Dr. Russ Marchese

Missing Even One Tooth?

 

If you're lucky enough to have all your teeth and they are clean and healthy, then lucky you are. You might also spend enough time brushing and flossing and that is a credit to you. But, if you're missing even one tooth, things start to happen and it usually is not good.

 

What happens if one back tooth is missing? First of all, there is a space. Rarely do teeth not move. But when there is a place they can go, they usually do. Upper teeth move down. Lower teeth move up. Adjacent teeth move sideways. The teeth that have moved vertically can cause serious bite or chewing issues and possibly joint issues. When teeth move horizontally, more spaces develop, spaces that may not be pretty or spaces that just compromise chewing. Ideal restoration, hence, usually means orthodontics first.

 

Secondly, losing one or more teeth means that every other tooth in your mouth now has to take on more force. Your muscles are just as strong and the forces are stronger than you might think. Teeth can break anyway but the ones most likely to break are those that are weaker such as teeth with fillings or especially those that have had root canal treatment. If a tooth breaks bad enough, we lose another and the collapse continues.

 

And lastly, missing a tooth means that there is a better side to chew on and we favor that side. Those teeth wear more. Even front teeth can wear more. And hopefully those teeth are not weakened because they, of course, can break. Missing more than one tooth? Bigger problems.

 

Talk to your dentist or hygienist. There are solutions! And there are more solutions than you think, especially these days, even for that one missing tooth.
Dr. Russell Marchese Jr. -- 585-343-2711. Like us on Facebook for more information.

When I was in dental school, one of our requirements was to fill a certain number of cavities with pure gold. Gold works well in our mouths but very few dentists use gold for fillings anymore. In dental school and after, we placed many silver amalgam fillings in the teeth of our patients. Eventually we would polish them up and marvel at how nice they looked. But, times have changed. Many people these days don’t have any fillings at all. But as far as filling materials go, they do get better and better. Someday, maybe before we completely rid our mouths of tooth decay, we will discover that perfect filling material. What are we using now? Basically, silver amalgam, composite resin and sometimes porcelain.

 

We have been using silver amalgam for 150 years and it is very hard to deny how well it has worked. Amalgam is a mixture of metals. Amalgam fillings are about half silver and half mercury with maybe some tin and copper thrown in. Once mixed, those metals come together to form another substance. We place it in the tooth and it eventually hardens. There may be a very low level release of mercury vapor over time but the overwhelming majority of evidence is that it does little or no harm. Amalgam is easily placed, extremely hard, and no material, to date, will last as long especially if they are small fillings. Some disadvantages besides the mercury content are that amalgam fillings can turn black and become very unattractive. They can also absorb moisture and expand to the point where they can crack teeth. Eventually, all fillings will break down and leak, causing decay around the filling.

 

Many dentists use predominantly the tooth‐colored filling material called composite. This is a particle‐filled resin or plastic material that hardens when exposed to a certain wavelength of light. Composites are bonded to teeth which makes them very strong. And there are many kinds of composites. Some are harder, some are prettier, some are smoother. Unlike amalgam, composites are more difficult or tricky to place, but they have many advantages. Of course they are tooth‐colored. And because they are bonded to the tooth, a dentist takes less tooth structure away, thus preserving more healthy tooth. Also when bonding in composite, larger fillings can be placed without pins or posts that have the possibility of hurting the tooth. In general, resin‐bonded composites will help a tooth stay together as opposed to causing it to break apart. Historically though, composites do wear faster than amalgam, and again, they can be tricky to place.

 

Porcelain is another option. These fillings are made outside of the mouth and then bonded into the tooth. Porcelain is very pretty, very hard and can preserve tooth structure. But it is usually the most time consuming and expensive option. We might see more porcelain restorations in the future as more dental offices become equipped to make them “in‐house”. Of course things keep changing.

 

So, what’s in your mouth? Dr. Russell Marchese Jr. -- 585-343-2711. Like us on Facebook for more information.

Welcome to one of the harshest Februarys that we have ever had. But instead of talking about the weather, let's talk about Children's Dental Health Month. This month is special for me because I spend two different Fridays either treating kids at the U.B. Dental School or visiting classrooms in Batavia preaching good oral health habits.

 

Obviously, the most important habit a child can have is brushing well enough or for long enough. That's for all of us. Parents are the best "quality control" people for how well their kids are cleaning. In addition, parents of younger children should be helping them brush. A parent can clean more in 20 seconds than some children can clean in 20 minutes.

 

What a child (or adult) eats might not be as important as how it is eaten. We talk about constantly coating our teeth with sugary things and how harmful it can be to our teeth. Soda pop, sports drinks, fruit juice (especially in baby bottles), coffee with sugar can be the most harmful. "Nursing" these drinks or sipping them for long periods of time is when it hurts the most. I tell my patients that if they have to have a drink like those to "drink it right down" and be done with it. If one has to sip something, make it water--hot or cold. Water is so good for us anyway. Lollipops or any candy that stays in our mouth for long will cause cavities as well. Eat it and be done with it. Fruits and veggies are the most healthy snack substitutes.

 

Of course, the best "quality control" person for your child or for anyone is your dentist or hygienist. If your child has teeth then they should probably see a dentist. We urge parents of young children to bring their young kids with them at cleaning appointments if not just to get used to coming in but also for a quick usually cost free check up. Your dentist might feel the same.

 

So, kids (and adults!) eat carefully, clean well, and visit your dentist enough. Now, enjoy what's left of our Winter for Spring will come, eventually! Dr. Russell Marchese Jr. -- 585-343-2711. Like us on Facebook for more information.

Maybe you haven’t noticed, but dental insurance isn’t what it used to be. First of all, count your blessings if you have it at all, because fewer people have it now than 25 years ago. Secondly, insurance premiums have skyrocketed and dental benefits have not. And it is COMPLICATED!!! There are so many plans and each one is different. I can guarantee that the front desk people and office manager at your dental office are working hard to understand your plan and to maximize your benefits. What treatment does this plan cover? What’s not covered? What are my yearly maximums? My deductible or co‐pay? What are those and why do I have them? Does my dental office participate with this plan? Why does my plan say 100% covered and yet I still got a bill? It’s complicated. There is a link to our website and the answer to these questions and more if you are interested. 

Tooth loss leads to additional consequences which may only hurt one's health. Traditionally we have replaced teeth with removable dentures or possibly with fixed dentures which are cemented to adjacent teeth. When possible, there is now an even better alternative, dental implants.

 

Your typical dental implant is basically an artificial root made out of titanium and placed into the bone. That's it. On top of these artificial roots or implants we attach teeth. Most commonly we see one tooth replaced by one implant and the tooth or crown attached to it. Three teeth can easily be replaced with two implants and often we replace one's whole upper or lower teeth on top of as few as four or five implants. One can use just two implants and give a lower removable denture unbelievable stability and retention.

 

Patients worry about the discomfort involved with implant placement. The truth is that there is really no discomfort during placement and rarely any reported discomfort afterwards. Your dentist might suggest "mini implants" which are even easier to place. They are classified as "mini" only because they are smaller, but often "mini implants" work better for a particular patient especially when simply anchoring a denture.

 

Costs of implants have come down and even compare with traditional tooth replacement options. Most dentists offer implant treatment whether they place the implants themselves or refer to specialists for implant placement or they may do both as we do in our office. If you are missing a tooth or you'd like to replace a denture that you do not like or may not even wear, talk to your dentist. Dental implants can be a magical way to stay healthy!

 

Dr. Russell Marchese Jr. -- 585-343-2711. Like us on Facebook for more information.