Risks of doing nothing--Here's my estimate of what's likely to happen, based on study, research & watching teeth since '65, stated in "Tahoe gamblers' terms"

70% chance--tooth functions satisfactorily for several more weeks, months or years (an armed time bomb).

25% chance--tooth works OK but is sensitive to biting tough foods, or sweet, sour, or temperature change. (All fractured teeth do NOT give this convenient warning before progressing to the three gruesome consequences below.)

25% chance--tooth fractures (a piece splits off, exposing sensitive "naked dentin", perhaps involving the gum tissue as well), requiring a more extensive "subgingival crown", possible periodontal surgery (gum gardening) & an increased risk of root canal treatment. These fractures generally occur on Christmas Eve, Fourth of July, Thanksgiving, or one of the other few days North Shore Dental is closed.--Fig. 1

3% chance--Fracture progresses into the pulp, requiring root canal treatment, possible dowel post & crown buildup in addition to the more involved crown & the risks listed above--Fig. 2

0.5% chance--Tooth splits completely down the root, requiring extraction of tooth & choice between replacing it (implant & crown, bridge--with two or more additional retaining crowns--or removable partial denture) or allowing the opposing & adjacent teeth to tip & drift.--Fig. 3



Fig. 1



Fig. 2



Fig. 3

(These options total MORE than 100% because more than one of the options can happen to a tooth simultaneously.) Estimates of the financial consequences of these scenarios can be obtained from our business assistants.

What are the disadvantages of restoring the tooth with an onlay or crown?

--Immediate financial cost (our fee for the service), 'tho this is considerably less than the financial costs of the other options -- other than doing nothing & dying before the tooth splits.

--The trauma of removing the old mercury filling & preparing the tooth for a new restoration & bonding it to your tooth further damages your tooth. This damage is usually insignificant but, if the pulp in the tooth is sick anyway, this extra trauma may be enough to cause the pulp to hurt you, requiring root canal treatment. Chances of this happening are about five percent & would happen anyway if you live long enough.

What caused my tooth to crack? It had no cavity!--Strong lateral forces.

What caused those forces?--The most popular causes:

1--Mercury fillings (aka "silver bullets") have been placed in well over 95% of the teeth that crack & the cracks nearly always extend from these metallic wedges outward to the edge of the tooth.

2--Sudden trauma--any accident that causes the teeth to slam together violently, like falls on your ski tips, auto accidents, upward knuckle pressure to the jawbone, etc.

3--Gradual trauma--prolonged forceful pressure from habitual clenching of the teeth in response to physical or emotional stress. Folks do this one both by day & at night--most popular with people who operate their own businesses & very rare amongst government employees.

4--Eating or drinking "foods" over about 100øF or under about 40øF, especially if they cause RAPID temperature change such as those involved in a shift from soup to ice cream, coffee to Pepsi. These thermal changes greatly aggravate & accelerate the other three.

Can you predict which of my teeth will fracture?--Yes, pretty accurately--the ones that will fracture are the ones that showed a crack in your last examination. Generally when someone calls to tell us their tooth broke, Lori can tell 'em which one it was by a quick, look at their chart.

Howcum my old dentist didn't tell me about these cracked teeth--Definitive diagnosis requires advanced & expensive technology (a $100 fibre-optic light probe we've been using since '72!). It baffled me for years why dentists don't use this instrument & inform their patient/clients. Sadly, I recently discovered the only answer that makes sense: 70% of dentists are still PLACING those expanding, leaking toxic mercury fillings in folks' teeth! (Why not? It's cheap, quick, easy & our establishment ADA & AGD still say it's OK -- provided we store any of the filling material left over in sealed containers under a layer of oil to prevent contaminating our office!) And of those 30% who DON'T put mercury in peoples' mouths, MOST of 'em DID use the stuff for many years (so did I, 'til the late 70's, when better materials became available). Apparently either consciously or subconsciously, they CAN'T discover those fractures 'til the teeth break, blaming "stress", "age", "chewing", "genetics", etc. Sad.

How do all the other species of animals on this planet avoid cracked teeth?--They don't eat the Standard American Diet (SAD), so they don't have "fillings" & they don't eat/drink stuff over about 100øF or under about 40øF & they don't alternate hot foods with chewing on ice cubes. They DO occasionally break their teeth thru trauma.

How can I prevent the rest of my teeth from cracking?--Gosh, why would you want to PREVENT cracked teeth? Their repair provides such fine emotional & financial rewards for your gentle Dental Team! Of course, if they were MY teeth, here's my recommendations: 1--If they don't already have mercury fillings, don't develop a need of any. 2--Avoid sucrose sugar. 3--Ask our gentle & thorough hygienist to seal any grooves & pits on the biting surfaces of your teeth that are too narrow to reach with your brush. 4--Avoid opening beer bottles with your teeth or biting on ice, rocks, sand in lettuce, buckshot in wild oysters, etc. 5--Avoid clenching your teeth during stress or sleep (&/or let us make you a removable "niteguard" appliance). 6--Avoid rapid temperature changes. 7--Avoid traumatic accidents.

Can fillings be replaced with sealants?

Yes.

How long will they last?

A few weeks. Sealants are unfilled or lightly filled resins; the composite materials used to Òfill" teeth are 40-80% filled with types of silicon, glass, quartz, etc. which gives them what strength they have. Most teeth that have deteriorated far enough to have already received a Òfilling" have structural damage requiring coverage of the biting surfaces with an Òonlay" or crown (gold, silver-palladium, porcelain or some hybrid composite) -- a circumferential restoration providing a ferrule effect to prevent the tooth from cracking.

Question: Some holistic dentists suggest antibiotics to fight infections in the mouth. Are these oral, topical, or both, and what do you think of them?

Answer: The antibiotics can be oral or topical. I think they're toxic to humans and bacteria. Since they're LOTS more toxic to the bacteria than to the human, they can help the body get back in control by weakening the bacteria, assuming the owner of the body is not going to eliminate the causes & provide total rest (fasting) to allow the body to heal. The number of folks who are willing to live hygienically is so insignificant that we're not even considered by the medical/pharmaceutical machines.

By the way, the term "holistic" can be misleading. It's sposta mean treating the body/mind as an integrated "whole", much greater than the sum of its parts, rather than "treating" a part (eg, a tooth) without regard to the owner of that part. It's come to mean, instead, any "therapist" who uses therapies other than those accepted by the medical establishment. I question if those additional "therapies" imply a truly "wholistic" approach & I suspect that many of those practitioners are treating the body as a "hole" (into which to dump drugs, potions, supplements, etc. & out of which to extract money).
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