Westlake Village, California Dentistry

I have a lot of old fillings and have heard that the mercury in them is not healthy. Should I have them replaced?

Mercury is a toxic material that makes up almost half of a silver filling. The theory is that the mercury is locked up with the metal. The amount of mercury that leaks over the life of the filling is minimal, and therein lies the controversy. How much is acceptable? I believe that when a silver filling needs to be replaced, it should be with something other than silver, but it could be left alone otherwise. If a patient is concerned with cosmetics or is sensitive to metals, then replacing it with a composite or porcelain is appropriate.

How much radiation do I get from dental X-rays, and is it harmful?

Historically, dental radiography emitted significant radiation, but with the advent of super fast films and digital radiography, radiation levels have become relatively insignificant. We have used digital X-rays in my office for ten years now, and though I always try to minimize X-rays, the benefits far outweigh the risks.

I drink a lot of bottled water. Do I get enough fluoride to protect my teeth?

A) Typically, unless specifically requested, bottled water does not contain fluoride. In fact, most municipalities no longer put fluoride in tap water because of costs. Fluoride is such a good cavity fighter in children that it is well worth the effort. You can purchase fluoridated water through companies such as Sparkletts or get a prescription for tablets from your dentist. Check with your city water municipality to find out if fluoride is added.

What does the term "sedation dentistry" mean?

Sedation dentistry refers to putting a patient into a light sleep through the use of medication delivered orally or intravenously. This requires special training by the dentist; often an anesthesiologist will be brought into the office at an extra charge. In rare instances, a patient could be admitted to the hospital. Sedation dentistry is used in more complicated procedures or for patients who are unusually afraid. In our office, I find that the use of nitrous oxide or anti-anxiety medication is sufficient for most fearful patients.

Do kids really need their wisdom teeth pulled out, or should it be done only in severe cases?

Wisdom teeth, or third molars, are considered a relic from our evolutionary past and are unnecessary for function and aesthetics. In a case where the jaw is not large enough to accommodate third molars, or if the person cannot adequately clean them, then removing all four is recommended. However, if the teeth erupt properly, there is no reason to extract them.

What are the different methods of tooth whitening, and what works best?

There are several ways to whiten teeth, but the common denominator is hydrogen peroxide in one form or another. The in-office method employs the strongest gel and supplements it with an ultra-violet light that allows whitening to occur within one hour or less. A patient can also be given custom-made trays with much weaker gel, which can produce equivalent whitening in about two weeks of daily use. The store-bought products use the weakest gel and take about one month of daily use to attain the same results.

At our office, we include the trays together with our in-office service to provide long-term maintenance, as eventually the teeth will darken again.

What is the best filling material, and what are the risks?

The three most commonly used materials are silver/mercury, composite, and porcelain. Silver lasts a long time, is easy to place, and is inexpensive. A composite is tooth-colored, hence more attractive, and it is still easy to place. My experience is that composites don't last as long as silver, but teeth rarely fracture, whereas it is more common with silver fillings. Porcelain fillings are my personal favorite, as they combine longevity with beauty, but they are more expensive and require two visits.