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HOME | PRACTICE | DOCTORS
| STAFF | OFFICE | PROCEDURES
PATIENT EDUCATION
| FINANCIAL INFORMATION | NEW
PATIENT | CONTACT US
Amalgam
Dental amalgam fillings, or silver fillings, have been used by dentists for
more than 150 years. They are relatively long-lasting and inexpensive and
have been used to restore teeth in more than 100 million Americans. Amalgam
fillings contain a mixture of silver, copper, mercury, and tin. The mercury,
one of the few metals which is a liquid at room temperature, renders the
other strengthening metals malleable so the dentist can shape the filling
into the prepared cavity.
Dental amalgam has an indisputable safety record and has been extensively reviewed. The U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam, except in the extremely rare case of the patient who is allergic to a component of amalgam. This supports the finding of the FDA, the National Institute of Health Technology Assessment Conference, and the National Institute of Dental Research that dental amalgam is a safe and effective restorative material. The current debate regarding amalgam has more to do with the impact that the disposal of the excess filling material may have on the environment, than its safety for use in humans.
Mercury, in large doses, can be toxic. The majority of mercury that enters our bodies comes from food (seafood), water, and air. In fact the most directly toxic form of mercury is organic mercury, such as that found in fish. The World Health Organization (WHO) has estimated that eating seafood once a week raises the amount of mercury in the urine 2-8 times the level from the placement of an amalgam filling. You would need to have 200 amalgam fillings placed every day or eat 25-100 servings of fish every day to reach a toxic level of mercury. For a recent article from WebMD about the safety of amalgam fillings, please click here.
Because of structural and esthetic reasons, however, Dr. Boyd may choose not to place an amalgam filling. Gold fillings are usually the strongest and porcelain or composite fillings are the most esthetic. If you would like to have your silver fillings replaced for any reason (esthetics etc.) or if they are defective, Dr. Boyd would be happy to remove them using techniques that reduce the amount of mercury released upon removal. If you have any further questions, please ask Dr. Boyd.
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Antibiotic Premedication
Patients with certain preexisting conditions, such as mitral valve prolapse
with regurgitation, may require "antibiotic prophylaxis." This
involves taking an antibiotic 1 hour before certain dental treatments in
order to prevent the possibility of bacteria growing on the valves of the
heart, known as "bacterial endocarditis." If you have a condition
which requires antibiotic prophylaxis or think you may, Dr. Boyd and
your physician will confer on how best to manage your particular situation.
To learn more about antibiotic prophylaxis and the links between dental
health and heart disease, click here to visit the American Heart Association's
web page.
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Bridges
When a tooth is missing, one option to replace it is a bridge. A bridge
fills the space between two (or more) teeth by suspending a "fake" tooth
(or teeth) between the crowns. This necessitates preparing some teeth
on either side of the space. Usually a bridge is made out of porcelain
that
has been fused onto metal (gold). This enables the dentist to imitate
the color and shape of the surrounding teeth. Click here for a picture.
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Composite (Bonding)
Composite (or bonding) is a kind of tooth-colored plastic material which
is applied to a tooth in a soft state and is then hardened by a light
or laser. While this is an excellent material for smaller cavities, small
chips (fractures), or spaces, larger cavities require materials that are
stronger, such as gold or porcelain. Click here to see before-and-after pictures of bonding.
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Cosmetic Dentistry
Cosmetic dentistry is the art of improving a smile through procedures like bleaching (tooth
whitening),
orthodontics (Invisalign), porcelain
veneers, porcelain inlay/onlays, composite
fillings, bonding, gingival recontouring,
bridges etc. If you are unhappy with any aspect of your smile,
please talk to Dr. Boyd.
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Crowns
When the whole tooth needs to be restored, a crown is fabricated which
replaces all of the surfaces that can be seen in the mouth. Gold and porcelain
can be used in these restorations.
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Dentures
When all the teeth of one arch (upper or lower) are missing, a complete
denture can be made. Either acrylic or porcelain teeth are held in an acrlyic
base which covers the gums. Even though the denture-wearing patient no
longer has teeth and may be satisfied with the performance of the existing
denture, regular check-ups with Dr. Boyd are recommended every six months.
This is to ensure that the gums underneath the denture remain as healthy
as possible and that problems can be identified as early as possible. If
you are dissatisfied with the performance of your denture, speak to Dr.
Boyd about the possibility of getting implants to help secure the denture.
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A valuable education information resource and directory containing many medical and dental websites of interest. Click here to go to educationpad.comTop of this page or Back where you came from
Fluoride Fluoride Community water fluoridation has been hailed as one of the greatest and
most cost effective public health efforts ever achieved. For the price
of a few cents per year per person, the occurence of cavities dropped 60%
in children born in areas with treated water. Although fluoride in a dose
much higher than is in tap water can discolor teeth (fluorosis) and in
tremendously high doses can even be fatal (just as sodium or potassium
are), its impact on dental health has been dramatic. Patients should be aware that although Manhattan and most of the surrounding
areas in New York and Connecticut have closely regulated, fluoridated water
supplies, parts of Long Island and most of New Jersey do not. In order
to check whether your home is receiving fluoridated water, you can call
your local governance, your local water supply company, or to search for New York counties, click here and for New Jersey
counties (last updated 1998) click here. Along with the fluoride received in the drinking water, topical applications
of fluoride (like ACT Rinse) aid the body in rebuilding teeth already eaten
away by small cavities. This is where fluoride in toothpaste and topical
applications of fluoride in the dental office play a role especially if
you are not receiving fluoride from your local water supply or only drink
bottled, non-fluoridated water. Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from Top of this page or Back where you came from
Fluoride is a mineral that occurs naturally in all water sources, even
oceans. More than 50 years ago, a dentist in Texas noted that children
in areas of naturally occuring fluoridated water had fewer cavities.
Since then, the ideal quantity of fluoride has been determined to be
0.7-1.2 parts per million. In an effort to take advantage of a very cost-effective
means of reducing the occurence of cavities in children, local governances
began regulating the amount of fluoride in their water supplies.
Brita water filtration systems have been tested and verified to remove
only a trace amount of fluoride over the life of a filter. Many brands
of bottled water do not contain the level of fluoride recommended by the
ADA. In fact, bottled water is not required to state how much fluoride
is contained in it and may in fact contain none at all.
Halitosis (Bad Breath)
Bad breath can be caused by foods such as garlic or onions, tooth decay,
periodontal (gum) disease, continued mouth dryness, use of tobacco products,
sinus or respiratory infections, some medical disorders (e.g. diabetes),
inadequate oral hygiene, or some medications. In most cases, bad breath
is caused by bacterial breakdown products called volatile sulfur compounds
(VSCs). In people with healthy teeth and gums, bacteria that live on the
far back region of the tongue produce the VSCs. If the back of the tongue
is the source of the halitosis, a tongue scraper or toothbrush used on
the tongue may help to remove the odor-causing bacteria. In people with
periodontal disease, bacteria reside in pockets on the roots of teeth beneath
the gums. It is of great importance to clean these area by regularly flossing
and brushing, as well as receiving regular dental cleanings. Ask your hygienist
and/or Dr. Boyd about methods to reduce or eliminate bad breath.
Implants
An implant is a titanium screw placed in the jaw bone into which another
screw can go. Essentially, the titanium screw replaces the root of a tooth.
If you are missing a tooth, an implant may be the best way to replace it
considering that implants have a success rate of greater than 90%. If Dr.
Boyd decides that an implant is the best option, he will confer with another
specialist (either a periodontist or an oral surgeon) who will then place
the implant. Usually, 3-6 months are needed to allow the bone to heal around
the implant before a crown can be placed on it. This is the phase of treatment
that Dr. Boyd will perform. It is important to remember that the charge
for the connector to the implant is separate from the crown.
Inlay/Onlay
When too much tooth structure has been lost or there has been a fracture
in a tooth, a larger restoration may be needed. Gold is the best material
for inlays (smaller) and onlays (bigger) due to certain properties of
the metal which enable it to be strong but kind to opposing natural teeth
and
keep teeth from fracturing further. Click here to
see how gold inlays can be virtually invisible. Porcelain can sometimes
be used in cases where
esthetics is of the utmost importance.
However,
porcelain
is
a brittle material that can fracture or wear away opposing natural
teeth.
Invisalign
Invisalign is a way of straightening teeth without metallic braces. Instead,
clear acrylic shells (like a night/mouthguard) are worn all the time (except
when eating) and slowly move the teeth into proper alignment. Every two
weeks, a new shell will be given to you by Dr. Boyd, until you have reached
the intended result.
Partial Dentures
A partial denture replaces several missing teeth in one arch. Usually,
a partial denture replaces both the teeth and the gums in those areas where
teeth have been lost.
Periodontal (Gum) Disease
Periodontal Disease is the loss of the bone support around teeth. There
are certain bacteria which live in and around the teeth in the periodontal
pockets that chemically cause the body to resorb bone around those infected
teeth. Reducing the number, altering the kinds of bacteria, and limiting
the amount of their food source is the best treatment for the disease.
This entails regular cleanings, proper oral hygiene (i.e. brushing and
flossing), and proper diagnosis. In some patients, medium-sized pockets can be treated
with Arestin, a local antibiotic, to help eliminate the bacteria in conjuntion
with regular cleanings. After diagnosis, some patients may be referred
to a periodontist, who specializes in the treatment of periodontal disease, for evaluation
and/or treatment.
Porcelain Veneers
In order to improve the appearance of your smile, you might consider porcelain
veneers (laminates). Veneers are shells of porcelain that cover the outside
of the tooth and can correct not only misshapen or dark teeth, but even
teeth that are poorly aligned. It is always best to whiten the teeth before
cosmetic procedures like this one. The procedure typically takes two visits
with about one to two weeks in between. In the first visit, a very small
amount of tooth structure is removed and the teeth have temporary veneers
placed. In the second visit after the case has returned from the lab, the
permanent veneers are cemented. Click here to see before-and-after pictures
of porcelain veneers.
Post and Core
After root canal therapy has been performed, if a lot of tooth structure
has been lost, a cast gold post and core will be required to give the future
crown something to fit around. The post end goes into the root(s) of the
tooth; the core end acts to replace the lost tooth structure. At the first
visit, Dr. Boyd will prepare a space for the post down the root and take
an impression. At the next visit the cast gold post will be cemented and
the tooth will be prepared for the crown.
Prosthodontics
Prosthodontics is the specialty in dentistry that is concerned with the
more complicated crown and bridge work like full mouth rehabilitation, dentures, partial dentures, placing
crowns on implants, and cosmetic dentistry. Across the country, in order
to specialize in prosthodontics, a rigorous three-year-residency is
required after the four years of dental school.
Root Canal
When the nerve in a tooth is no longer alive, either from decay, fracture,
or trauma, a root canal is needed. Dr. Boyd will refer you to a specialist
in this area called an Endodontist who will treat the tooth. In the specialist's
office, the tooth will be anesthetized and the canal in which the nerve
lies will be cleaned with tiny files and irrigated with antibacterial agents.
Then the endodontist will fill the canal with an inert, sterile material.
After this procedure you will most likely need a post and core and a crown.
Toothache
There are many reasons why a tooth may be hurting you. It is important
to come in and see Dr. Boyd as soon as you can once a tooth begins to hurt.
After a thorough exam, Dr. Boyd will diagnose the problem and take steps
to take you out of pain. If you have a toothache after working hours, please
call the answering service at (212) 774-1485 and they will be able to locate
one of the doctors who can assist you.
Tooth Whitening (Bleaching)
There are a variety of procedures provided by the office that will help whiten teeth stained from coffee, cigarettes, red wine etc. One technique is a home bleaching kit which takes two weeks when used for two hours daily or one week when used overnight. A second technique uses a laser, which takes only two visits to the office, but should be maintained with regular use of the home bleaching kit. Click here for a picture.
Disclaimer
This information is provided for informational and educational purposes
only. No diagnosis or treatment is being provided. The information provided
here should ONLY be used in consultation with your dentist. In no way are
the materials presented here meant to be a substitute for professional
medical/dental care or the attention of a dentist. Always check with your
doctor if you have any questions or concerns about your condition, or before
starting a new program of treatment. Under no circumstances should you
change your treatment based on the information provided herein without
the knowledge of the dentist currently directing your care. Neither Drs.
Boyd, nor any party who has been involved with the preparation of this
work, shall be held responsible for errors or omissions in information,
nor liable for any special, consequential, or exemplary damages resulting,
in whole or in part, from any viewer's use of or reliance upon this material.
amalgam (silver) fillings
antibiotic premedication
bridges
brushing technique
composite (bonding)
cosmetic dentistry
crowns
dentures
educationpad.com
flossing technique
fluoride
halitosis (bad breath)
implants
inlay/onlay
partial dentures
periodontal (gum) disease
porcelain veneers (laminates)
post and core
prosthodontics
root canal
toothache
tooth whitening (bleaching)
disclaimer
