Montrose Star interviews trusted dental authority Dr Randy Mitchmore from his Montrose practice called LifeSmiles.
M.S. You got me. What do artificial limbs and other body parts have to do with dentistry?
Dr M If someone has the very unfortunate situation of having lost an arm or a leg, they usually want to have it replaced. If a limb has gangrene – no blood supply and is infected there is no debate, it must be removed. However, they will usually take extreme measures before giving up and having an amputation. The loss of teeth is much the same. The weird thing is that sometimes I see people approaching a dental problem with just the reverse mentality.
M.S. Tell me more?
Dr M I have a friend that had a small wound on his big toe. Because he is diabetic, it did not heal like it normally should. He spent a year and thousands of dollars and multiple doctor and hospital visits trying to save his toe. It got gangrene and he got very, very sick. The toe had to be amputated. Had he had aggressive treatment early on he would not have lost his toe. He is emotionally very upset and now is faced with how to have it replaced with an artificial limb. There are not very good options that come close to the function – helping balance, or the look of the real thing.
I had a really nice patient come in recently with a mild gum infection. He was very healthy otherwise. His first thought was “Just take my teeth out. Then I will be done with it and I will get implants.” You see this is like saying, “Amputate the offender and I will get an artificial body part because it is quicker”. That thinking is full of rotten cavities – Pun intended.
M.S. I have to admit, I am with him. I thought it would be quicker, and better. Where did I go wrong?
Dr M I am told that I am exceptionally good at making artificial teeth (dentures, partials and bridges). I spend a lot of time and effort to fool the eye that there is anything artificial. But I am here to tell you, old fashioned dentures, bridges and partials are only 30% as effective as the real thing. Ask anyone with an artificial leg. They can dress it up to look like a leg but it just does not work like one. To add to the problem, it actually ends up costing considerably more and the old fashioned materials can make you sick.
M.S. Whoa! What’s this about the artificial materials making me sick?
Dr M Up to now, dentures and partials have been made out of acrylic. Acrylic is porous. Bacteria in our mouths love to have warm, dark, moist places to grow in. That is why dentures can really stink. Literally. By the way, fungus likes it too. When that is pressed against the gums, the gums get inflamed and infected and that makes you sick. And smell bad.
M.S. What are some better choices?
Dr M: Two things come to mind. First technology is my friend. While most dentists still use acrylic, I like alternate materials that are not porous like zirconium. It also does not break, chip, or stain. Second, think long and hard before having a tooth amputated. The artificial replacements can actually be more costly over time. However, if a tooth is badly infected or has gangrene, or cracked in two, there is no debate – it must be removed and the sooner the better, otherwise that can make your whole body sick.
M.S. What other artificial parts can make me sick?
Dr M I frequently see people that have the old technology of porcelain crowns that are fused to a silver colored metal. They frequently look dark grey at the gum line. The silver metal often is a base metal like some costume jewelry and if it touches the gums, the gums react to it in a not so good way. Ask for the newer technology that is all porcelain that can be fused to the tooth and not just glued on. There is no caustic metal in it.
The other thing is the silver fillings. Most people have no idea that those old silver fillings are made of mostly silver and some other metal alloys and 50% of the filling is mercury. Some foreign countries ban the use of silver fillings because they do not want the left over mercury in the dental office going into the drains, landfills and ultimately the water supply. There is a lot of scientific debate if the mercury gets out of the filling once it is bound up in the filling. I will tell you this. I have not used mercury in over 20 years. The dentists that still use mercury (and most do) are required to put the left over scrap from the filling and place it in a biohazard container and ship it to a special storage facility to protect the water supply. Hmmmmmm…. Let me see – it is OK to put in the mouth, but is too dangerous to put in the trash? You make the decision. There are alternatives to the silver fillings.
Here is the kicker. Silver fillings have an expected life span in the mouth of about 15 years. They do not last forever like most people think! At the 15 year mark they corrode and no longer make a good seal. Cavities grow in and around that corrosion. They also swell and cause micro cracks in the teeth. That causes teeth to break – probably the most common phone call I get on Monday morning – “My tooth broke over the weekend and I was eating something very soft!” Typically the tooth had a very old silver filling and there were cracks in the tooth. The filling stays in and a large chunk of tooth fractures off.
When your dentist removes the old silver/mercury fillings it is recommended to drape the mouth with a rubber dam. Continually spray the tooth with a water mist while it is being worked on, and evacuate the contaminated mist with high speed suction. That is so that you will not breathe or swallow the contaminated mist.
Dr Mitchmore is active in the community. He was appointed by the Texas Legislature and serves as Vice-Chairman of the Montrose Management District. His passion is Dentistry. He has also been a City Councilman and Chairman of the American Academy of Cosmetic Dentistry’s Charitable Foundation, Give Back A Smile. The foundation helps survivors of intimate partner abuse regain their smile.