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Maintaining a Beautiful Smile

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Q. My dentist said that white fillings don’t last in the back of the mouth. Is this true?
A.
Statistically, your dentist is correct. According to expert dental researcher Dr. Gordon Christensen, the average posterior white filling lasts seven years. This is not a long time in the mouth. However, when white fillings are placed correctly using meticulous attention to detail and a rubber dam, white fillings, correctly called resin composite, will last just as long as silver mercury fillings or 20+ years. I have published cases on Dental XP, the premier international dental forum, that show how successful bonded resin fillings can be.

Q. Why does my dental insurance refuse to pay for white fillings in the back of the mouth?
A. The insurance company uses Dr. Christensen’s statistic of a seven-year survival rate and has determined that the material is not acceptable for use in the back of the mouth. What is my opinion? Bonded white fillings are the best material when the dentist is highly trained, has great skill and uses a rubber dam to place the filling. Remember that many dental schools still do not teach their students to correctly place white fillings, so it is not surprising that the material does not last.

Q. Why are so many crowns placed in dentistry today?
A. Many years ago, before bonding, the dentist had only a few options to repair teeth: silver mercury fillings, gold inlays and onlays and crowns. Silver mercury fillings were not supposed to be used when the tooth decay was very large and therefore dentists placed crowns to provide more protection for the tooth. This is the way I was trained. Since 1992, the rules have changed with the introduction of adhesive dentistry, also known as “bonding.” Bonding strengthens the natural tooth and resin is sufficiently strong to withstand biting forces long term. Some dentists, even after 25 years, still rely on older definitions for when to use a crown. In my mouth, I want a well-done bonded white filling instead of a crown any day of the week.

Q Are all dentists the same and if they are, isn’t it wise to go to the cheapest?
A
. I hear people say all the time, “All dentists are the same.” Like cars, clothes, houses and schools, some of them are excellent, some good and others less than ideal. If a patient values their teeth, then it should be important to find the best dentists that they can. A good dentist will take their time; take photographs; take a lot of continuing education; take pride in their work; and use a rubber dam. ■

Written by: Dr. Gerald Benjamin

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Gerald C. Benjamin, DDS, brings tireless devotion to his work, 39 years of experience in restorative and esthetic dentistry and the highest quality service to create extraordinary smiles in the New York Capital District. Dr. Benjamin believes it takes a team to achieve the long-lasting effects of a great smile. His practice is located at 18 Division Street, Suite 205 in Saratoga Springs, New York; call 518-583-1116 for a consultation.