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Posts for: February, 2015

By Edward C. Smith, DMD, MPH, LLC
February 27, 2015
Category: Oral Health
Tags: oral health  
DentalMetalsPoseaLowRiskofAllergyAmongMostPeople

In modern times, metals have played an important role in tooth preservation and restoration. From the dental amalgam used for a century and a half to fill cavities to the titanium alloy of dental implants, your dental care would not be as comprehensive as it is today without them. But could these metals, so important in providing oral health, cause an allergic reaction in some people?

An allergy is an exaggerated response of the body’s immune system to any substance (living or non-living) it identifies as a threat. The response could be as minor as a rash or as life-threatening as a systemic shut-down of the body’s internal organs. An allergy can develop with anything, including metals, at any time.

A low percentage of the population has an allergy to one or more metals: some surveys indicate 17% of women and 3% of men are allergic to nickel, while even fewer are allergic to cobalt and chromium. Dermatitis patients seem to have a higher reaction rate, some allergic even to metals in jewelry or clothing that contact the skin.

Dental amalgam, an alloy made of various metals including mercury, has been used effectively since the mid-19th Century to fill cavities; even with today’s tooth-colored resin materials, amalgam is still used for many back teeth fillings. Over its history there have been only rare reports of allergic reactions, mainly localized rashes or moderate inflammation.

The most recent metal to come under scrutiny is titanium used in dental implants. Not only is it highly biocompatible with the human body, but titanium’s bone-loving (osteophilic) quality encourages bone growth around the implant’s titanium post inserted into the jawbone, strengthening it over time. But does titanium pose an allergic threat for some people? One study reviewed the cases of 1,500 implant patients for any evidence of a titanium allergy. The study found a very low occurrence (0.6%) of reactions.

The conclusion, then, is that the use of metals, especially for dental implants, carries only a minimal risk for allergic reactions and none are life-threatening. The vast majority of dental patients can benefit from the use of these metals to improve their oral health without adverse reaction.

If you would like more information on metal allergies with dental materials, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Metal Allergies to Dental Implants.”


By Edward C. Smith, DMD, MPH, LLC
February 12, 2015
Category: Dental Procedures
PadmaLakshmisSmileARecipeforBeauty

Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.

So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.

Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.

Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.

There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.

The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.

There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.

So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”