YOUR QUESTIONS

Q. Which material should I have my back teeth restored with?

A. Some of the concerns regarding mercury toxicity in amalgam fillings are based on reports in the media, rather than scientific studies. Scientific studies show very small amounts of mercury leaching from amalgam fillings at levels not considered to be harmful to health.

Amalgam is a strong, reasonably inexpensive, long lasting way of restoring back teeth.

The alternatives are:

1) White composite fillings. These are most suitable for smaller fillings in the back teeth where the surrounding tooth will take most of the chewing load.

2) Porcelain inlays. These are more durable for larger restorations and are tooth coloured. Sometimes these may break, particularly if you grind your teeth.

3) Gold inlays. These are very long lasting. The gold is slightly soft and gives under chewing loads, so that is doesn't break in half. However some people do not like the appearance of gold.

4) Crowns - for when the tooth is badly broken down, heavily restored or root filled.

Q. Will root canal treatment affect my general health?

A. The simple answer is no! Some very poor research was carried out which seemed to show this, and unfortunately this has spread as an "urban myth".

Q. What can I do about loose dentures?

A. For some people new dentures will be tight enough for comfortable use, but this depends on the shape of the bony ridges in the mouth, how good the dentures are and individual tolerance to dentures.

The ridge of bone in the lower jaw is smaller, so most problems are with lower dentures.

Two implants in the lower jaw will give good retention of a lower denture.

Four implants are required in the upper jaw joined together with a gold bar, with the upper denture sitting on the bar.

Four implants joined with a bar in the lower jaw will allow a lower denture which does not rely on the soft tissues of the mouth, but is supported by the bar.

Six implants in the lower jaw will support fully fixed bridgework.

Eight - ten implants in the upper jaw will support fully fixed bridgework.

Q. What are the options for a missing tooth?

A. There are a number of options for a missing tooth:

1) Leave the space - there is not always a need to replace every missing tooth.

2) Orthodontics - wearing a brace to close the space.

3) A partial denture - this is a removable plate to replace a missing tooth and can be effective, especially as a temporary measure.

4) A stick-on bridge (Maryland or resin retained brisge) - A very small amount of tooth preparation is carried out on a neighbouring tooth to allow a metal wing to be bonded to this tooth, from which another replacement tooth is cantilevered. These bridges rely on bonding to tooth for their retention, so some do come unstuck (30% over 5 years)

5) Conventional bridge - the teeth either side of the gap are reduced in size to allow a bridge to be cemented over the top of them. These bridges usually stay cemented very well, but the amount of work carried out on the teeth means that the tooth nerve sometimes dies, requiring root canal treatment (15% risk of this hapening).

6) An implant - a titanium screw is placed into the jaw bone and then left to heal and the bone to integrate with the titanium.

A crown can then be placed on the implant. The advantages of implants are that they preserve bone and do not rely on the neighbouring teeth. There is a 5-10 % risk that the implants do not integrate with the bone.