Gold Fillings, Crowns, Onlays for Teeth – still the Gold Standard!

When asked what filling or crown material will last the longest, there is a very simple answer that has held true for over a century now, and it is still true today: Gold crowns, onlays, and dental bridges.  Plain and simple, as much as I love doing cosmetic/esthetic dentistry with the ceramic materials available today, I still feel confident that NOTHING will last as long as a gold tooth restoration.

To tell the truth, I haven’t always felt that way, but I’ve come to that conclusion based on 11 years of seeing dental work that works over the long-term.  For many years after graduating dental school, I never did gold restorations except in extreme situations where it was the only realistic material.  But I have seen too many gold crowns, gold onlays, gold inlays, and even gold bridges that are 30-, 40-, or even 50+ years old!  While very few dental materials have been in use longer than 30 years, of those, none have had the longevity of gold.  So what are the advantages of gold?

• It requires minimal drilling of a tooth to have sufficient thickness to be strong – only 0.5mm (trust me, that’s SMALL!)

• It has the ability to deform slightly over time to match changes in adjacent teeth

• It can be burnished, or “massaged” hard to the tooth edge to create an amazing seal against bacteria, sugar, acid, etc.  Only in the last few years have porcelains reached equivalent seals, and even then the porcelains require absolutely exquisite bonding technique or they’re doomed to early failure.

So here is today’s example of a tooth with a failing silver/amalgam filling (decay around the edges and deep cracks that could have led to the tooth breaking at an inconvenient time) replaced with a gold onlay:

Family dentist Dr. Charles Payet used a gold onlay to fix a cracked tooth that had an old silver filling.

The gentleman who chose this is around 40 years old, and with regular dental care and the same excellent home care he has, this tooth and gold onlay will probably last until he is no longer in need of teeth any longer.

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Does dentistry last forever?

This is a question I’m frequently asked, especially when a patient is considering a significant investment of time and money into some form of cosmetic dentistry, such as:

• Porcelain veneers
• Bonding (tooth-colored fillings)
• Porcelain crowns and bridges
• Teeth whitening
• Even Six-Month Braces

It’s a very understandable question, and the simple answer to the question, “How long will my dental work last, Dr. Payet?” is “It depends.”

Just like a car, your teeth and gums require regular care to ensure that they are working properly.  Sure, you can go 10-20,000 miles between oil changes given how improved cars are nowadays, but do you really want to take the risk?  Same thing with teeth……….some people go for 5-10 years with no dental check-ups and are fortunate when they come in to find no problems, such as cavities or gum disease. But it’s not many people that are so lucky!

I always remember a quote from some lecturer at a dental conference years ago telling us his response whenever a patient asks the question, and it’s really the most honest, best answer that can be given, “Clearly the teeth that God gave you haven’t lasted your entire life, and since I can assure you that my work is not nearly as good as God’s, unless you die first, the work I do (no matter how excellent) will not last forever either.”

So what can cause your dental work to fail?

• Grinding your teeth — when the human jaw clenches, it can create an amazing amount of force, and over time, enough clenching will cause teeth to crack and break.
• Acidity — anything that increases the acidity in your mouth is good for the bacteria that cause cavities in particular, including Acid Reflux, Sodas, Power drinks (Monster, Red Bull, etc), Sports drinks (Gatorade, Powerade, etc).
• A very sugary diet — the bacteria that cause cavities love sugar.  High sugar content means the bacteria feed like crazy, produce acid, and the acid is what eats away the teeth to cause cavities.
• A compromised immune system — your saliva contains important antibodies that help keep the cavity-causing bacteria under control.  If your immune system is knocked back due to a disease or some medication, those antibodies will be decreased, allowing the bacteria to grow uncontrolled.
• Decreased saliva (dry-mouth syndrome) — again, due to medications or illness, the amount of saliva may be decreased.  With less saliva, there is less “washing” action of the teeth.
• Trauma — obviously.  LOL  One of my patients a few years ago fainted and fell face-first into a brick wall, shattering a front tooth.  Another ran into a pole, shattering another front tooth.  Clearly, if you are injured in such a way that your natural teeth would break, any dental work will break, too.
• Bad habits like chewing hard candy or ice regularly — hard candy and ice are just that — HARD!  Ice, in particular, is easily as hard as your enamel and as porcelain or bonding.  So if you bite down on ice frequently enough and/or hard enough, you can break your teeth and dental work.

That covers most of the major causes of dental work failing.  With regular care, use of appropriate mouthrinses and toothpastes, proper brushing and flossing, regularly scheduled check-ups and dental x-rays, using a nightguard, and being aware of diet, etc, your dental work can and should last a very long time.

But always remember — my dental work isn’t as good as the natural teeth God gave you, so my work probably won’t last forever either.  😉

Fun Fun Fun! Single-visit porcelain crowns with CEREC 3D!

OK, I know that most people don’t think that going to the dentist is fun, but it sure can be a lot more interesting than it used to be for sure.  The advent of digital dentistry, particularly CAD/CAM dentistry that allows us to make all-porcelain crowns in just 1 visit, is just pretty darn cool, and that’s even according to my patients who’ve benefited from it.  We brought the CEREC 3D system into our office at the end of December 2007, and in that time we’re approaching our 200th CEREC crown.   In the beginning, I didn’t take many pictures because I was really concentrating on learning how to make the crowns beautiful, fit well, and happen smoothly and quickly.  Now that we’ve become more comfortable with the technology, I’m taking the time to really take quality photos to show off just what we can do, and yesterday just was the perfect opportunity.

This gentleman had these porcelain-to-metal crowns placed about 4-5 years ago, but he is a major grinder and started breaking the porcelain off within a year.  That’s one of the potential problems of adding porcelain on to metal like that.  They obviously needed to be replaced, and he drove all the way from Asheville, NC for us to do this in 1 appointment; since we clearly needed very strong porcelain, we chose EMAX, which has truly remarkable strength.  Take a look and see the results for yourself after the crowns were glazed in our oven:

Dr. Jim Boyd – creator of the NTI-tss therapy for headaches & jaw pain

I count myself very fortunate to have known Dr. Boyd for about 4 years now, and it was through online communication with him that I originally began learning about the NTI and the remarkable abilities it has, in the hands of a properly trained dentist, to provide amazing relief to so many patients who’ve suffered from migraines, chronic tension headaches, TMD, jaw pain, etc.  Quite honestly, he’s been a tremendous mentor and influence during that time, and I am grateful for all the hard work he has put in to educate both doctors and patients on what we call “Parafunction,” more commonly referred to as bruxism, grinding, or clenching.  I’d like to share with you a video that he has posted on YouTube for both professionals and the public, in which he explains so clearly why he developed the NTI protocol and how it works and why it works so amazingly well.  If you’d like a Complimentary Consultation to if you think the NTI might help you, please call us at 704-364-7069 or Request an Appointment through our website.

Yet ANOTHER cracked tooth due to bruxism (grinding/clenching)

I just can’t say it enough – if you grind your teeth, you need a properly made and professionally adjusted nightguard!

Perfect situation this morning: a young lady of only 29 years age came in for a root canal and crown on a lower molar because of a badly cracked tooth.  It didn’t look all that bad on the outside, and seeing how small the previous filling was, you’d really think that the chances of this are practically non-existent……..but you’d be wrong. Take a look:

A Badly Cracked Tooth From Grinding/Clenching

And let me tell you – it is NOT a coincidence that this young lady has suffered from chronic migraines for years, but we haven’t addressed that for her quite yet.  First we had to get her out of the terrible pain she had every time she bit down.

If you grind or clench your teeth (and notice that this tooth doesn’t even look worn down or flattened), please be willing to spend a little money, even if your insurance doesn’t cover it.  It could literally save you THOUSANDS of dollars in dental treatment, lots of time in the dentist’s chair, and even pain.

So I grind my teeth, Doc – what’s the big deal?

Many people grind their teeth.  Many people clench their teeth.  Many do both.  The worst part is, though, that many have no idea that they do it, or how much damage they’re doing to their teeth — or how much it could cost to fix.  Sadly, too, many dentists don’t do anything about it either.  Here are 2 examples of just how badly one can damage teeth by grinding/clenching.

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Teeth damaged by grinding & clenching become short, chipped, worn, jagged, sharp, and ugly

How teeth can look after years of grinding and clenching.

Look how uneven the teeth are as they’ve been ground down.  See the gum recession and the deep “notches” in the teeth?  These things are NOT caused just by growing older and our mouths aging.  It takes incredible force to wear down enamel, which is the hardest substance in your body.  But once you wear through enamel into the second tooth layer – dentin – that wears down much faster and the damage accelerates.

Both of these gentleman wanted better-looking smiles.  The first one was completed over 4 years ago; we are still in the process of completely rebuilding the mouth of the second gentleman.  Needless to say, it is very expensive to rebuild teeth like this.  Sadly, it could have been almost completely avoided if they had known about and used a nightguard years ago.

So if you think you grind your teeth – call us today!  Sure, your nightguard might cost several hundred dollars………but what is that compared to thousands and thousands of dollars in treatment and many hours of time in the dentist’s chair.  You’re investing in the future health of your mouth.

Don’t wait like these gentlemen did.  Call us at 704-364-7069 and make your appointment to have a nightguard made and protect your teeth!

Visit our Smiles by Payet Dentistry page on this for more information on the NTI-tss nightguard.

Sleep Apnea, Snoring, and Dentistry

There is a rapidly growing area of dentistry concerned with treating sleep apnea and snoring.  There’s an important reason for this, too….people who snore and/or experience sleep apnea on a regular basis are at SIGNIFICANTLY higher risk of certain health issues.  I am going to relate a very personal story that I hope will help drive the point home, as well as give you a link to a website that will provide you with FAR more detail than I can provide in this blog.

THE STORY:

My dad turned 63 in March ’08.  Up until that time, he had always been a very healthy individual with no particular health problems.  He regularly traveled the world for his job and had been doing so for many years; he and my mom enjoyed an active life, involved with their church and the arts.  The only problem that had plagued him for a couple years was a nagging cough that simply would not resolve, no matter what he took.  Not just a nagging little cough, but a deep, powerful, and often painful cough that would sap his energy, leaving him drained.

(To interject a bit of dental history: I’d been telling my dad for a number of years that he clearly has a history of grinding his teeth, and coupled with the fact that he had always been an EXTREMELY LOUD SNORER (to the point my mom often kicked him out of bed or slept in another room herself), I’d also recommended he get a sleep study done.  With his travel and work schedule, though, it had just never quite worked out.)

Well, in early 2008 he’d finally had enough of the cough and went to see a pulmonologist.  During a routine visit to see how well a certain medication was working, they noted that his heart rate was at an alarming 140 beats per minute!! Naturally, they immediately sent him to the hospital!  He ended up staying for several days for evaluation.

It ended up taking many months of testing, trying several medications, and undergoing several procedures for his heart and to drain some disgusting and nasty fluid, before they finally got things under control.  One of the most crucial tests of all, though, was a sleep study.  Remarkably, his sleep apnea was SO BAD that the doctors woke him up halfway through the night to put him on a CPAP machine.

Long story short: the doctors determined that his sleep apnea was one of the largest contributing factors to his heart problems, which had led to the lung problems.  Since he started using a CPAP machine to help him breathe at night, he is a different man.  Dad says that he now wakes up and feels amazingly well; he actually feels like he slept well!  He no longer has the rapid heartbeat; his lungs are no longer filling with awful fluids; he sleeps well; my Mom sleeps well; and he’s healthy again!

If you know that you snore loudly; if you’re a man and your neck size is 16.5 or greater; if you often wake yourself up with “snorts” at night; if you always wake up and feel you’ve slept poorly no matter how many hours you were in bed……..these are some of the risk factors/warning signs that should tell you to see your doctor and your dentist.

I’ll talk more about treatments and how dentists can help in the future, but for now, here’s a link you should follow to learn a lot more — QUITE LITERALLY, THIS COULD SAVE YOUR LIFE, AS IT HAS MY DAD’S.  DON’T TAKE A CHANCE:

SnoringIsn’tSexy.com