My youngest daughter has been cursed with bad teeth. She has had constant problems with cavities, root canals and extractions from age 13 or so (she’s now 21). She now has to go through another round of fillings and at least one extraction; the newest caries are underneath older metal fillings, and she has been told by her current dentist that one of the reasons for her problems is that the older amalgam fillings “just don’t last as long” as the newer porcelain or composite resins.
It’s been my understanding that the traditional mercury amalgam filling material has been shown to be the most durable and reliable filling material, questions of toxicity from mercury aside.
I suspect that her current dentist might be giving her advice slanted toward his own profit.
I wouldn’t ask for specific information on her condition here, I know that every individual case is different, but I would like to get a sense of what experts, with no monetary stake in her treatment, would recommend that she do. A second opinion would be great for sure, but a second opinion from whom?
A secondary question that I have: for those people that have “soft” teeth, are there any new technique(s) that can help guard against future problems, other than good dental hygiene, flossing, fluoride treatments, etc.?
I also seek advice from those of you who have “soft” teeth and experience these sorts of dental problems. Could you please share your experiences?
I have bad dental enamel as well. I have 2 crowns, which I think is a lot for a 24-year-old. Most of my fillings are the metal amalgam type, which I have been told by my dentist last longer than the resin kind.
The best advice I can give (since I’m not a dentist) is to make sure your daughter keeps track of what’s going on with her fillings. The root canal procedure I had done was due to an old filling which had separated from the tooth and allowed an infection to set in under it. I have another very old filling which I’m getting replaced tomorrow, since my dentist noticed that it was in bad shape and putting my tooth at risk.
The good news is, I don’t think I have any problems currently with new cavities–it’s the old ones that have fillings which are causing my current problems. So maybe it’s possible for these conditions to improve.
The problem with this is that most of the new composites (and porcelain replacements) for posterior placement barely have any track record. Several new products, or improved versions of really-not-that-old products, are introduced each year. They may have a year of use in very controlled settings before they are released for sale. Much of the clinical data comes after the release.
If the dentist is talking porcelain, he most likely is referring to pressed composite/leucite crowns, inlays and onlays. Porcelain by itself just doesn’t hold up well under the forces generated by chewing and grinding; it’s too brittle unless backed by a rigid substrate. (We do like porcelain fused to gold for crowns.) These newer materials are very aesthetic and we’ve used some with lovely results. How long they will last we can’t say. Many of these materials were introduced within the past 5 years. The one we use most frequently hit the market in 1997.
Amalgam has decades of clinical data. It is very strong and holds up quite well under chewing forces. We will use amalgam for a filling that my employer considers too big for composite. Sensitivity is still an issue with deep composites. Margin wear on occlusal surfaces can be greater for composites than amalgam. That’s not as big a problem with the newer micro-filled formulas, but then we’re back to materials with little track record. If the cavity is that big and the patient doesn’t want amalgam, the recommended restoration will be a crown. That may change in a few years, as more data comes in for the composites.
I don’t have “Soft Teeth”, but I have lots of dental experience.
A procedure she may want to look into that will drastically help reduce the incidence of cavities is having her teeth sealed. It is basically a plastic compound (I think)that is melted into the crevaces of one’s tooth or teeth. It keeps out the stuff that causes cavities. I have never had a cavitiy in my life, and I’m sure that having my molars sealed has been instrumental in making this possible for me.