Chicago, Your Top Dental Questions Answered
Forget what they say about eyes being the window to a soul Ė we all
know a killer smile communicates more than words. And itís certainly
more effective with beautiful teeth. We asked Benjamin Fiss, DDS
and his staff to answer some of their patientís most common questions
for TCW readers.
What are the advantages of having an implant versus a bridge?
Bridges were once the standard of care in tooth replacement therapy.
Implants, although available, had limited success. In the past
20 years, some of the greatest advances in cosmetic dentistry have
been in the area of implants. With implants, we can provide amazing
cosmetic results matching natural teeth, veneers or crowns. Implants
also stand alone, not endangering adjacent teeth (which would need
to be reduced in bridge placement). Brushing and flossing are easy
with implants as they mimic natural teeth. Bridges are harder to maintain
and keep clean. They tend to accumulate food in the area of the
missing teeth. Finally, implants, once placed in the bone, maintain the
height of the bone. Bone without a tooth present (under a bridge) will
diminish over time, creating unsightly gaps and spaces.
Can bleaching be harmful to my teeth?
Although there have been reports of enamel weakening after bleaching,
a recent study at Loma Linda University showed that no adverse
affects to micro-hardness or surface anatomy occurred after tooth
bleaching. Using products that are not pH neutral or using abrasive
whitening toothpastes can reduce enamel thickness, actually darkening
the teeth through the thinning enamel. Following your dentistís instructions
is very important. I donít recommend using bleaching trays
for more than one hour a day, as excessive bleaching can also cause
extreme sensitivity. I find the best results are obtained using the inoffice
ZOOM or the take-home trays.
How long do crowns and veneers usually last?
The average lifespan of a crown or veneer is 10 to 15 years. The actual
material that crowns and veneers are made of is incredibly strong,
but bringing the human factor into play can change this. Anything that
can crack a natural tooth can fracture a porcelain restoration. Tooth
grinding without the use of a night guard can create intense trauma to
the teeth while sleeping. This can cause chipping or cracking to the
crown or veneer. Eating foods which are too hard to chew (such as
hard candy, ice and un-popped popcorn kernels), nail biting and using
your teeth to open things can also chip or shear porcelain off of the
restoration. Playing contact sports without a mouth guard also poses
a danger to the longevity of the dental work.
Can I change all my silver fillings to tooth colored?
The answer is yes, but with reservations. My philosophy is to fix only
what is broken. As silver fillings age, they absorb moisture and expand,
eventually cracking the surrounding tooth structure. The teeth
at this point are asymptomatic, meaning patients are unaware a
problem exists. When these fillings are removed and replaced, the
micro-fractures in the enamel go from a chronic phase (non-painful)
to an acute phase (sensitive to temperature and pressure). Ninetyfive
percent of the time, these symptoms disappear within one to two
weeks. Occasionally, these fractures may be near the nerve of the
tooth, causing irreversible damage and creating the need for root canal
therapy. Patients should be aware of this risk prior to treatment.
Are over-the-counter whitening systems safe?
I donít recommend over-the-counter whitening systems, as I donít believe
most are safe. Many are abrasive and chemically unsafe for the
surface of the enamel. The application is ill-fitting, as one size must
fit all. This creates a very poor seal for the bleaching liquid, allowing
it to easily spill into the oral cavity. The only over-the-counter system
I recommend is Crest Whitestrips. Itís highly recommended to bleach
your teeth under the care and supervision of a dental professional.
About Dr. Fiss
Benjamin Fiss, DDS prides himself
on his state-of the art facility and
friendly staff. Having been in practice,
specializing in general, cosmetic
and restorative dentistry for 31 years,
he and his staff keep up on the latest
trends and advancements through
extensive continuing education.
Fiss won the U.S. Commerce Associationís
2009 Best of Chicago
Award, and has been named one
of Americaís top dentists every year
since 2003 by the Consumer Research
Council of America.
Dan Merlo Photograph
This article appeared in the December 2009 issue of the Todayís Chicago Woman Magazine. www.tcwmag.com