A couple of weeks ago my nephew called and said he’d chipped his tooth and thought it would need a crown. His question was if he flew up from California could I fix it for him? I always hate calls like this. Not because I’m not willing to help family out, but because I don’t know what I am agreeing to and whether or not I can even solve the problem.

Well when he got in the chair and my assistant took some x-rays my worst fears were confirmed and more. The tooth he was concerned about was so badly decayed and broken down that it couldn’t be saved and would need to be referred to an Oral Surgeon. But there was another tooth that also would need extraction because there was nothing but an enamel shell left that would break into many pieces as soon as anyone attempted to extract it.

So I sent him of to my favorite Oral Sergeon and a while later the troublesome teeth were out at a cost of over $500. What really hurt was that if he had just gone to see his dentist sooner these teeth could have been saved with a filling for a fraction of what the extractions cost, let along what he will have to pay to replace these two teeth.

So see your dentist, hopefully me , on a regular basis and decrease the chance of having this happen to you.

The best diet for your mouth is also the best diet for your entire body. After all your mouth is a part of your body. While you hear about all kinds of ways you should eat, very few of us even follow the guidlines of the Dept. of Agriculture or Health and Human Resorces. So lets start there even though I feel from scientific evidence they can be improved on.

So what are these recommendations?

Eat whole grains, the fiber is good for you and you will feel full while eating less. I wish I had always done this , because then I might not have gotten diverticulites and wouldn’t have had to have surgery. So eat whole wheat bread (look for the ones with the most fiber as some “whole wheat” breads aren’t much better than white bread.) brown rice and oatmeal. By doing this I lost weight and lowered my cholesteral by 45 points.

Eat a variety of fruit, vegtables and grains because they all contain different nutriants and if you eat just one thing and rely on vitamin supplements you will still be missing out on some of the vitamins and minerals the body needs.

Be moderate, particularly with your intake of sugars. Your body can get all the carbohydrates it needs from other sources than sugar and corn syrups.

If you are eating lots of whole grains you’ll be surprised at how much protein you are getting. So then use meat more as a seasoning, like chicken in oriental dishes or beef in lasagna , than as the main corse.

Lower your salt intake and do some kind of activity ona regular basis.

You can go to http://www.choosemyplate.gov/ to see how these guidelines can be adapted depending on your sex, age and physical activity levels.

Many patients don’t like having silver fillings because they don’t look good or are worried that they may not be good for the patients health. So they ask if they can have their teeth restored with a more cosmetic material. And the answer is of coarse.

For smaller fillings a tooth colared plastic/resin filling can be used. However, on larger fillings that can sometimes be filled with silver filling material the resin restorations may not hold up as well. So in those cases I will use a custom made piece, often out of porcelain, which is then cemented and sometimes bonded to the tooth. Names for these restorations are inlays. onlays or crowns depending on how much of the tooth is replaced.

I am often asked why fillings or crowns don’t last forever. So I ask my patient to stop and think for a second. If you can get decay in a healthy tooth, doesn’t it make since that it should be easier to a get a cavity where a filling or crown joins the tooth. No matter how tight the filling or crown is to the tooth this area becomes an area of susceptibility for recurrent decay. In fact it’s amazing we don’t get more recurrent decay.

A couple of years ago I read an article in the Journal of the American Dental Association relating that the most common place for this recurrent decay is where the filling material is closest to the gingiva or gums. In fact it was significantly higher if the white plastic filling material was used.

Another cause of recurrent decay is if the filling material or the tooth chips where they join. This often makes a little groove that plaque can collect in. And since plaque causes decay your chances of new decay goes up.

So what can you do to decrease your chance of getting recurent decay? Brush and floss yes brush and floss and brush and floss again. It’s the same instruction to help prevent any decay.

Harry D Chambers DDS.