), B.Ed., M.A.(Edu.), M.Litt.(Edu.), Ph.D.(Edu.Psy.)PGDCA.

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Women Don't Get Proper Dental Care During Pregnancy

Women may not receive dental care before or during pregnancy, and many factors are at play, says a Florida study.

The study included 253 African American women between the ages of 18 and 35. They were surveyed within one month of giving birth.

Researchers asked about dental visits before and during pregnancy. They also asked about any guidance the women received on dental care during their prenatal visits.

Most women did not visit a dentist while pregnant. There were several reasons:

Lack of insurance
Difficulty finding a dentist
Low priority on dental care
Misconceptions about whether dental care during pregnancy was safe

Few women remembered receiving advice on dental care during prenatal visits.

Poor oral health particularly periodontal (gum) disease has been linked with pregnancy problems. In addition, mothers who have poor oral hygiene and a personal history of multiple teeth with cavities can pass decay-causing bacteria on to their young children. This increases the children's risk that their children will experience tooth decay.

Routine dental care is generally regarded as safe during pregnancy. Pregnant women who need urgent care also should visit a dentist. Examples of urgent care include treatment for a tooth infection or toothache.

A long-term German study found lower rates of tooth decay in the children of women who had preventive dental care while pregnant. These lower rates lasted into the children's teen years.

The Florida authors suggest more attention be paid to educating women about oral health and dental care during pregnancy. They said barriers to dental care for pregnant women also need to be addressed.

The Florida study is in the December issue of the journal Birth.

By Nancy Volkers
InteliHealth News

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Dental Implant Sector Set to Surge

ZURICH—Executives of large dental-implant makers say their business will take a bigger bite of overall consumer spending next year, despite continued weakness in the global economy and stiff price competition from new entrants.

Expansion rates of 5% are realistic for 2011, they say, while double-digit growth is possible in two years once consumers regain confidence, reversing a more than 6% drop that hurt the $18 billion dental industry in the downturn.

During that time consumers have opted for cheaper replacements, such as bridges, because costs for implants can run between $500 to more than $10,000 depending on the size and material.

But even though implants require surgery and offer risks of infection, they have gained in popularity because such artificial teeth are fixed more securely and look more natural.

As penetration rates are still very low in the U.S. and Asia, "I am optimistic the market will get back to double-digit growth," said Beat Spalinger, the chief executive of Switzerland-based Straumann Holding AG.

Demand will be driven forward because "people are getting older, the technology has advanced and the education has increased," said the chief financial officer of Swiss rival Nobel Biocare Holding AG, Dirk Kirsten. "The fundamentals are intact."

Their views are backed by a research report published by consultant MarketsandMarkets, which expects the global dental equipment market to reach a size of $27.6 billion by 2015. The implants segment is set to grow by 10.5% per year as "aging baby boomers can afford expensive dental procedures", according to the report.

Such budding, high-level optimism comes amid accelerated consolidation within the sector, and reflects renewed interest in it. U.K.-based AstraZeneca PLC has put its dental implant and medical devices unit Astra Tech on the block. U.S.-based Sybron Dental Specialities Inc, a unit of Danaher Corp., took over Implant Direct International Inc. in November. And Birmingham, Ala. startup BioHorizons wants to list its shares on Nasdaq.

Dental-implant technology was invented around four decades ago. The market took a long time to build, but eventually reached staggering growth rates of 15% to 20% in the years 2003 to 2007, when consumers in the U.S. and Europe started to switch to implants from conventional bridges and tooth-replacement techniques.

The boom attracted a flurry of low-cost manufacturers. This sapped off growth from established players and led to a general margin erosion, which accelerated during the downturn, and is expected to keep margins off historical highs and may also keep a lid on stocks, analysts say.

"We can achieve a profit margin of about 20% to 25%," said Nobel Biocare's Mr. Kirsten. "But a pre-crisis margin of 34% isn't realistic," as the company's recent revamp—amid which it broadened its offering to include less expensive treatments—incurs higher costs.

The threat from the low-cost manufacturers, coupled with the weak economy, has prompted revamps and cost cuts across the industry that includes players such as Dentsply International, Zimmer Holdings Inc's Zimmer Dental and Biomet's 3i, which is owned by private equity companies such as Blackstone Group and Kohlberg Kravis Roberts & Co. As a consequence, investors shunned the sector this year.

Shares of Nobel, partly due to its protracted restructuring, has lost more than 50% in value this year as investors such as UBS AG and FMR LLC, a unit of asset manager Fidelity, reduced their stake. Straumann's stock shed nearly 30% of its value even as investment firm Mannin & Napier Advisers built a 3% holding.

"The question of course is when the market is turning around," said Daniel Jelovcan, analyst at brokerage Helvea. "Because many people postpone complicated dental interventions, the market is expected to recover later in the cycle because people tend to first spend on cars or vacation once the economy stars to take off."

Those who have embraced the high-end technology see huge potential there. "Quality is a key factor of our past success," said Dr. Haleh Abivardi, co-founder and CEO of Swiss Smile Holding AG, one of Europe's fastest growing dental centers with outlets in Zurich, St. Moritz, London and Bangalore.

"Even during the economic crisis, demand for quality implants [from Straumann and Nobel] has been growing by about 20% and will remain high in the future, especially in countries such as India," she said.

A major test of the market's health will come with the planned sale of Astra Tech, which some market observers have suggested could fetch as much as $2 billion.

While companies such as Straumann and Nobel Biocare are considered potential acquirers, analysts believe that a consortium surrounding Blackstone is more likely to go for a takeover of the Swedish-based unit, allowing them to merge Biomet with Astra Tech.

Straumann and Nobel Biocare declined to comment on Astra Tech. Blackstone and Astra Tech couldn't be immediately reached for comment.

Depending on what multiples a potential bidder is prepared to offer for Astra Tech, dental implant makers could get a lift from an eventual transaction and move closer towards historic valuations.

The sector's price to earnings ratio—an industry figure reflecting market profit projections—currently stands at about 12 to 15, a steep discount to the 40-level before the crisis erupted. A level of around 25, analysts say, could be fair provided the current consolidation round attracts enough capital.

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Cheap dental crowns from China may contain dangerous levels of LEAD

Dental experts say the crowns can contain dangerous levels of lead

Dentists who use cut-price and potentially deadly crowns and dentures from China are putting their patients at risk, it was claimed today.

The products are often made in unregulated laboratories and can contain dangerous levels of lead, dental experts warned.

In the U.S., four cases of lead poisoning have been linked to Chinese dental fixtures. A laboratory test revealed that some contained 210 times the acceptable amount of the toxic metal.
Richard Daniels, the chief executive of the Dental Laboratories Association, said the number of potentially dangerous imports was rising.
"At this point nobody knows what the health risks are," he said.
"The fact is the majority of NHS work will be coming from China or India in the next five years. We need to be moving towards proper regulation of the industry.
"It's not just a matter for the NHS either - many of the big corporate groups also have agreements with factories in China to make their fixtures."
Fears over the toxic metal content of crowns, veneers, bridges and dentures were raised when a 73-year- old Ohio woman became sick after being given a new crown made in China.
Subsequent tests on other Chinese crowns revealed that some had dangerous levels of lead, forcing the U.S. National Association of Dental Laboratories to issue a warning to patients.
Dangerous crowns and dentures have yet to be reported in Britain. However, there has recently been a huge surge in the number of dental fixtures imported from China into the UK.
These now make up five per cent of the market, compared with less than one per cent three years ago.
There have been concerns about other products made in the country, which is widely regarded as an emerging economic powerhouse.
Last year, toy manufacturer Mattel launched a massive product recall after some of its products made in China were found to have high levels of lead.
David Smith, a board member of the Association, said: "The worst case scenario is we'll end up with a large number of people in the UK with mouths full of lead and they've got no idea that that's the case.
"It's a ridiculous situation. Mattel could simply pull its toys off the shelves when they realised there was a problem. It's nowhere near as simple if the contaminated product is a dental fixture in someone's mouth.
"In theory what happened in America should never happen here as there are regulatory bodies which should prevent these problems in the UK.
"But the truth is, if the situation isn't addressed then it is only a matter of time before there is a similar case as in the States. We've watered down all the rules in such a way that you could drive a bus through them.
"In the end, the whole system is profiteering. Any savings made by outsourcing the work to China are never passed on to the patient."
British dentists can now take an impression of a patient's tooth, send it to a Chinese lab by express post and get a crown back within four days.
Suppliers of imported fixtures ask for around £10 per crown, compared to the £100 fee charged by British labs. The cost of a crown on the NHS is around £193.
Medical devices in this country are tightly regulated, but the supply of dental fixtures is harder to control.
Although the materials used to make crowns, bridges and dentures must carry a CE safety mark, there is no way of checking whether the manufacturer has used the correct materials.
Mr Daniel said: "A British laboratory gets routine, unannounced inspections, but outside the EU no one is checking to see what is going into these products."

By DAVID DERBYSHIRE and LIZ HAZELTON

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