Last week we talked about teeth whitening and concluded that although it’s one of the most common cosmetic dental procedures available, it’s likely a waste of money for most people. Today we’ll consider amalgam filling replacement.

All About Amalgam

Most fillings are amalgam in nature - meaning they’re made of a composite material including metal and mercury. While these fillings are more noticeable than porcelain or composite fillings, they tend to be stronger and more durable than their less-noticeable counterparts. If you are considering replacing an amalgam filling simply because you want a filling that’s less likely to be noticed by someone looking in your mouth, think about the drawbacks:

• You have to remove tooth structure to get the amalgam filling out
• Amalgam fillings with mercury in them aren’t linked to any ill health affects
• The replacement fillings will be weaker and less durable than what you had before

In addition to these common-sense reasons, you can save yourself money by keeping a perfectly good, well-functioning amalgam filling in your mouth.

Atypical Tooth Restorations

When a tooth breaks, chips or cracks, tooth restoration is a helpful way to repair the tooth and protect your mouth from infection and further injury. However, a cosmetic dental treatment has popped up which uses advanced equipment to detect microscopic lines or defects on the surface of a tooth. Some dentists will recommend opening the tooth and filling it with a porcelain or composite material to correct the minor defect which is often unnoticeable to the naked eye.

Use common sense and avoid this kind of cosmetic procedure. Not only is it expensive, but it’s unnecessary. In many cases, your saliva will repair the minor defect. Crowns cost a lot of money and should be reserved for teeth that have genuine, significant decay. Instead of unnecessary restoration, opt for monitoring the decay; if it worsens over time, wait until a crown or filling is legitimately called for to remove the decay and repair the tooth.

Cosmetic dentistry is a relatively new field, somewhat similar to plastic surgery. The aim of cosmetic dental procedures is to help people feel happy with the way their teeth work, more so than the actual health of their mouth. Common cosmetic dental procedures include:

• Teeth whitening
• Amalgam filling replacement
• Minor tooth restorations
• Unnecessary removal of wisdom teeth
• Excessive x-rays
• TMJ surgery

Some of these procedures can be necessary and helpful at times. At other times and for some patients, these can be optional, expensive and unnecessary dental procedures. Over the next few weeks, we’ll consider each one and how you can save yourself some money by knowing when you should have them done and when you should just keep your mouth the way it is.

Teeth Whitening

Teeth whitening is the most common cosmetic dental procedure. It’s become so mainstream in fact, that you can purchase a home whitening kit over the counter and whiten your teeth yourself at home. According to a Consumer Reports article about dental procedures its February 2012 issue, most survey respondents were more satisfied with an at-home whitening treatment than one they had their dentists perform in-office.

For starters, at-home teeth whitening kits and whitening strips cost less. Most yellow-tinted teeth are perfectly healthy. A slight yellow tint is actually a sign of a well-calcified tooth. Regular brushing and flossing will remove tea and coffee stains just fine. So, unless you have $300 that you’d rather not spend on anything other than teeth whitening, stick to an over the counter kit or focus your efforts on brushing and flossing.

Whether they have insurance or not, cost is the number one reason that most Americans give for delaying the dental work they desperately need. Americans holding off on dental work because of cost have good reason to do so. Check out these average, pre-insurance prices for common dental work as reported in the February 2012 issue of Consumer Reports magazine:

• Fillings - $288
• Extraction - $501
• Crown - $1,018
• Root canal - $1,201
• Bridge - $2,698
• Dental implant - $3,938

If those prices scare you, take a deep breath and realize that these are reader-reported averages from across the country. If you’re one of the 43 percent of Americans without dental insurance, don’t let it stop you from getting the dental care you need. Consider the options available to you outside of dental insurance to pay for dental procedures that can relieve your pain and prevent worse problems from occurring.

Visit FairHealthConsumer.org and look up what a typical rate for a dental procedure with dental insurance costs in your zip code. Ask your dentist to accept that rate, or even less, in cash, if you can afford it. You may find success especially on higher priced procedures like bridge work and dental implants.

Check out a community health center in your area, if one exists that offers dental care. Or, call a local dental or dental-hygienist school. If you are willing to allow students to work on your teeth, you may be able to receive free or discounted dental work. Find a list of dental schools at ada.org.

Emergency Dental Care, USA Inc. offers locations in select cities across America. While each location is independently operated, most offer finance options including all major credit cards and payment by check. We’re unique in that we specialize in after hours dental care. Like many good dentists, we care most about helping our patients and hate to see concern over cost keep them from getting the help they need.

January is a popular time for dental work. In many cases, that’s because dental insurance plan coverage starts over and people suffering from tooth pain or people who have put off necessary dental work and checkups can now get those procedures done with the help of the dental insurance dollars instead of having to pay for the procedures entirely on their own.

In general, having dental insurance is better than not having it, especially if you can get it through your employer as opposed to paying for an individual plan on your own. Most dental insurance plans are designed to pay for preventative dental work like semi-annual dental checkups and teeth cleanings. Most of the time, dental insurance won’t cover the entire cost of getting a crown, bridge, filling or root canal. Dental insurance plans also almost always have maximum dollar amounts that they will pay, after which, you’re on your own.

The National Association of Dental Plans reports that 98 percent of Americans with dental insurance get it through their employers or a large group like AARP. If you’re one of the 43 percent of Americans without dental insurance, don’t let it stop you from getting the dental care you need. Look into an individual dental plan and research the options available to you.

Check out what’s available through online insurance websites like eHealthinsurance.com. Select a few plans that cover the types of dental procedures you think you’ll most often need done (fillings, root canals, crowns, teeth cleanings, x-rays, etc.). Compare your findings with estimates posted on HealthCareBlueBook.com to see if the plan(s) you’re considering is worth the money.

Whatever you decide about dental insurance, don’t let cost keep you from addressing tooth pain and dental problems. As we’ll discuss next week, even without dental insurance, there are still options available to you to help you get the dental work you need.

Fear of anything is a vicious cycle. Sometimes, fear can be effectively managed by completely avoiding the source of that fear. Most often though, avoidance only makes your life more inconvenient, increases your fear and limits your opportunities. If you’re afraid of driving on the interstate, you can choose to take only surface streets, but you’ll have to plan more travel time and any long road trips will take longer and cost more.

If you’re afraid of going to the dentist and therefore never go, you may be more likely to develop dental pain and problems. Dental problems often start as minor issues that can be easily and painlessly resolved; left unchecked, minor problems turn into major ones that are costly, unpleasant and sometimes, painful to deal with. If you wait until you can’t stand the pain any longer to see a dentist about it, your fear of the dentist always being associated with pain and discomfort will only be confirmed.

The truth is that going to see a dentist for annual checkups and teeth cleanings will commonly reduce the dental pain, discomfort and fear that you experience. The best way to deal with dental fear is to meet it head-on. Confront your fear by finding a dentist that will help you get through it by being sensitive to it. If you don’t have a dentist now, ask friends who they recommend. If you have a friend of co-worker who shares your fear but goes to the dentist in spite of it, ask that person what he thinks of his dentist. If he’s happy with his dentist, chances are good that you will be too.

Visit a few dentists until you find one that you are comfortable with. Be upfront with the dentist about your fear and ask what he and his assistants can do during your visits to reduce it. Some tactics you and your dentist might agree on for lessening your pain and fear include:

• Local anesthetics
• Pain-killing drugs like Novocain
• Pre-arranged hand signals when you need a break from a procedure
• Nitrous oxide gas
• Anti-anxiety medication

Discuss the options with your dentist and make the best choice for you. Just don’t let fear stop you from taking good care of your teeth.

From everyone at Emergency Dental Care USA, Inc. and Ask the Emergency Dentist, we want to wish a Happy New Year to you and your teeth! What would be a better way to start off 2012 than with 12 resolutions, that if followed, should result in a happy, healthy mouth?

1. Eat less starchy crackers and chips. Doing so will help your teeth and your waistline as they can be just as harmful to your teeth as sweets.
2. Drink tea and coffee without sugar. Holding the sugar on your tea and coffee can reduce plaque buildup and cavities.
3. Brush your teeth twice a day or after every meal. Regular brushing will keep plaque buildup low and your breath fresh.
4. Floss daily. Take care of your gums this year by flossing in between your teeth at least once a day, twice if possible.
5. Don’t use your teeth to open things. Use your hands or scissors, not your teeth to open packages, cut tape and tear open things this year.
6. Switch to fluoride toothpaste. If you don’t already use toothpaste with fluoride in it,  start as it will help your teeth grow strong and plaque-free.
7. Give up smoking. It’s good for your health not to smoke and reduces the staining that tobacco products cause to teeth.
8. Chew sugar-free gum after lunch. Many people find it difficult to work in a tooth-brushing session after lunch. If it’s more convenient for you, carry around a pack of sugarless gum and chew a stick after lunch or a mid-day snack.
9. Use a soft-bristled toothbrush. Nylon-based, soft-bristled toothbrushes remove plaque and tartar from your teeth without scratching or ruining the naturally protective enamel coating.
10. Trade in your toothbrush every three months for a new one. Like so many other things in life, toothbrushes wear out and need to be replaced regularly to stay effective.
11. Wear a mouthguard. If you play competitive sports, a mouthguard can protect your teeth from breaking and cracking, which can occur contact sports.
12. See your dentist regularly. Get a checkup every six months to keep 2012 a healthy one for your teeth and gums.

The last week of the year can be a great times to get dental work done, especially work that you want but don’t necessarily need. Getting the most out of your dental insurance is a skill honed with practice, kind of like herding cats. While it may seem unnatural at first, learning how to work the system to your benefit is both legal and practical. Here are three steps to getting the most out of your dental insurance.

#1 - Get Your MBA. Look at the paperwork you received when you signed up for your dental insurance this year or go online to find the explanation of your dental benefits. Specifically, find your maximum benefit available (MBA). The MBA is the most money your dental insurance will pay for root canals, teeth cleanings and other dental work in a calendar year. Whatever you don’t use of the MBA is lost at the end of the year. Think of it as money you paid for that’s sitting in your dental insurance account, waiting to be used by you and only you.

#2 - Gather Your EOBs. Dental insurance companies send handy, but often confusing, statements called “explanation of benefits” or “EOBs” that detail how much they’ve paid for your dental expenses each time a dentist submits a claim to them for work you had done. Total up all that your insurance has paid out, as shown in your EOBs. Call your insurance company if you need help and just ask them how much you have remaining on your maximum benefit.

#3 - Give Your Dentist a Call. Armed with the knowledge of how much (or little) credit you have available in your dental insurance tank, call your dentist and schedule an appointment to have necessary dental work done. If you have $500 left on your MBA, for example, and have been wanting to get your teeth whitened all year, call your dentist, ask what he charges for the service and get those pearly whites serviced before your big New Year’s Eve bash. You’ll enjoy ringing in the new year, and your mouth will show it!

Watch out for the Nutcrackers this Christmas; biting down on something hard could lead to a broken tooth and that could destroy more than just a nice Christmas meal and night of caroling. A broken tooth can cause sensitive nerves to become exposed. An exposed nerve can cause a lot of pain, which may make eating a warm sugar plum or drinking a cold glass of egg nog anything but a Christmas treat.

Most teeth are remarkably strong but they can chip, crack or break if they come into contact with something hard or are hit suddenly. The worst thing you can do when you break a tooth, even if it is on Christmas Eve, is to wait or try to ride out the pain until after the holidays. You have the best chance of saving a broken tooth if you get to the dentist within thirty minutes of the break.

If you break a tooth this holiday season or any time during the year, here’s how to take care of it:

• Look in your mouth and around you on the table or floor for broken pieces of tooth.
• Gather tooth pieces into a small bag or glass.
• See the dentist within 30 minutes if the entire tooth is knocked loose out of your mouth.
• Don’t touch any exposed roots.
• Rinse your mouth gently with saline solution or water.

There are a few simple tips you can follow as well to help prevent breaking a tooth in the first place. Avoid chewing on hard things like ice cubes, frozen candies and nuts. Wear a mouth guard when playing in sports, especially contact sports like football or soccer.

If you do break a tooth and don’t have a dentist or need help outside of normal office hours, Emergency Dental Care USA, Inc. may have a location near you where you can be seen to get your tooth fixed and pain relieved right away.

According to popular opinion, the worst food to get stuck in between your teeth is a poppy seed. These tiny little black seeds are common on rolls, muffins, bread and even in tea. They may taste good but can create chaos for your gums and teeth. Other foods that commonly get stuck in between teeth and gums include:

• Cooked spinach
• Celery
• Apple skins
• Red meat
• Broccoli
• Salad lettuce
• Corn on the cob
• Popcorn husks

Little bits of sticky candy can also easily become lodged in the spaces between teeth. In general, getting food stuck in between your teeth is a simple problem, easily solved with dental floss and regular brushing. The problems come when people don’t have floss on them and improvise by using toothpicks, nail files, forks and other small, sharp objects to attempt to dislodge the unwelcome visitor from their mouths.

Dislodging Unwelcome Bits of Food

If you’ve used something other than floss to get a piece of spinach or a seed out of your teeth and have walked away unscathed, consider yourself fortunate. Others don’t always fare so well. At the the Emergency Dentist, we see patients who’ve damaged their gums and teeth severely by sticking dirty or sharp items in their mouths to try to clean them. Lacerations can quickly become infected, creating an even worse problem that in extreme cases leads to teeth being pulled.

The best way to remove a strand of celery or a poppy seed from your gumline or from in between your teeth is not with your fingernail. It’s with dental floss. If you aren’t at home, run into a grocery story or pharmacy and purchase a roll of dental floss. Find a mirror (preferably in a bathroom, but your rear view mirror will do as long as you’re not driving while trying to remove the foreign object). Tear off a 12-15-inch piece of floss. Wrap the ends around your middle fingers.

Gently, slowly and carefully work the floss in between the teeth where the food is stuck. Work the floss up and over the object. Then, pull the object down along with the floss to remove it from your teeth. Swish some clear water around in your mouth to help dislodge pesky pieces of food. Keep working at it with floss and water. Then, brush your teeth, if necessary to work the food out completely and leave your mouth feeling fresh.

If you hurt yourself trying to get the food out some other way, call your dentist and have him or her remove the food for you.

Webster’s dictionary defines cantankerous as “difficult or irritating to deal with.” Donkeys and old women unaccustomed to change are given as examples of the word. After talking to my mother-in-law recently about some dental problems she’s been having, I’d have to say that Webster’s needs to update their listing to include canker sores as an example.

My mother-in-law has never had good teeth. Lately, it seems like she’s been having one bad problem after another with her teeth and mouth. The latest development includes canker sores. After having four new back molars put into her mouth, she developed a line of painful canker sores along the sides of her tongue. When she went back to her dentist in search of relief from her pain, he told her that it was a reaction to the new molars. Apparently her tongue didn’t know what to do with the new additions to her mouth and just kept rubbing up against them causing canker sores to develop.

One antibiotic shot to her tongue and a little tooth filing later, my mother-in-law was on the phone telling me through rather garbled speech that she’d have to endure another 7-10 days of life with these cantankerous visitors to her mouth. That got me interested in finding out more about canker sores and how they’re treated.

What Causes Canker Sores

According to the American Dental Association, canker sores are “annoying and painful” sores caused by “infections from bacteria, viruses or fungus; a loose orthodontic wire; a denture that doesn’t fit; or a sharp edge from a broken tooth or filling.” The ADA recommends having your dentist examine any canker sores that last longer than one week.

Canker sores are actually tiny ulcers that consist of a white or gray base surrounded by a red border. They form inside the mouth and are not contagious. You can develop one canker sore at a time or multiples that come and go over time. While specialists don’t know exactly what causes canker sores, these sources have been suggested along with what was mentioned in the quote above:

• Fatigue
• Stress
• Allergies
• Hormonal changes as part of a woman’s premenstrual cycle
• Adverse reactions to hot or cold beverages
• Intestinal issues like Crohn’s disease

Caring for Canker Sores

Canker sores most often heal on their own within 1-2 weeks. Gels and other topical anesthetics are available over the counter at your local drugstore and may be used to temporarily relieve the pain canker sores cause. Your dentist may prescribe an antibiotic and oral bandages if you have a severe case of canker sores, like my mother-in-law. While you’re waiting for your canker sores to heal, avoid spicy, hot and acidic foods or drinks and be thankful that you’ll soon be free of their unwelcome presence in your mouth.