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There is no substitution for a natural healthy tooth. Dental fillings are intended to replace tooth structure and restore a tooth damaged by decay (a cavity) back to its normal function and shape. Silver (amalgam) and tooth-colored (composite) fillings last a long time, though they can develop decay when the integrity is compromised by open margins, fracture, or recurrent decay. In this blog, we discuss the signs and symptoms that indicate your filling may need to be replaced in order to prevent further complications.

Amalgam fillings are made of an alloy (mixed metals) that expands and contracts. They have no bonding properties, and so to place an amalgam filling, the hole in the tooth may need to be larger. Because of these two factors, fractures frequently occur. There are three types of cracks that are commonly associated. Craze lines are superficial with no treatment needed. Fractures extend along other parts of the tooth and may require a filling replacement or crown. Cracks extend toward the root and can require a root canal and crown or, if too severe, extraction.

A filing needs to be sealed to the tooth. If the seal between the tooth and the filling breaks down, food debris and bacteria can seep down under the filling and cause recurrent decay. If the decay is treated early, replacing the filling is adequate. If not, a crown and even a root canal may be needed. The biggest mistake you can make is waiting to do something about a broken or unsealed filling until it is painful. Doing this will only make the treatment more involved and often times more expensive.

Regular dental exams and X-rays are used to evaluate dental fillings. You will not be able to tell on your own when your fillings start to fail. Just as a car mechanic will change the oil, correct your alignment, or change your tires, a dental checkup will help you identify small concerns to fix as you go in order to avoid a critical emergency.

Pay attention to any bite or temperature sensitivity in teeth that have fillings. This can be an indicator for some of the problems listed above. You know your teeth better than anyone. Your observations are most valuable when evaluating a filling for replacement. If replacement is needed, know you are doing what is best to prevent future dental calamities and make an appointment to see Dr. Tijen Lacin, Dr. Yan Wang, Dr. Debby Hwang, Dr. Alessandra Dagostin, Dr. Ronald Lechner, Dr. Young Kim, and Dr. Neha Kuthiala.

We're thrilled with the feedback we've received over the past few months, and we're excited to share a little of it with you in this week's blog! Gentle Dental takes the post appointment surveys you send us following your visits to our office very seriously, and not a single one goes unread! Thanks to those who took the time to leave them recently, we look forward to sharing more with you in the coming months!

Friendly, fast, and professional
After not having dental insurance for the last 3 years, I was in desperate need of a teeth cleaning! Gentle Dental was able to get me an appointment within a week. The staff at the front desk was helpful in walking me through what to do as a new patient and gave me a wonderful goody bag!). The dental hygienist and dentist were both very thorough and friendly. They listened to me and recognized that I already knew a lot about what was going on with my teeth. They recommended treatment on a few teeth where my gums have been receding, and they made sure to explain why this would be helpful in the long run. They also knew that my insurance would not cover the procedure, though, so they happily provided me with a quote for how much it would cost and told me which teeth were the priority teeth to treat if I couldn't afford all of them. Very impressive!!

Great Dental Office!!
Although I have only been to this office once but I have already scheduled my next appointment...I am very pleased with the kind of dental office this is. Everyone was very friendly and made me feel comfortable.

Outstanding, Relaxing and Professional Dentistry
I have been going to Gentle Dental for quite a while. I used to have extreme anxiety going to the dentist, but Gentle Dentle has patiently understood and worked with me to overcome my fears. The whole team, from the receptionist, Patricia, my hygienist, to the doctor are always friendly and professional. I would recommend them to anyone!!

I love that I'm heard
Gentle Dental understands my trepidation and does whatever they can to make me comfortable, both physically and mentally. After jumping dental offices for years, this is an office I will stick with.

Best Dental Experience Ever!
Gentle Dental not only lived up to it's name, my experience by far exceeded my expectations. I had my first appointment here this week and I've found a dental office for life! Dr. Wang and her assistant treated me kindly and explained my situation clearly and honestly. And most importantly they look to the future to improve your overall dental health, not just finish the current task/job. I was never comfortable with the dentist and always had bad experiences.. Happy to finally find a good dental office =)

Happy Independence Day from Dr. Tijen Lacin, Dr. Yan Wang, Dr. Debby Hwang, Dr. Alessandra Dagostin, Dr. Ronald Lechner, Dr. Young Kim, and Dr. Neha Kuthiala and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the Gentle Dental Associates! blog to some fun facts about the Fourth!

• My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
• Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
• The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
• Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
• The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!

An article was recently released to the public stating that dental X-rays contribute to a type of brain cancer. After reading an article like this, your first thought may be to avoid dental X-rays, but you may want to hold off on that quick judgment. As with any treatment we offer at Gentle Dental Associates, education is your most valuable tool in deciding what is best for you.

How often dental X-rays are taken is based on risk for infection, physical symptoms, and clinical findings. The American Dental Association (ADA) is a governing body over the dental profession. The ADA states, “ . . . healthy adults receive routine mouth X-rays every two to three years. Dental X-rays are recommended every one to two years for children and every 1.5 to three years for teens. Children often require more X-rays than adults because of their developing teeth and jaws and increased likelihood for cavities.” [1]

The article summarized, "The chance of these tumors arising in patients who were X-rayed yearly was low," he notes in a news release. "Nonetheless, dentists and their patients should strongly consider obtaining X-rays less often than yearly unless symptoms suggest the need for imaging."[2] The article was also described as flawed because of inconsistent supporting evidence.

Caries risk category often determines how often dental X-rays are taken. The most recent documented resource to determine a caries risk is Caries Management by Risk Assessment (CAMBRA). This was adopted by the ADA and is used by dental professionals giving interval recommendations for X-rays.

With knowledge of your risk for dental infection, you will be informed by Dr. Tijen Lacin, Dr. Yan Wang, Dr. Debby Hwang, Dr. Alessandra Dagostin, Dr. Ronald Lechner, Dr. Young Kim, and Dr. Neha Kuthiala of the interval at which dental X-rays should be taken. You can rest assured that the standards published by the ADA have been researched extensively and are there to protect your personal health and safety.

Dental X-rays are most commonly digital, which significantly reduces exposure. There is more radiation exposure from the sun or in an airplane than in a dental X-ray. It is common practice to use a lead apron with a thyroid collar for protection during X-ray exposure.

Having a cavity means having an active, potentially harmful infection. Diagnosing such infection with minimal exposure through digital dental X-rays at our Ann Arbor, MI office does more good than harm.

[1] http://www.webmd.com/brain/news/20120410/dental-x-rays-linked-brain-tumors?page=2

[2] http://www.webmd.com/brain/news/20120410/dental-x-rays-linked-brain-tumors?page=2