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You’ve made an appointment at our Franklin and Asheville, NC office to treat your cavity, the decayed area has been removed, and the site has been cleaned and prepared for a filling. Now it’s decision time. What kind of filling should you choose? Well, that depends. There are durability, aesthetic, and price considerations involved in any of your choices, so let’s look at some options before you decide.

Gold

This is a classic choice for a reason. Gold is very durable and can last longer than fillings made from other materials. Because they are crafted from precious metal, gold fillings are more expensive than other alternatives. They are also most often indirect fillings—that is, they are not immediately placed in a tooth, but are formed based on a mold of your tooth taken on your first visit and set in position on a second visit. A gold filling is also noticeable, which can be a matter of concern or a style statement!

Metal Amalgam

An amalgam is a mixture, and an amalgam filling is usually composed of several metallic elements, including silver, tin, copper, and mercury. This filling is also very durable and is one of the most cost-effective choices. Its silver color does not blend into the tooth, so visibility is a factor. Amalgam fillings are considered a safe option, but, if you wonder about potential metal allergies or the amount and kind of mercury involved, we will be happy to discuss your concerns. One possible drawback to amalgam fillings is that sometimes more tooth structure needs to be removed to accommodate them, so this is also a subject we can discuss.

Composite Resins

These fillings are often selected because they are both durable and almost invisible when the color is matched to your tooth. Made of acrylic resin and powdered glass, a composite filling is what is called a “direct filling”—one that can be completed and bonded to the tooth in one visit. These are often more expensive than amalgam fillings, but might be preferable for cosmetic reasons, especially when a front tooth is involved. They also need less tooth structure removed to accommodate them and can be better bonded to small excavations than some other options. They can be prone to staining over time.

Ceramic

Ceramic fillings have the virtue of being virtually undetectable. They can be color-matched to your teeth for a seamless look, and are more stain-resistant than composite fillings. They are also a more expensive option, and, like gold fillings, can involve a two-phase process with a filling molded to fit the excavation site placed in your tooth on a second visit.

Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris and our team are happy to discuss all of your options before it is time to treat your cavity, since there are a number of factors which might impact your decision. A molar will require a more durable filling than a front tooth, while being less visible when you smile or speak. Insurance plans might pay for only a portion of a filling’s cost if it is more expensive than an amalgam, or will pay for a composite filling only if it is in a visible location. We can help you decide which filling best fits all your needs, providing you with the healthy and beautiful smile you deserve!

Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Appalachian Dental Associates team for tips on proper brushing and flossing.

Many dentists and hygienists recommend fluoride treatments for their adult patients. You might ask yourself, “Do I really need a fluoride treatment? I thought those were just for my kids.” After all, most insurance plans cover fluoride treatments only up to the age of 18.

What you need to know as a dental consumer is that studies have shown topical fluoride applications performed by a dental professional create a significant benefit for adults who have moderate to high risk for cavities.

There are several circumstances that warrant extra fluoride protection among adults. Many prescription medications reduce saliva flow or otherwise create dry mouth. A reduction in saliva increases cavity risk.

Adults often experience gum recession, which exposes part of the root surface of teeth. These areas are softer than the hard enamel at the top of the tooth, which makes them more susceptible to decay.

In addition, adults often get restorative work such as crowns or bridges. Fluoride can help protect the margins of these restorations, ultimately protecting your investment.

Today many people opt for orthodontic treatment (braces) as adults. Braces make it more challenging for patients to maintain good oral hygiene. Just ask your kids! Fluoride can keep the teeth strong and cavity-free even with the obstacle of orthodontic appliances.

Have you had a restoration done within the last year due to new decay? If you have, that puts you at a higher risk for cavities. Fluoride treatments are a great way to prevent more cavities in patients who are already prone to them.

How is that flossing coming along? You know you should floss daily, but do you? If your oral hygiene is not ideal, fluoride could be just the thing to keep your neglect from leading to cavities between your teeth.

Fluoride can also help with the growing problem of sensitive teeth. Diets high in acidic foods and beverages, general gum recession, and increased use of whitening products all tend to produce sensitive teeth. Fluoride treatments re-mineralize tooth enamel and reduce that sensitivity.

Patients who undergo radiation treatment for cancer also benefit from topical fluoride applications. Radiation damages saliva glands, thus greatly reducing the flow of saliva. Saliva acts as a buffer against the foods we eat and beverages we drink. Once again, less saliva greatly increases the risk of cavities.

If one or more of these conditions applies to you, consider requesting a topical fluoride treatment. Be sure to ask Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris at your next appointment whether you might benefit from a topical fluoride application.

Five words no one welcomes: “You need a root canal.” But if you are delaying treatment because you are worried about pain and an uncomfortable day in the dentist’s chair, please think again! Modern root canal procedures are designed to repair your damaged tooth gently and efficiently, and leave you with a restored natural tooth that can last a lifetime.

• Why might you need a root canal?

First, a little tooth biology. Each tooth has a crown (the part we see above the gums) and one or more roots (the part of our tooth below the gum line that is attached to bone in our jaw). The tooth has three basic layers: the hard enamel and cementum that cover the outer crown and root, the softer dentin beneath that layer, and, on the inside, the pulp. Pulp is made of living tissue, and contains the blood vessels and nerves that nourish the tooth and keep it vital.

Even with the protection the enamel and dentin provide, sometimes the pulp can be infected or damaged. If you have suffered an injury to your mouth or jaw, or an infection has developed from an opening in the tooth caused by a deep cavity or crack, you may need a root canal to prevent further infection, pain, and even tooth loss. Call our Franklin and Asheville, NC office immediately if you feel pain with chewing or pressure, prolonged sensitivity to heat or cold, swollen, and tender gums around a tooth, or tooth discoloration.

• The Root Canal Procedure

If a root canal is necessary, the procedure is very straightforward. After the area around the tooth is numbed, we will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and removed bacteria and dead or dying tissue. The area will be thoroughly disinfected, and the inside of the tooth shaped and then filled and sealed. A temporary filling or crown might be placed on the tooth to prevent bacteria and food from entering the site if a permanent crown needs to be created. The entire process usually takes from one to three visits.

If we suggest a root canal, it is because this is the best way to save your tooth. Please feel free to talk to us about your particular needs and concerns. Which tooth is affected, how many roots are involved, what type of filling or crown might be best—we will work with you to provide all the information you need and all the options you have available.

Common Concerns

• Are you concerned about pain?

The most painful part of a root canal is often the severe discomfort your tooth causes before treatment. And infections and damaged nerves can affect not only the injured tooth, but the gums, tissue and even bone surrounding it. With our modern dental techniques, a root canal procedure is often no more uncomfortable than a regular filling. The local anesthetic we use will prevent you from feeling any pain during the procedure, and, while the area around your tooth might be a bit sensitive following treatment, the pain caused by the infection or injury should be gone.

• Are you anxious about the procedure?

If dental treatment causes you anxiety, please let us know. There are several sedation options we can pursue to make this procedure less worrisome. Our goal is to make your treatment as gentle and comfortable as possible.

No one welcomes the news that a root canal is necessary, but with today’s procedures, this treatment can be just what you need to relieve your pain and keep your natural tooth where it belongs for many years to come. And that is welcome news, indeed!