Modern tooth repair options

HISTORICALLY SPEAKING: Last week I talked a bit about tooth decay and the impact it can have on our teeth. Today I would like to mention some of the modern options for repairing and restoring teeth that have been broken down by tooth decay. In the past, we typically would fill back teeth with mercury amalgam fillings which are very durable, but offer no strength to the tooth. Mercury is also known to be a neuro-toxin and its safety has been debated for over a hundred years. Some claim that in the form of an "amalgam", the mercury is bound and safe. Some studies done in the past seem to show otherwise, that mercury vapor is released from the fillings in small quantities for years, and that traces of mercury can be found in various body tissues and organs. Other options which eliminated the mercury question included gold restorations ... these have been considered the standard against which to measure other options. Gold was usually costly compared to the amalgam fillings and therefore amalgam was often the restorative material of choice. In the '60's the ability to bond filling material to tooth structure was developed. At that time dentistry and medicine focused on amputation, or removing body tissue in order to repair a problem (surgery). Today the focus is on Augmentation. Our goal is to preserve as much healthy body tissue as possible and add back what is missing. This is true of both medicine and dentistry. Dental technology has advanced by leaps and bounds since then, but the discovery of bonding has changed the course and face of dentistry. PROPERTIES OF AN IDEAL RESTORATIVE MATERIAL: Research is always being conducted to improve dental materials and make them more ideal. Some desirable properties of restorative materials would be:1) Durable and functional 2) bond to tooth structure - thereby strengthens tooth 3) ability to seal the tooth with the filling 4) conservative preparation - ability to preserve tooth structure 5) esthetic i.e. looks like a tooth 6)Bio-compatible - does not harm us to have the material in our mouths. Bonded restorations are able to deliver these requirements. We can bonded resin based filling materials and porcelain restorations to tooth structure. These are such things as tooth coloured fillings, porcelain or resin-based onlays, porcelain veneers, and porcelain or resin-based inlays. All-ceramic crowns can also be bonded to tooth which seals the tooth and creates a durable bonded to tooth which in turn strengthens the crown. With modern dental materials and techniques it is possible to create beautiful, long lasting, health-supporting, smiles. This is by no means exhaustive but rather intended to let you know some of the possibilities that are available. Until next time I sign off sincerely, Dr. Marty Frankel 5775 Yonge Street, suite 1000 Toronto, Ont. 416-770-8526