University of Colorado Health (formerly Poudre Valley Hospital System (PVHS)) has switched dental insurances to Delta Dental of Colorado Dental Insurance. Our Westminster dentists are in-network with Delta Dental of Colorado with the PPO, EPO and Premier Plans.
J.B. Dental is accepting new patients. We want to be your Westminster Dentist. Please call (720) 458-6561 to check on your dental benefits and schedule your dental appointment today.
Creating a healthy oral environment involves many components, one of which is replacing old fillings that are breaking down or leaking. Amalgam fillings, commonly referred to as “silver” or “mercury” fillings are one of the biggest reasons for replacement restorations. The metal nature of the material causes it to contract and expand as hot and cold elements enter the oral cavity, which results in a breakdown of the material and often cracks in the teeth. Once the material is compromised or a crack in the tooth is evident, microscopic bacteria is then able to penetrate the enamel and dentin of the tooth and cause recurrent decay. This leads to the need for a replacement restoration to prevent larger problems down the road.
Many patients get concerned over having these fillings removed safely or may even want them removed preemptively because of their concerns over mercury exposure. At this point, it’s important to gather the facts before making any decisions on treatment. Here we will discuss the properties and benefits/risks of amalgam fillings to help guide your decision making.
Amalgam fillings are approximately 50% elemental mercury, but are also composed of tin, copper and silver. The reason that mercury is used is because it bonds well to the other mixture of metals, is malleable (able to be shaped to fit the shape of the tooth), and is extremely durable. The important distinction is that the type of mercury used is elemental which means that the risk is for the mercury to be inhaled as a vapor. Originally amalgam fillings were thought to be completely inert once the liquid mercury and the alloy powder were mixed, and therefore harmless in terms of vapor inhalation of mercury. More recently however, sophisticated tests have shown that small amounts of the vapor can be released as the amalgam filling wears. It’s important to note three things about mercury vapors, however. One, in the mouth, saliva creates a water/protein barrier that significantly reduces the amount of vapor created. Two, the amount of vapor actually released is in the billionths of an ounce. And three, the ADA has stated it would take at least 300 amalgam fillings in the mouth for a person to have any adverse side effects from mercury vapors.
As far as removal of amalgam fillings, your dentist will be using copious amounts of water and a securely placed high-speed suction to provide safe removal of the amalgam and any residue left behind. Those techniques alone will eliminate over 90% of amalgam exposure to the patient. A rubber dam is also available to isolate the tooth being worked on the prevent any possibility of exposure during removal. Please advise your dentist if this is something you’d like to have during your procedure.
Elective removal of amalgam fillings is not currently recommended by the FDA or the ADA. Due to the high amount of evidence supporting the safety of amalgam use over the last 150 years as well as considering that removing a sound amalgam filling will also remove healthy tooth structure, these combined considerations do not support the unnecessary removal of amalgam fillings. If you have any further concerns over the safety or the esthetics of your existing amalgam fillings, please consult with your dentist. An open dialogue will lead to higher patient comfort and a better acceptance of treatment if you understand that safety and durable, quality restorations are our highest priority.
Paige Tscherpel, RDH, BSDH
Consulted sources include:
http://www.ada.org/~/media/ADA/Member%20Center/FIles/safety.ashx
http://www.colgate.com/en/us/oc/oral-health/procedures/fillings/article/dental-amalgam-a-health-risk
Dental X-rays…Why do we need them and how safe are they? One of the most asked about topics during a patients appointment are X-rays. Do I really need them? Are they safe? Can’t I just go ahead and skip them? These questions are understandable. Radiation in any form has an effect on your body and we want to help you understand the reasons we take X-rays, how we determine how often and which kind are needed and the steps we take to keep you safe during this procedure.
First, why are we taking X-rays? Very simply, to make sure you’re healthy. Unfortunately, Superman did not bestow his X-ray vision to dentists, therefore we can’t prove there isn’t a problem until we can see clearly the entire tooth and its surrounding bone and ligament spaces. Many patients state “But I’m not having any pain, why do I still need X-rays?”. In general, we are looking for cavities, periodontal disease and cancer. For the most part, patients don’t feel any of these conditions until the stakes are high and tooth loss, or worse, is imminent. Much like having a physical with your doctor requires bloodwork to assess the overall health of your body, dentists and hygienists require diagnostic X-rays to ensure your dental health is stable.
Second, who needs X-rays and how often do they need to be taken? Anyone at risk for cavities, periodontal disease and cancer needs diagnostic X-rays on some sort of regular interval. Currently, the ADA recommends healthy adults with no risk for cavities (having not had a cavity in the last three or more years) have diagnostic X-rays taken every 12-36 months. Most adults and children do not fall in this category, most are considered at moderate to high risk since they have not passed the 3-year mark of being cavity-free. Therefore, it is standard practice to have 4 posterior bitewing X-rays taken every 12 months and a full mouth series of Xrays taken every 3-5 years. Again, if you have a history of cavities, periodontal disease or oral cancer, X-rays may be recommended more frequently to monitor your dental health more closely.
Lastly, what is the risk to our patients and what are we doing to keep you safe during your procedure? As a rule, the dental community follows the ALARA (As Low As Reasonably Achievable) principle. We use the least amount of radiation possible and individually evaluate each patient for necessity of X-rays.
Beyond that, we follow a guideline of physical barriers to keep you safe. Every time you are exposed to radiation, we will cover your abdomen and thyroid with a lead vest and collar. These are to protect any highly-reproducing organs from radiation exposure, as they are the most susceptible to damage given their high cell-turnover. These include your thyroid gland and reproductive organs. Please be sure to tell your dentist or hygienist if you may be pregnant, as we generally avoid any type of radiation around pregnant women.
The dose of radiation you will be exposed to is extremely low, especially with the advancement of X-ray technology and digital imaging. The typical yearly dental X-rays performed will give you a dose equal to less than a day’s worth of natural background radiation (0.005 mSv). Natural background radiation exposes most people to approximately 3.1 mSv/year. A chest X-ray will give an exposure of 0.1 mSv and a Chest CT scan will give a dose of 7 mSv. To put that in perspective, simply enjoying the Colorado sunshine is going to expose a person to more radiation than dental X-rays ever will.
Our goal is to educate our patients so that they not only understand our methodology of diagnosing and treating dental disease, but so they feel comfortable with all the procedures involved.
Please feel free to ask any questions you may have at your next dental appointment. We look forward to seeing you at your next checkup visit!
S. Paige Tscherpel, RDH, BSDH
