Q. I have some old silver fillings which are beginning to look bad. What can be done to improve them? 

A.Silver amalgam fillings, which are composed of 50% mercury and 50% silver alloy ,eventually need to be replaced. It may surprise you to know that the average life span of a silver filling is five to eight years. Your dentist can tell you when they appear to NEED to be replaced due to leakage, breakdown or recurrent decay.

If your concern is strictly COSMETIC, there are many new methods available to replace the fillings with beautiful, functional long lasting restorations.
Such things as white filling materials, porcelain inlays , crowns and veneers may be used to give you the smile you are seeking.

There is currently a great deal of interest in new reinforced hybrid materials. These beautiful resin materials may be reinforced with fibers, similar to fiberglass, and used in very conservative inlays and bridges without having to grind away a whole healthy tooth.

Q. I am missing several teeth. A friend told me that she recently had implants to replace her missing teeth and is very happy. What are implants?

A.Dental implants are a wonderful way to replace missing teeth when certain conditions exist. Such things as your overall general health and the length of time you have been missing your teeth must be considered. The replacement of missing teeth using dental implants frequently requires a team approach.

After your dentist does a thorough examination and treatment plan the surgical phase of treatment takes place. In most cases a periodontist or an oral surgeon will put the implant(s), the artificial root(s) into the jaw. When healing is complete, usually after 4-6 months, The tooth or bridge segment can be placed on top of the healed implants by a general dentist or a prosthodontist . Some dentists are trained to place the surgical part of the implant as well as the prosthetic or tooth part.

You should ask your dentist if you are a good candidate for implants and ask for a referral if he or she doesn't do them.

Q. There are so many different toothbrushes on the market today. How do I know which one is the right one for me?

A.This is a good question, which we hear daily. The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head and how frequently you replace your brush.

We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums.Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose.

We recommend replacing your brush at least once a month. One should brush, on average, 5 times a day. We brush first thing in the morning, after each meal and at the end of the day . If you are not able to do this because of your busy schedule, we recommend brushing twice a day at a bare minimum.

Q. When I visited my dentist for my last checkup, she told me that I have impacted wisdom teeth and she wants to remove them. They are not bothering me. Should I see a specialist if I decide to have them removed? What should I do?

A.Having regular dental checkups with x-rays allows you to learn about potential problems and have them corrected BEFORE they begin to bother you. There are a number of reasons for recommending removal of unerupted or impacted teeth. Your dentist may have seen that these teeth could cause problems for the adjacent teeth if left in place. There is also the possibility that you could develop such things as a cyst or abscess if left in place.

General dentists who provide any specialty service such as root canal treatment, braces, oral surgery or periodontal surgery are required by law to adhere to the same standard of care provided by a specialist Your dentist should be happy to talk more with you about this. If you still have questions, you might want to see another dentist for a second opinion.