Patient Information

Amalgam and Composites

If you have tooth decay and your dentist recommends a filling, should you choose a white (composite) filling, or a silver (amalgam) filling?

First, if the filling will show when you smile, go for the white. It may not last quite as long as the amalgam, but it looks more attractive, and it should last for several years. You should be aware that almost all insurance companies will only pay for silver fillings on molars and pre-molars, and the cost for composites is generally higher than for amalgams.

Although it is the patient's choice to have the white composite fillings and pay the extra fee, we generally recommend silver fillings on rear teeth. There's a lot of misinformation about filling materials, particularly from the same people who recommend against vaccinating your children. Amalgam is an alloy of mercury, silver, and other trace minerals; large well-regulated studies have failed to find any link between amalgam restorations and any medical disorder. We have an amalgam separator that keeps any residual mercury from going into the water system.

The American Dental Association cautions that for a dentist to recommend removing silver amalgam fillings from the non-allergic patient for the alleged purpose of removing toxic substances from the body, when such treatment is performed solely at the recommendation or suggestion of the dentist, is improper and unethical. The main symptom for such removal is a green discharge from the wallet!

Teeth Bleaching

Bleaching lets everyone have the same bright white smile that used to set celebrities apart. If your teeth look yellow either because of age or genetics, there are different methods that can brighten them up. According to the American Dental Association, whiteners may not correct all types of discoloration. For example, yellowish hued teeth will probably bleach well, brownish-colored teeth may bleach less well, and grayish-hued teeth may not bleach well at all. If you have had bonding or tooth-colored fillings placed in your front teeth the whitener will not affect the color of these materials, and they may stand out in your newly whitened smile.

Here are some options to whiten your teeth:

  • Whitening toothpastes. All toothpastes help remove surface stain through the action of mild abrasives. "Whitening" toothpastes have special chemical or polishing agents that provide additional stain removal effectiveness; however, they do not change the color of teeth because they can only remove stains on the surface.
  • Over-the-counter whitening strips and gels, tray-based whiteners, and mouth rinses. These work better because they are peroxide-based. Instructions and results vary with the product. Initial results are seen in a few days and final results are sustained for about four months.
  • In-office bleaching. The whitening product is applied directly to the teeth, and then used in combination with a special laser light. To achieve good results, several appointments are needed. This is the most expensive technique. Our office purchased the equipment necessary to do this procedure, but we feel the cost to the patient is too high and the result is underwhelming, so we do not personally recommend it.
  • Custom trays made in the dental office. Peroxide-containing whiteners actually bleach the tooth enamel. They come in a gel and are placed in a custom-made mouthguard that will last for many years. Initially you use the trays for 20 minutes a day for 10 days, and may repeat when necessary (some use them every two or three years thereafter).

Please call our office at (503) 873-8335 and schedule an appointment.

Tooth Loss in Adults

Did you know that the leading cause of tooth loss in adults is not decay, but gum disease? If you don't like to brush your teeth because "it makes your gums bleed," you are in danger of losing your teeth. If the tissues that support the teeth become infected, the supporting tissues break down, and pockets develop around the teeth. No matter how "strong" your teeth are, the supporting tissues may be badly infected.

Daily brushing and flossing, visiting your dentist regularly, and eating fruits, vegetables, cheese and other healthy foods help prevent gum disease, but there are factors that can increase the risk. If you smoke or chew tobacco, have diabetes, are pregnant, or are on certain types of medications, you are at greater risk of developing periodontitis.

Look for the warning signs: gums that bleed easily; red, swollen tender gums; persistent bad breath or bad taste in your mouth; gums that have pulled away from the teeth, or teeth that seem to feel loose. If you have any of these signs, call your dentist and come in for an appointment.

Did you know that Silverton's City water is Fluoridated?

Fluoride is a mineral that occurs naturally in all water sources, but less in Oregon than in some other states. Fluoride is effective in preventing and reversing the early signs of tooth decay by making the tooth structure stronger, so teeth are more resistant to acid attacks. Acid is formed when the bacteria in plaque break down sugars and carbohydrates from the diet. Repeated acid attacks break down the tooth, which causes cavities. Fluoride also acts to repair, or remineralize, areas in which acid attacks have already begun.

It is due to the efforts of Dr. Wayne Feller that Silverton's city water is fluoridated, and because of that, tooth decay in Silverton has been reduced dramatically. Many people continue to be misinformed about fluoride and fluoridation: fluoride is like any other nutrient, it is safe and effective when used appropriately. The fluoride ion comes from the element fluorine. Fluorine is never encountered in its free state in nature. It exists only in combination with other elements as a fluoride compound (just as salt is a compound of sodium and chloride).

If your water source is a private well or if you chiefly rely on bottled water, it is unlikely that you and your children are receiving the optimal level of fluoride; also, home water treatment systems can reduce the fluoride levels in water supplies.

Fluoride is obtained in two forms: topical and systemic. Topical fluorides (toothpastes, mouth rinses and professionally applied fluoride therapies) strengthen teeth already present in the mouth making them more decay-resistant. Systemic fluoride becomes incorporated into forming tooth structures, and includes water fluoridation or prescription dietary fluoride supplements in the form of tablets or drops.

No matter how you get fluoride you can be confident that fluoride is silently at work fighting decay. Safe, convenient, effective, fluoride fits naturally into any dental care program.

Dental Health for Senior Adults

The unique dental needs and challenges of senior adults include a vital connection between a healthy body and a healthy mouth. If you want to feel good, stay healthy, and look great throughout life, you might be surprised what a difference a healthy mouth makes. By adopting healthy oral habits at home, making smart choices about diet and lifestyle, and seeking regular dental care, you can help your teeth last a lifetime.

As you know, your teeth are important for speaking, chewing, smiling, and appearance. Whether you have your natural teeth, implants, or wear dentures, the following are important reminders:

  • Brushing and flossing your teeth is just as important now as it was when you were a child. Brush your teeth twice a day with a toothbrush with soft bristles that you replace every three to four months. Clean between teeth daily with floss or other interdental cleaners such as picks or brushes. An electric toothbrush helps if it's difficult to reach the back of your mouth.
  • Bacteria stick to your teeth and also to full or partial dentures. If you wear dentures, remember to clean them on a daily basis. Take your dentures out of your mouth for at least four hours every day. It's best to remove your full or partial dentures at night. To stay healthy, the lining of your mouth needs to rejuvenate after prolonged contact with dentures. Use denture cleaning products like denture cleansers and overnight soaking solutions to help keep dentures fresh and clean.
  • Consuming fluoridated water throughout life helps prevent tooth decay no matter how old you are. Thanks to Dr. Wayne Feller, Silverton's tap water is fluoridated.
  • Smoking and tobacco chewing increase problems with gum disease, tooth decay and tooth loss. Either one also affects healing after dental procedures, and the retention of dental implants. There are tobacco cessation programs, over-the counter products and prescription medications to help quit tobacco use.
  • Some medications cause dry mouth that greatly increase the environment for cavities.
  • It's important to have regular dental checkups and cleanings, and to keep your medical health history updated at your dental office.

Dr. Carter would be happy to discuss all areas of your dental health with you. Please call for an appointment.