Are white fillings OK in wisdom teeth?

Years ago, I let a dentist who obviously did not know what he was doing put white fillings in my teeth. Almost immediately I had to have several of them replaced, because my teeth became really sensitive and it was extremely uncomfortable to eat. At that same time, I let the same dentist put white fillings in my lower wisdom teeth, to “protect them against future cavities”. I had never heard of this practice, but did not know enough to argue.

The fillings have since worn completely away, and the teeth underneath where they used to be are not a pretty sight. I need to have fillings done again, but my regular dentist won’t do silver fillings. She said that many dentists won’t do silver fillings anymore, because of the mercury. Problem is that I don’t trust those white fillings to last, or to not cause me pain. What should I do?

Ron from Atlanta

Dear Ron,

The white fillings were not the problem–it was the technique used to place them. Placement of white fillings is still not taught in most schools of dentistry today, and it was certainly not part of the regular coursework “many years ago”. Placing white fillings, particularly in back teeth, is more challenging than placing amalgam fillings, because the area must be kept absolutely isolated from saliva or other fluids.

If your current dentist does not place amalgam fillings, then logic dictates that she is probably well trained and expert at placing white fillings. She would have a difficult time staying in business if she wasn’t! So I have to think you can trust her to do a good job with the white fillings to replace the ones that were in your wisdom teeth. Also, dentists as a group tend to be very ethical, so if she is recommending white fillings for your wisdom teeth, then she knows she can do a good job placing them for you.

The subject of the mercury in amalgam fillings in an ongoing controversy in the field of dentistry. The most current research cannot conclusively prove one way or the other whether or not the small amounts of mercury vapor released when you chew are harmful to the body. Many dentists (and patients) are choosing to err on the side of caution, and are just avoiding the amalgam fillings altogether.

Beyond the mercury issue, white fillings are much more cosmetically attractive than amalgam fillings. This may not be a top priority to you in the very back of your mouth, but an added selling point is that white fillings create a stronger structure after placement. The composite material actually bonds to your tooth, creating a stronger, more stable structure overall.

I hope you can trust your dentist to place those white fillings for you. The technology to place them has evolved a great deal, and hopefully you can trust your dentist’s skill and training.

Good luck.

Posted in Stained Teeth, White Fillings | Comments Off

Should I let Clear Choice extract all my teeth?

I had a disturbing appointment with a clinician at the Clear Choice clinic in Salt Lake City.

I wear an upper bridge, which is anchored by two dental implants I had placed by my former dentist (he retired). I was thinking I needed at most two more implants with crowns to cover my missing teeth (seven in all). But when I tried to explain to them what I wanted, the clinician quite literally waved my opinion aside. I started to explain, and she cut me off and waved her hand as if to indicate that my opinion had no value, and said, curtly, “We will need to just extract your remaining upper teeth to go forward with our treatment plan.” And then the push was on to schedule surgery.

The more I think about it, the more upset it makes me. She was so condescending! She did not care at all to hear what I had to say about my own treatment.

I went to Clear Choice because they have a reputation for being the best, but now I am starting to think that they just have the best marketing department. The two implants I have and the bridge cost me over seven thousand dollars. Clear Choice didn’t care at all about working with me for my individual situation. All they wanted to do was get everything out of the way and do it their way, regardless of the expense, or of what I wanted.

Dylan in Cheyenne, Wyoming

Dear Dylan,

Sadly, your story is not uncommon. I’ve had many patients tell me that they came away from an appointment with a Clear Choice clinic feeling like they were not being offered any choices at all.

Each patient, each situation is unique. One-size-fits-all dentistry is never the answer. I hope you will seek a second opinion for your additional dental implants. Did your former dentist leave a referral list, or have a partner? That might be a great place to start. Be very careful that you choose a dentist who is fully trained and experienced with dental implants. Of all dentistry procedures, dental implants have perhaps the most potential to go seriously awry if not performed by a qualified expert.

Good luck to you.

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