Q: # 1) Will my insurance pay to remove my old silver mercury fillings and have them replaced with white fillings?
A: Usually not, unless the tooth has a cavity (decay).
If there is cavity decay present, a dentist is able to bill for a new dental filling. Rarely do insurance companies pay 100% of the price for any type of new filling. If there is cavity decay, insurance will pay to have the decay removed and replaced with a new filling.
Many insurance companies still only cover a portion of the cost of putting a new “silver” mercury amalgam filling, for back teeth. This means that there is an extra charge to upgrade to any type of white filling material, as mercury fillings are cheaper than even the lowest quality of white fillings. If there is no decay present, the insurance company will not pay anything to remove the old mercury filling.
White filling material comes in many different brands and qualities. Just as you can buy one type of ground beef at Walmart for one price, you can buy an entirely different type of ground beef, typically organic, grass fed ground beef at Whole Foods and there is a significant price difference.
There is a concern about dental toxins and as a result there are some very new white dental filling materials. I use the finest quality white filling material available today and I am delighted to inform my patients that I have found one product which is Bisphenol-A (BPA) Free. This is a very positive step for all of us who have a concern about putting BPA, a known endocrine interrupter into our patients’ mouths.
Q #2) I don’t want a crown. If I have mercury fillings, why can’t I just have them drilled out and replaced with a white filling?
A: It is possible. If less than 50% of the tooth is decayed.
Dental fillings are designed to fill a hole. Filling material is not designed to sculpt a whole new tooth. If there will be more than 50% of the tooth drilled away, the tooth may need more than a filling. A crown or an onlay may be recommended to provide the structural support which is needed for chewing food. If a filling is used and there is not enough tooth left, it can lead to a fracture and tooth loss.
Q #3) I had periodontal disease years ago and I had a deep cleaning, so why do I have gum disease again?
A: Periodontal Disease requires quarterly maintenance and home care to stay inactive. One treatment will not cure gum disease.
Periodontal gum disease is an aggressive, progressive and degenerative disease. Once the periodontal bacteria is in your mouth, we can do a “deep cleaning” (scaling & root planing). This is the first step toward inactivating gum disease. Because the periodontal bacterial colonies begin to reproduce every 55 to 75 days, the American Academy of Periodontology, (www.Perio.org) recommends patients have periodontal maintenance cleanings 4 times per year to remain in an inactive state. If you had a deep cleaning and did not continue on to the quarterly maintenance cleanings, you can expect to have active periodontal disease again, usually within a relatively short period of time. When it is neglected, sadly we need to start over with a deep cleaning. Much like doing Spring cleaning at your home, if you do not do any further cleaning for 6 months, you will find yourself needing to start over with the Spring cleaning process.
In addition to having quarterly maintenance cleanings, there are some simple additional things you can do at home to help keep periodontal bacteria minimized. Download my free e-book, “8 Simple Holistic Dental Tips”.
Q# 4) Why did I get fillings? I don’t even think I needed them?
A: This is a question we hear often. Most Dentists have good intentions and hopefully fillings were done for some good reason.
The best we can do is diagnose what cavity decay is present at the time we see a patient. We take the time to educate our patients with x-rays, intra-oral photos and early detect cavity technology, to document the necessity of the treatment. This keeps my patients from spending more money on more invasive, expensive treatments after it is too late.
Many patients are very surprised when they see all of the evidence of decay and it helps them to make good healthy choices to minimize the price of dentistry in the long run and save tooth structure. Decay is progressive and waiting can lead to the decay spreading and causing more involved procedures such as onlays, crowns and even loss of your living teeth.
Q #5) How do I avoid a root canal?
A: By going to the dentist at least twice a year for early prevention. Once the decay has eaten through to the nerve, there is no magical way to turn it around and re-create a healthy, uninfected tooth. At the point that cavity has either gotten very close to the nerve canal or has actually penetrated the nerve, the tooth is most likely going to die.
You are either going to choose to have a root canal, which means the nerve tissue will be removed and you will no longer have a living tooth in your mouth. You will have the external shell of the tooth left and the nerve canal will be filled with a substance.
Your only other choice will be to have the diseased tooth extracted and replaced with a bridge or an implant. Dentists do not have any magic method of reversing decay and giving you back a living tooth. There is research being done which shows some promise regarding cloning teeth.
99% of the patients we treat could have prevented root canal and tooth loss by going to the dentist at least two times per year for early prevention.
Q #6) Why do I need my teeth straightened? I think I’m too old for cosmetic dentistry. (We hear this from patients from 21 to 65 years old)
A: Straight teeth tend to be healthier teeth.
Many times it is not about appearance at all. If your teeth are off your bite, it can cause multiple problems including gum issues, discomfort, TMJ and more. Health is the first step, cosmetic appearance is nice, but healthy teeth and gums are the keys to retaining your teeth for your lifetime. People are living longer now. It is all about how young the patient feels, wants to manage their teeth and stay vibrant.
Q #7) Why does my dental insurance pay so little?
A: Insurance is there to take care of basic necessities, such as maintenance. Coverage is typically $1,000 to $1500 per year, the same amount as it was in 1960 (over 50 years ago)
Insurance companies know that regular maintenance and prevention are the cheapest paths to oral health. When problems become complex and expensive to treat, coverage is less and co-payments become more expensive.
Unfortunately once people lose their insurance, many times they stop going to the dentist. This is a huge mistake as your mouth needs regular care to remain healthy. Too many times, we see people suffering from not going to the dentist regularly. Not going costs people money, pain and tooth loss. While people wait, the problems can build up and become much more complex. People sometimes wait and suffer through pain, loss of sleep and even end up avoiding chewing in areas, not eating properly as they do not have dental insurance.
Sometimes the pain subsides and it seems as though the tooth has somehow healed… Sadly, most times the tooth has become infected and the treatment which will be needed is far more complex and expensive. Prevention is the key and going to your dentist regularly is by far the most cost effective method of maintaining healthy teeth.
