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Tuesday, December 14, 2010

Dental Amalgam Dangerous? (Silver Fillings)

Once again, dental amalgam (silver filling) is in the news. Last week on NBC's Evening News with Brian Williams, they ran a story about the FDA's concerns about amalgam fillings and the possible risks of the mercury content.



Personally, I have not used silver amalgam in my practice since around 1994. I believe it is simply an inferior material to a well-placed bonded composite (white) filling. White fillings are the standard at Palm Beach Smiles (click to learn more).  The teeth in the photos below belong to my wife.  :-)




Silver amalgam starts off as a fine metal powder composed of silver, copper, and other metals which is mixed with a droplet of mercury. This forms a sort of paste which quickly hardens into a solid amalgam. Once hardened, the components are chemically locked together.

The concern is about the possibility of mercury release from those fillings in your mouth over time. There has been a LOT of controversy about this over literally 150 years. To date, no recognized scientific entity has determined that there are any negative health issues with amalgam fillings. And, I am inclined (so far) to believe that there are no real health issues with the mercury that is locked up in amalgam fillings. However, I am open to REAL scientific evidence to the contrary.

A far bigger source of mercury in our environment is from coal-burning electric plants that put tons of mercury in the atmosphere. That mercury ends up in the ground and water. You've probably heard about mercury concerns when it comes to eating fish.

Oddly enough, the government or regulatory bodies in some parts of the U.S. have deemed scrap amalgam as a hazardous waste. Meanwhile, some other government entities assure us it is safe for use in dentistry. So, it's against the law to put it in the garbage or landfills in some places. But, it's safe to put in your mouth? Things that make you go, "Hmmmmm."

Another thing that will make you go, "Hmmmm" is that the goverment is banning incandescent (traditional) light bulbs in favor of the so-called "green" compact fluorescent bulbs. Those are the "curly-cue" bulbs. And, they contain mercury. Click here to see what the EPA recommends if you drop and break one in your house! This is a clear illustration of the contradictory agendas we see, and it should definitely make you go, "hmmmmm."

Some countries around the world have restricted the use of amalgam. And, every so often, the notion of banning it in the United States comes up. And, so here we are again. I believe it will be banned eventually - possibly for the wrong reasons - But, it will be banned some day.

There are some valid concerns over banning it, however. Amalgam has some advantages over other materials. It's EASY to place. It's cheap. And, it WORKS.

By contrast, bonded composites require painstaking attention to detail to place them correctly. If meticulous technique is not used, they tend to fail catastrophically and quickly. They are more expensive in terms of material costs and time (to be meticulous). Most insurance plans do not pay for composite fillings. So, dentists who have patients depending on insurance will face financial concerns. Banning amalgam will put those people between the proverbial rock and a hard place.

Fortunately, in my practice, I simply haven't had those issues in the 16 years I've been "amalgam-free." I've cultivated a practice based on what I would do for my own family rather than cater to insurance executives' and shareholders' interests.

I do not advocate the wholesale replacement of amalgams in order to prevent or treat any medical condition. And, I won't until credible scientific evidence supports the notion. However, I do understand that some patients do not want them in their mouths for a variety of reasons, including cosmetic concerns. "Silver" fillings are really BLACK fillings.  And, who wants that? 

Stay tuned, as I believe this will be an ongoing issue. And, please visit us at www.PalmBeach-Smiles.com to keep up with what we're doing at Palm Beach Smiles.

Thursday, December 9, 2010

Don't listen to Dr. Oz about teeth whitening!

Recently, the famous TV doctor, Dr. Oz, blogged about natural dental "remedies." With all due (or not) respect to Dr. Oz, he is no more qualified to give advice on dentistry than I am an expert on cardio-thoracic surgery (his specialty).

The theme of his blog post was natural remedies to whiten teeth.

One of his suggested remedies was to eat raisins. The rationale is that raisins will stimulate salivary flow (true), rinsing away plaque (ummm.... baloney!). Raisins are classified as a "sticky sugar." Combine sticky sugars with plaque, and that's how you get cavities (tooth decay). The notion that saliva will rinse away the sticky bacterial mass that is "plaque" on your teeth is utter nonsense. The only way to remove plaque from your teeth is MECHANICALLY. That means brushing and flossing. Period!

Dr. Oz also suggested that the vitamin C in strawberries would "clear away plaque." Again... simply not true. Brush and floss. And, get a professional cleaning twice a year. There is no magic elixir, rinse, fruit, or berry that will "rinse" or "clear" away plaque.

So, he might as well have suggested eating Tootsie-Pops to "rinse away" your plaque. Tootsie-Pops will also stimulate salivary flow. But, like raisins, candy will cause decay if not eaten in moderation. And, I certainly would not recommend either (or any kind of sticky sugar) to do anything beneficial for your teeth. NOT AT ALL.

Dr. Oz's second, and even more frightening suggestion is to use a slurry mix of baking soda and lemon juice on your teeth to whiten them. Put simply... it's crazy! Lemon juice is acidic. And, it's not a little bit acidic. The pH is about 2. The pH scale goes from 0 to 14. The strongest acid is 0, where as the strongest base / alkali (opposite of acid) is a 14. Care to guess what the pH of Coca-cola is? It's about a 2! It's the same.

Now, let's add baking soda... an abrasive material. It's also a mildly basic material, which would cancel out some of the acidity of the lemon juice. That's why you'll see bubbles - a chemical reaction. But, I do not agree with the idea of putting an acid on your teeth in combination with an abrasive. It's a recipe for erosion of your enamel.

While Dr. Oz's blog suggests leaving it on for only 1 minute with the caveat that it's acidic and will dissolve enamel, it doesn't account for most people likely REPEATING this process over and over. And, over time... repeated (although short) applications of acid WILL ERODE THE ENAMEL. 100% certainty!

Please don't do this! Don't put acid on your teeth to whiten them. Don't get dental advice from non-dentists. Not medical doctors. Not podiatrists, optometrists, nurses, or veterinarians. Not even famous TV heart surgeons like Dr. Oz. I'm a doctor, too. But, I wouldn't suggest you ask me for advice about heart surgery.

The very idea that a celebrity heart surgeon like Dr. Oz would suggest a DESTRUCTIVE method to "whiten" your teeth in an effort to save a few hundred dollars (cost of professional and SAFE whitening) is stunningly ignorant and a danger to the public, in my opinion.

If you want to explore options on how to SAFELY and EFFECTIVELY whiten your teeth, click on the link in this sentence or please ask a DENTIST.

Stick to what you KNOW, Dr. Oz! Remember, "First do no harm." And, I promise I won't give out advice on how to save money with do-it-yourself heart surgery.