Chicago, Your Top Dental Questions Answered

Forget what they say about eyes being the window to a soul – we all know a killer smile communicates more than words. And it’s certainly more effective with beautiful teeth. We asked Benjamin Fiss, DDS and his staff to answer some of their patient’s 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 effects to micro-hardness or surface anatomy occurred after tooth bleaching. Using products that are not pH neutral or using an abrasive, whitening toothpaste can reduce enamel thickness and darken the teeth through the thinning enamel. Following your dentist’s instructions is very important. I don’t 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 in-office 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). Ninety-five 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 don’t recommend over-the-counter whitening systems, as I don’t 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. It’s highly recommended to bleach your teeth under the care and supervision of a dental professional.

About Dr. Fiss

Dr. FissBenjamin Fiss, DDS prides himself on his state-of-the-art facility and friendly staff. Having been in practice and 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.

Dr. Fiss won the U.S. Commerce Association’s 2009 Best of Chicago Award, and has been named one of America’s 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 Today’s Chicago Woman