amalgam While the majority of dentists now use mercury-free composite fillings, some continue to use dental amalgam, also known as "silver fillings". Over the years, concerns have been raised about the use of amalgam because it contains mercury. Here are answers to some common patient questions about dental fillings.
What is in a mercury-metal filling?
Metal Fillings are composed of mercury, tin, silver (not much), and copper.  The actual mercury content is between 43 and 54% mercury when placed.  They are not chemically bonded to the tooth as tooth colored, or composite, filling material is.  It is the consistency of wet sand when it is placed in a tooth and is only held in by undercutting the tooth structure so it is wedged into place.  As time goes by, the filling breaks down in three ways:
  1. The release of mercury vapor in the mouth lessens the strength, longevity, and resilience of the filling.
  2. Corrosion of the surface of the filling due to the persistently wet environment.  This process is similar to rusting iron.
  3. Attrition of the surface and edges of the filling from eating, clinching, and grinding cause the edges to be tattered and irregular, causing food traps.
How do mercury-metal fillings work?
When a tooth is prepared mercury-metal filling, healthy portions of the tooth are undercut in order for the filling to stay in the tooth.  Essentially, it relies on mechanical retention (it is wedged into place), rather than having a chemical bond and seal to the tooth such as with a tooth colored, or composite) filling.
[caption id="attachment_1586" align="aligncenter" width="584"]sandwich-1 What you can't see: decay often occurs underneath amalgam fillings, and it doesn't always present on x-rays. By removing "silver fillings" and replacing with white composite resin, your dentist will accurately assess any future damage and treat with tiny fillings versus more indepth restorations like crowns, root canals, and/or dental implants.[/caption]
How do these metals affect the tooth?
Metal mercury fillings, without exception, microscopically expand and contract over time (just as mercury does in a thermometer).  This causes the enamel of the tooth to fracture over time.  Enamel fracture leads to tooth fracture.  The more damaged a tooth is, the more expensive it is to repair.  The expansion and contraction compromises the seal between the filling and the tooth, allowing cavity causing bacteria to colonize the area below the surface of the filling between the filling and the tooth, eventually causing new cavities.
Cavities beside metal fillings likely grow more slowly than some others because the metals in the filling kill bacteria through exposure.  But eventually, the bacteria grow in number enough to overpower the effects of the metals.  These new cavities are often difficult to recognize on routine dental x-rays because the metal distorts the view immediately around the filling.  But if the margin of the filling is not smooth and perfect, then the cavity forming process has already begun.  The new cavities develop over time, possibly causing the tooth the break or facilitating the need for a Root Canal Procedure or an Extraction.
How do metal filings affect your body and overall health?
It has been demonstrated through extensive studies that the amount of mercury released from fillings each day is considerably lower than the amount normally absorbed from the rest of our environmental sources including air, water, and foods.  Other studies have demonstrated safety for patients and dental professionals in the removal of amalgam fillings.
[caption id="attachment_1590" align="aligncenter" width="950"]Amalgam v/s Composite Fillngs Amalgam v/s Composite Fillngs[/caption]
What do we believe?
We do not believe profound evidence exists showing the mercury is affecting the overall health of most of the individuals who have them. We also find it compelling that if you could actually suffer through reading all of the metal filling related regulations, according to the FDA, EPA, ADA, state governments, and local municipalities, there are only two places where it is acceptable for metal-mercury filling material to exist; Hazardous Waste Disposal, and your mouth. Think about that.
However, we do know with certainty that the amalgams are incredibly detrimental to the health of the tooth.  So generally, we believe that if metal fillings are present, they should be removed and replaced with a restoration, porcelain or composite, which will restore the strength of the tooth to last in the long term.   BOTTOM LINE:  we remove amalgam fillings because we know (with 99% accuracy) that if the margins are not sealed and they are of a certain age, there is decay destroying the tooth structure below the filling.
It's that time of year again! Screen-Shot-2014-10-28-at-9.07.57-AM.png For the fifth year in a row, we are teaming to support The Second Harvest Food Bank of Middle Tennessee and help fight hunger. Screen Shot 2014-10-28 at 9.08.41 AM The need for donations is real! Did you know that 1 in 6 Tennesseeans struggle with hunger and at least 25% of children in Tennessee are food insecure? But working together we can make a real difference. Last year alone we collected over 1000 non-perishable food items that helped feed many of your neighbors here in middle Tennessee. We were, quite literally, TRIPPING over your GENEROUS donations for weeks! Trippin In exchange for helping us feed the hungry we are offering FREE CUSTOM FIT BLEACHING TRAYS! Just bring in 30 non-perishable food items during the month of November and we will schedule you for an appointment to have your custom fit trays fabricated. If you already have the trays, bring in 15 items and we will restock your bleach. To provide optimal bleaching results and ensure that prescription bleaching methods are a safe and effective option for you, an exam and recent cleaning are required. Give us a call for further details. Please pass the word along to your friends, family, and coworkers! We look forward to seeing you soon!
[caption id="attachment_1546" align="aligncenter" width="650"]photo: Pinterest photo: Pinterest[/caption]

A little selfie-consciousness may be good

One recent study was conducted by NIH-funded researcher Dr. Lance Vernon (Senior instructor, Case Western Reserve University) three dentists from India, another researcher from the United States. They examined the feasibility of using smart phone video “selfies” to help improve toothbrushing technique. The small proof-of-concept study aimed to determine whether toothbrushing with selfie-taking was worth further study. As part of the study, Indian dental students were given a one-time toothbrushing training session. Then over two weeks, they recorded – on their phones in the privacy of their own home – five toothbrushing selfies. Later, the dentist researchers from India reviewed and characterized the selfies. With further analyses from my US colleague, we found some changes and variation over time in the quality and accuracy of toothbrushing. These changes may suggest that participants were trying to create a new habit, trying to change their behavior, almost as if, while taking the selfie, someone was watching them. The thought was that by using selfies, participants were more self-conscious about changing their ingrained toothbrushing approach and so may have been better able to “override” their habitual way of brushing. Also, the participants may have had more fun or been more curious about doing a sometimes mundane task. Habits are hard to change. One needs to overcome “muscle memory” to establish a new behavior. So relearning or retraining, just as with any sports-related skill, may be a gradual process, one prone to trial, error, forgetting and relapse. Some of our data might generally support this. But, based on the pilot study, it seems like adding the selfie to the mix could help people learn, well, new tricks. While it was a very a preliminary study, it opened a door. But keep in mind, it’s not just the taking of the selfie alone. Patients will need to review the selfies with their dentist or dental hygienist to get tips on how to improve and on the most important things to work on. Over time, this new, more effective brushing style could become your default habit. But then, you may need another selfie every so often, to make sure that the patient was not slipping back into old habits. An application of the toothbrushing selfie is that technology could be used to evaluate, monitor and permit providers to give real-time, convenient oral hygiene feedback to people across periods of time. This can help put a greater emphasis on prevention, which, at a minimum, should promote good dental checkups and could help keep costs down. Show us your toothbrushing selfies! We would gladly want to see them. READ MORE ABOUT THE STUDY
The September 2016 Nashville Lifestyles Magazine issue celebrates Nashville's TOP DENTISTS, and we're happy for Dr. Clark to be included in that stellar list! Dr. Daron Clark: Nashville Top Dentist 2016 Screen Shot 2016-09-06 at 9.30.59 AM  
We were recently reading a Spear Digest post by Imtiaz Manji where contributor Dr. Gary DeWood stated, “remember, dental insurance doesn’t exist.” What does this mean, considering all the energy and resources the average practice devotes to working with patients’ dental plans, dental insurance sure feels like a reality to most dentists? The point Gary is making is that dental insurance is quite simply not insurance, in the true sense of the word. It’s not like home insurance or auto insurance, where you pay a premium in exchange for blanket coverage in the event of losses or expenses. If dental insurance were really insurance, patients would submit their claims for all necessary work that needed to be done and be fully reimbursed (minus an agreed-upon deductible). But that’s not how dental plans work. What dental plans offer are benefits – a limited allowance to go towards funding dental care costs, which is a different thing. These are indeed useful and valuable benefits to patients and it is perfectly understandable that dental practices would want to help patients manage and maximize their benefits. But it is also important that patients are not fooled by the term “insurance” to the point where they have false expectations. The best advice seems that dental practices should not use the word “coverage” when talking about dental plan benefits. Similarly, we in the dental community, as Gary keeps reminding us, should stop thinking in terms of “insurance.” That’s a word that dental plan providers use. It’s a mindset trap, one we should not fall into. Great dentistry comes at a cost. If that cost can be offset by a patient's benefit plan, great. But we can’t allow ourselves – or patients – to let these allowances govern treatment decisions. Because that’s what they are: allowances, benefits, economic supplements. It is not insurance. Because dental insurance does not exist. source: Spear Education
When teeth and jaw are improperly aligned, it can cause straining of the muscles that support the face, neck and back. It is this muscle imbalance that causes much of the pain associated with TMJ disorders. In most cases, TMJ disorders stem from a condition called malocclusion, which means having a “bad bite”, or from accidents and trauma. Malocclusion means that your upper and lower teeth do not close together in the correct way—they are misaligned. As a qualified neuromuscular dentist, Dr. Clark can follow up on any TMD diagnosis and give you customized TMD treatment. https://www.youtube.com/watch?v=ZrEeopiE6aQ  
There is a genetic code that determines your eye color, tooth size, and a lot of other information about how your face should look. However, not all faces develop in the same way, and there are key external factors that make a face both structurally sound and aesthetically balanced. https://www.youtube.com/watch?v=GnJjvjgyDfU  
Physiologic dentistry is a comprehensive view of oral health, balance, and beauty:  it's making sure that the shape and position of the teeth and jaw support natural pain-free function.  The teeth, jaw joint, and the muscles that support them must all be balanced or the system will break down over time.  Symptoms of an unbalanced bite show up in many ways:
  • clenching and grinding
  • TMJ/TMD symptoms
  • headaches
  • vertigo/motion sickness
  • tinnitus
  • airway obstructions
  • gum recession
  • chipped and broken teeth
  • many more!
But physiologic dentistry is more than just health and wellness....when the underlying facial structures of the teeth and jaw are balanced, the result is a beautiful natural smile and more youthful facial features! Being able to offer our patients their healthiest and most beautiful smiles requires having a thorough understanding of what is necessary to create symmetry and balance. It’s basically Anatomy 101: the lower half of your head is a complicated, condensed network of bone, ears, brain stem, nerves, arteries, lymph vessels, palate, airway, acupuncture meridians, teeth, muscles, gums and joints. It’s by far the most complex area in the human body. As such, it’s got potential for diverse problems. Only with a specialized dentist who is passionate about discovering and FIXING facial and dental formation can these problems be revealed and fixed. By fixing the underlying imbalances we are able to provide https://www.youtube.com/watch?v=5C7KlUSvLUM
[caption id="attachment_1501" align="aligncenter" width="564"]photo via Pinterest photo via Pinterest[/caption]

Manual Toothbrush/PROS:

  • Thoroughly clean teeth with proper brushing technique. Brushing only takes 2 minutes and you can most definitely keep your teeth at a grade A+ level with a manual toothbrush.
  • Multiple toothbrush styles, bristles, heads and colors to choose from. You have the ability to choose soft bristles if you have sensitive gums, and a smaller head if you have a smaller mouth. Some brands even make special prints on toothbrushes for children. Nevertheless, you’ll never be short of options with manual toothbrushes.
  • Easy to travel with. All you need is a toothbrush case and you’re all set to go for your trip. No need to worry about batteries or charging outlets.
  • No batteries or charging.
  • Inexpensive and often free whenever you make a trip to your dentist. Keep in mind that you should ditch your toothbrush after about 3 months of use.
Manual Toothbrush/CONS
  • More work.
  • No timing. Manual toothbrushes require you to guess how long your brushing session will last (unless you set a two-minute timer).
Electric Toothbrush/PROS:
  • Easy to use. With a powered toothbrush, all you need to do is place the toothbrush at a 45° angle and let the toothbrush do all the work.
  • Less work for better results. Studies have shown that electric toothbrushes do a better job of cleaning your mouth and removing plaque and gingivitis.
  • More fun to use for children. Children like to take the easy way out on chores. If a child never brushes their teeth because they don’t want to, try having them use an electric toothbrush. It’s less work, it tickles their teeth, and the timer will let them know they’re all done! It’s a lot easier (and more fun).
  • Built in timer. Electric toothbrushes use a built in timer that stops the toothbrush once two minutes are up; no more guessing!
Electric Toothbrush/CONS:
  • Charging. You’ll either have to charge your toothbrush or replace its batteries.
  • Cost. Electric toothbrushes cost significantly more than a manual toothbrush. There are several types of powered toothbrushes but be prepared to pay more than you usually do.
  • Not as easy to travel with. Traveling with an electric toothbrush can be a hassle. They are bulky and bringing a charger along doesn’t help with room constraints.
  • Easy to break. Dropping your toothbrush can be fatal. You have to be more careful whenever using an electric toothbrush.
One last thing to point out: there have been a few studies that prove electric toothbrushes remove statistically significant more plaque compared to manual toothbrushes and are better at fighting gum disease. Despite the studies, your oral health will remain healthy (despite which type of toothbrush you use) as long as you consistently take care of your teeth. If you are on the fence of buying a powered toothbrush, talk to Dr. Clark the next time you come in for a cleaning. Studies http://www.dentalcare.com/media/en-US/research_db/pdf/Page31_2580.pdf http://www.webmd.com/oral-health/news/20050419/study-advantage-seen-in-electric-toothbrushes Resource: Jefferson Dental Clinic

How Does Chemotherapy Affect the Mouth?

Chemotherapy is the use of drugs to treat cancer and other diseases. These drugs kill cancer cells, but they may also harm normal cells, including cells in the mouth. Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; and the glands that make saliva, as well as an increased likelihood of cold sores and other mouth infections.

It’s Important to Know Side Effects in the Mouth Can be Serious

  • The side effects can be painful and make it hard to eat, talk, and swallow.
  • You are more likely to get an infection, which can be dangerous, when you are receiving treatment.
  • If the side effects are bad, you may not be able to keep up with your cancer treatment. Your doctor may need to cut back on your treatment or may even stop it.

What Mouth Problems Does Chemotherapy Cause?

The problems depend on the chemotherapy drugs and how your body reacts to them. You may have these problems only during treatment or for a short time after treatment ends.
  • Painful mouth and gums
  • Dry mouth
  • Higher risk of cavities
  • Burning, peeling, or swelling tongue
  • Infection
  • Change in taste

Why Should I See a Dentist?

If you go to the dentist before chemotherapy begins, you can help prevent serious mouth problems. Side effects often happen because a person’s mouth is not healthy before chemotherapy starts. Not all mouth problems can be avoided but the fewer side effects you have, the more likely you will stay on your cancer treatment schedule. It’s important for your dentist and oncologist to talk to each other about your cancer treatment. Be sure to give your dentist your oncologist’s phone number.

When Should I See a Dentist?

You need to see the dentist at least two weeks before your chemotherapy begins. If you have already started chemotherapy and didn’t go to a dentist, see one as soon as possible. You should also see a dentist as recommended or needed during and after treatment.

What Will the Dentist and Dental Hygienist Do?

  • Check your teeth and gums.
  • Take X-rays if necessary.
  • Take care of mouth problems - especially infected teeth which may cause problems later.
  • Show you how to take care of your mouth to prevent side effects.

What Can I Do To Keep My Mouth Healthy?

See a dentist before you start cancer treatment. Ask about whether you may need artificial saliva, fluoride, and/or other rinses. Once your treatment starts, look in your mouth every day for sores or other changes. These tips can help prevent and treat a sore mouth. LEARN MORE about your oral care during cancer treatments. Resource: Delta Dental