Q: I have a terrible fear of going to the dentist yet I know I need to. What should I do?
If you fear going to the dentist, you are not alone. Between 9% and 15% of Americans state they avoid going to the dentist because of anxiety or fear. The first thing you should do is talk with your dentist. In fact, if your dentist doesn’t take your fear seriously, find another dentist.
The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable.
The good news is that today there are a number of strategies that can be used to help reduce fear, anxiety, and pain. These strategies include use of medications (to either numb the treatment area or sedatives or anesthesia to help you relax), use of lasers instead of the traditional drill for removing decay, application of a variety of mind/body pain and anxiety-reducing techniques (such as guided imagery, biofeedback, deep breathing, acupuncture, and other mental health therapies), and perhaps even visits to a dentophobia clinic or a support group.
Q: How do whitening toothpastes work and how effective are they?
All toothpastes help remove surface stains through the action of mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth.
None of the home use whitening toothpastes can come even close to producing the bleaching effect you get from your dentist’s office through chair-side bleaching or power bleaching. Whitening toothpastes can lighten your tooth’s color by about one shade. In contrast, light-activated whitening conducted in your dentist’s office can make your teeth three to eight shades lighter.
Q: What’s the latest word on the safety of amalgam-type fillings?
Over the past several years, concerns have been raised about silver-colored fillings, otherwise called amalgams. Because amalgams contain the toxic substance mercury, some people think that they are responsible for causing a number of diseases, including autism, Alzheimer’s disease, and multiple sclerosis.
The American Dental Association (ADA), the FDA, and numerous public health agencies say amalgams are safe, and that any link between mercury-based fillings and disease is unfounded. The cause of autism, Alzheimer’s disease, and multiple sclerosis remains unknown. Additionally, there is no solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will be cured of these or any other diseases.
In March of 2002, the FDA reconfirmed the safety of amalgams. Although amalgams do contain mercury, when they are mixed with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for more than 100 years to fill and preserve hundreds of millions of decayed teeth. The National Institutes of Health conducted several large-scale studies that concluded in 2006 that amalgam fillings were safe.
In addition, there has been concern over the release of a small amount of mercury vapor from these fillings, but according to the ADA, there is no scientific evidence that this small amount results in adverse health effects.
Q: When will drill-less dentistry become a reality?
Drill-less dentistry, also called air abrasion and microabrasion, is being offered by some dentists now. Air abrasion can be used to remove tooth decay, to remove some old composite restorations, to prepare a tooth surface for bonding or sealants, and to remove superficial stains and discolorations. The air abrasion instrument works like a mini sandblaster to spray away the decay, stain, or to prepare the tooth surface for bonding or sealant application.
With air abrasion, a fine stream of particles is aimed at the tooth surface. These particles are made of silica, aluminum oxide, or a baking soda mixture and are propelled toward the tooth surface by compressed air or a gas that runs through the dental handpiece. Small particles of decay, stain, etc., on the tooth surface are removed as the stream of particles strikes them. The remnant particles are then “suctioned” away.
Q: What are dental sealants, who should get them, and how long do they last?
Sealants are a thin, plastic coating that is painted on the chewing surfaces of teeth — usually the back teeth (the premolars, and molars) — to prevent tooth decay. The painted on liquid sealant quickly bonds into the depressions and groves of the teeth forming a protective shield over the enamel of each tooth.
Typically, children should get sealants on their permanent molars and premolars as soon as these teeth come in. In this way, the dental sealants can protect the teeth through the cavity-prone years of ages 6 to 14. However, adults without decay or fillings in their molars can also benefit from sealants.
Sealants can protect the teeth from decay for up to 10 years, but they need to be checked for chipping or wear at regular dental check-ups.
Q: How safe are dental X-rays?
Exposure to all sources of radiation — including the sun, minerals in the soil, appliances in your home, and dental X-rays — can damage the body’s tissues and cells and can lead to the development of cancer in some instances. Fortunately, the dose of radiation you are exposed to during the taking of X-rays is extremely small.
Advances in dentistry over the years have lead to the low radiation levels emitted by today’s X-rays. Some of the improvements are new digital X-ray machines that limit the radiation beam to the small area being X-rayed, higher speed X-ray films that require shorter exposure time compared with older film speeds to get the same results, and the use of film holders that keep the film in place in the mouth (which prevents the film from slipping and the need for repeat X-rays and additional radiation exposure).
Also, the use of lead-lined, full-body aprons protects the body from stray radiation (though this is almost nonexistent with the modern dental X-ray machines.) In addition, federal law requires that X-ray machines be checked for accuracy and safety every two years, with some states requiring more frequent checks.
Even with these advancements in safety, it should be kept in mind, however, that the effects of radiation are added together over a lifetime. So every little bit of radiation you receive from all sources counts.