Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Do White Fillings Cause Pain?

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I’m having a problem with my new white fillings. I wanted white fillings after seeing how great my wife’s looked, but my dentist seemed reluctant. A week ago, I had two done but now have constant aching on that side of my mouth. My dentist did warn me about the possibility of infection from saliva and wasn’t 100% on board with doing the white fillings. The procedure was painful, and now I have this constant aching. I am wondering if this will clear up on its own, or should I go back in? I have been using Advil for the pain. I’m not sure I want to call this dentist back. What would you recommend?

Dave D. from Illinois

Dave,

This is something you have to be very careful with—asking your dentist to do some procedure that they haven’t suggested. What happens is that your dentist may not be comfortable doing that procedure, but doesn’t want to say that. When you think about it, that’s an understandable approach. Dentists are taught in school that they need to approach their patients with confidence to minimize the patient’s anxiety. So to respond to you, they go outside their comfort zone and don’t share the discomfort with you.

From what you’ve told me, it appears that your dentist wasn’t familiar with the proper procedures for doing white fillings. I’m saying that because of how he or she tried to discourage you from doing the white fillings. When white fillings are done properly, there is no contamination from saliva. When dentists know how to do them properly, they much prefer the white fillings to the old silver/mercury amalgam fillings.

Here are some possible causes for the pain you are feeling after these new white fillings:

  • As your dentist explained, the cavity could be contaminated with saliva during the filling procedure.
  • The filling wasn’t properly bonded to the tooth for other reasons.
  • The filling material wasn’t completely cured.
  • The filling material was inserted in bulk and cured in one piece, causing it to shrink and put stress on the tooth.

I always recommend that if your dentist is reluctant to do something, it’s not a good idea to push them. Instead, it’s best to find a dentist that is comfortable with the procedure and has the training. Often dentists like this will mention on the website that they are a mercury-free dentist.

I would recommend that you have the fillings replaced by a dentist that knows how to do them properly. The problem is that if there was contamination during the bonding process, the bacteria was allowed in the little tubules of the dentin of your teeth. The filling is also not sealed against continual contamination and further problems. This could lead to further harming your teeth. Most dental insurance won’t cover replacing recently placed fillings, but I would highly recommend doing it anyway.

Best of Luck!

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Dentist Insists on Expensive Treatments

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I am not sure what to do. My dentist is insisting I get a white filling. He says he’s what’s called a mercury-free dentist and that the silver fillings aren’t good for my teeth. The problem is, my insurance doesn’t cover the white fillings. It just covers the silver ones. I can’t afford the others. What do you recommend?

Pam

Dear Pam,

Left: silver filling Right: White filling

An affordable dentist doesn’t insist on expensive procedures

So there are a few things at play here. Many dentists have switched to a mercury-free practice. Some of it is because of patient demand and some of it is because of the strong belief that the silver fillings are bad for both you or your teeth.

While the American Dental Association (ADA) has declared the silver fillings safe, that doesn’t mean they’re the best fillings for your teeth. What your dentist means by them being bad for your teeth is that the amalgam fillings actually weaken your tooth structure. The white fillings will strengthen them.

I realize your insurance doesn’t cover those. While it’s unfair of a dentist to insist on a procedure a patient can’t afford, even if it’s a superior treatment. If he’s a mercury-free dentist, he doesn’t even offer the other filling. He wouldn’t be able to provide it for you.

You have a couple of options here. First, you can stay with this dentist and ask him to bill your insurance for the silver filling and just let you pay him the difference if that’s possible for you. Your dentist may even be willing to allow you to pay out the difference.

Finding an Affordable Dentist

If your dentist is unwilling to work with you in any way, then you’ll need to find a different dentist. There are affordable dentists out there.

I’d simply do an internet search using the term affordable dentist and make a list of several of the practitioners whose names pop up. Be sure to check their reviews to make sure they have a pleasant chairside manner. It’s no fun to have a dentist who’s a complete jerk.

Also, be careful not to confuse cheap care with affordable care. A cheap dentist is significantly lower in price than his peers. But, that ‘s usually because he’s either bad at his job or he cuts corners in order to make up profits.

Both of those things end up hurting the patient. Usually, it results in either an infection or a failed procedure which has to be redone, costing double or even triple.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Is It Possible My Tooth Gap Will Close?

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I’m seventeen years old. My teeth are completely straight and healthy except for a small gap between my front teeth. I know that I’ve kind of lucked out in the teeth department but the small gap between the two front teeth really bugs me. My wisdom teeth still haven’t come in. Is there a possibility when they do come in it will push the gap closed? If not, is there something I can do to close it that doesn’t include a mouth full of metal?

Amanda P.

Dear Amanda,

While it is possible that the eruption of your wisdom teeth could shift your top arch and close the gap, there are also a few things that could keep that from happening.

First, the gap could be too large. That may mean that your teeth shift, but not enough to close the gap completely.

Second, there is a small piece of tissue in between your two front teeth which is known as a frenum. Most people who have a gap between their teeth, the frenum is the cause. In some patients, the frenum is so large they need to have it removed so that the gap can be closed with orthodontics.

impacted wisdom teeth

Third, not everyone’s wisdom teeth come in straight. If they do, great. But, many patients have to have their wisdom teeth removed because they end up impacted. If that’s the case with your wisdom teeth, they won’t be available to push your diastema (tooth gap) closed. The above image shows you what impacted wisdom teeth can look like.

If it happens that you aren’t able to use your wisdom teeth to shift everything, there’s still hope. And, it won’t require a mouth full of metal.

You could use Invisalign. These are invisible aligners that can close the gap for you in a more effective and comfortable way than traditional braces.

If you don’t want to use orthodontics at all, you can go the cosmetic route. The simplest procedure is to have dental bonding done by a good cosmetic dentist. It uses composite material, similar to what you’d find with white fillings to fill in the gap. You want an experienced cosmetic dentist in order to ensure they’ll be able to make it look natural.

I hope this helps.
This blog is brought to you by Dr. Ryan Noah.

Can Children Get White Fillings?

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I went to a pediatric dentist who said children can’t get white fillings, but I have a friend who gets them for her children. Is my dentist right or hers?

Pamela M.

Dear Pamela,

It’s not a right or wrong as much as what the individual dentist is comfortable doing. If your pediatric dentist isn’t comfortable giving white fillings to children, don’t press it. The results won’t be good, neither will your child’s experience. It’s better you go to a dentist familiar with placing them on children.

One word of caution. They do require the patient to be perfectly still. If the white filling doesn’t stay dry, the bond won’t hold. For that reason many dentists who place white fillings on children will suggest you get nitrous oxide.

Nitrous oxide is perfectly safe. Dubbed laughing gas, it will relax your child. In fact, a friend of mine just took her child in for six white fillings. She opted for the nitrous with him, even though he’s a compliant child. He’d need six shots of lidocaine and she wanted him to be as relaxed as possible. He ended up so relaxed he actually slept through half the procedure.

The key will be to find a dentist who’s done this procedure with children that you’re both comfortable with.

This blog is brought to you by Dr. Ryan Noah.

Did my filling cause the rash on my face?

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I recently had a silver filling placed on one of my back teeth to repair a broken tooth. Now I’m dealing with this itchy red rash on my face, right where the broken tooth was. There also seems to be a round circle on my face. Is this cause for concern, maybe an allergic reaction of some kind? I am supposed to get a crown on the tooth in a month and I’m worried.

– Sherry from South Carolina

Sherry,

Based on the procedures you have had done and what you described, it is unlikely that the rash and circle on your face was caused by the filling. When individuals are allergic to materials used in the filling, it is typical to see a reaction on the inside of the mouth. For example, the gum tissue that actually comes in contact with the filling may become irritated.

In regard to the silver filling or what is called an amalgam filling, they are actually made up of more than half of mercury. They also contain slightly less than half of silver, copper, and tin, as well as some other materials. Some people are concerned over the potential health concerns with having mercury placed in their mouths. That said, I am not familiar with a case where the amalgam caused a rash on the face.

If it was right after your dental appointment that the rash occurred, it may have been the use of the latex gloves that your dentist used.

This post is sponsored by Tulsa dentist Region Dental.

Related links: mercury-free dentist, white fillings, emergency dentist