The issue involves dental labs who outsource their work to China. Some American dental laboratories, in an effort to save money, send the dental work offshore for some or all of the process. The Chinese, as we all have come to realize, don’t have the quality controls that we’re accustomed to in this country. They use metal alloys that contain lead when casting the metal framework for crowns. That’s bad. The dental profession has been warned about this for many months. Hopefully, now that it has come to light, the practice will end.

This has never been a concern for our practice. Our labs do all of their work in-house. We now this with certainty. There are very few labs in this country who can create the high quality crowns and bridges that we require of them. These labs take such pride in their product that they could not outsource and part of their process and still maintain that level of quality. Sending the work to China is done for only one reason – to lower cost. Our labs do not attempt to compete on cost. In our profession, that’s a no win situation. Cost and quality go hand in hand in providing the services we do. We always look for value in the labs and materials we work with, but we never sacrifice quality.

That you can be sure of…

Yours in Health,

Dr. Bill Greenberg

It’s not just about teeth.

Sometimes we need to look beyond the teeth. Gums create a frame for the teeth and smile. In this case, there was just too much gum tissue. By reshaping the gums and then making porcelain veneers we created a beautiful, balanced smile. The teeth are in proportion and the result is a natural smile that blends with the patient’s face.

She was thrilled.

Your in health,

Dr. Bill Greenberg

We see this all too often. A patient will finally get up their courage and come to see us. They will tell us that they have a wedding or reunion or some other special occasion coming up. Then they drop the bomb. It’s in 2 weeks and they just can’t go looking like this! We sympathise, of course. But we just can’t make up for years of neglect and turn back the clock in 2 weeks. If you know there are problems, please realize that they only get worse over time. We understand that no one likes to go to the dentist. Everyone realizes, however, that you’re better off having those problems fixed than letting them get worse.

Yours in health,

Dr. Bill Greenberg

Technology in dentistry just gets better and better. Sometimes it’s a big change, like lasers that eliminate drilling, or a more lifelike porcelain for making crowns that look just like brand new teeth, and sometimes it’s something small. One of these small, but exciting none the less, innovations is our new computer smile simulator. The idea isn’t new. We’ve been using a service for years to give patients an idea of what their smile might look like. We’d take a picture, send it away, and a week later we’d get back the images. Now we can do the same thing in a few minutes right in the office.

If you ever wondered what your smile might look like if it were whiter, or without those crooked from teeth or with the edges nicely lined up and straight, mention it to us when you come in for your next appointment. We can even give you a copy to take home.

Of course it’s just an estimation of what we could do, but we’re pretty good at our estimates.

Yours in Health,

Dr. Bill Greenberg

Teeth are living tissues. The part of the tooth that is alive and has feeling is the inside part of every tooth. We call it ‘the nerve’, but it is really a complex arrangement of nerves, blood vessels, and cells that extend toward the surface. Whatever happens to a tooth causes a reaction in this tissue from which the tooth must heal. Having cavities repaired and fillings placed is surgery. We don’t often think of it that way, but an operation on living tissues is surgery, and the healing process is not always predictable.

Teeth have a very limited ability to heal. Decay is a trauma to teeth. It is a bacterial infection of the tooth. Bacteria can penetrate the tooth and grow toward the nerve. Tooth clenching and grinding is a trauma. It can cause cracks to form that allow bacteria deep inside the tooth. Chewing ice and getting hit in the mouth are also traumatic to teeth. These traumas accumulate, and the nerve inside the tooth becomes less and less healthy.

It’s like a bag of groceries. You put more and more groceries into the bag; you take it to the car. By the time you get home, the bag is pretty weak. You pick it up to bring it into the house and it tears. It didn’t tear because you picked it up, and leaving it in the car isn’t the answer. Whenever the bag gets too full or what’s in it is too heavy, there’s the risk of spilling your goods all over the garage floor. It’s kind of like that with teeth. As new decay forms and fillings get bigger, as other traumas occur to the tooth, the chances of the nerve remaining healthy become less.

Sometimes it takes just one more thing, a filling, a hard pretzels, a tap with the back of your baby’s head, to start the downward spiral that means a root canal is needed. When the nerve is finally injured beyond its ability to heal, it usually (but not always) causes symptoms. The tooth starts to hurt.

Root canals and crowns often go hand in hand. Teeth most often need crowns because of some structural weakness. This is usually because of a large filling or fracture. The fact that the tooth is in this condition tells you it’s been traumatized, either by a fracture or large cavity, sometime in the past. We try to make crowns for teeth before they get too bad, but sometimes making the crown is that one more thing that causes the bag to tear. It brings to the surface a problem that has been lying there quietly, but lying there none the less.

We do everything we can to make our treatments as kind as possible to the teeth. Avoiding treatment pretty much guarantees problems down the road. As gentle as we are, it’s not always possible to avoid the need for root canal therapy. Sometimes it’s predictable, sometimes it’s a surprise. Just try to remember, it’s not the dental treatment that caused the need for it, it is the problem that necessitated the treatment that’s to blame.

Yours in health,

Dr. Greenberg

It’s a fact of life. Teeth crack. Teeth break. Sometimes we can see it coming, sometimes we can’t.

There are certain warning signs we always look for when we examine a patient. When we see cracks forming or when we hear a patient complain about a tooth that’s sensitive to biting pressure, we look for ways to protect the tooth from further damage. As time goes by, cracks get deeper. Bacteria follow the cracks. The end point of this process is often root canal problems, or worse. Sometimes the tooth breaks in half and needs to be removed.

There are specific restorations that are designed to wrap around the weak parts of the tooth and strengthen them. Crowns and onlays are made to solve these problems.

This is a tooth where we diagnosed a crack, but before the patient came back for the crown, it broke. Fortunately, it broke in such a way that it is still fixable with a crown. You can see there are more cracks just waiting to break. Not everyone is so lucky.

Yours in Health,

Dr. Bill Greenberg

Norway has just enacted a ban on the use of dental amalgam for fillings. This was done in response to environmental concerns, not health effects of the mercury that represents approximately 50% of the compound. Norway’s neighbour, Sweden, has stopped reimbursing dentists for amalgam fillings. This policy has effectively ended the use of the material in that country as well.

Dental amalgam has been used for fillings for almost 200 years. It has been placed in millions of teeth around the world. It is inexpensive, durable, and relatively easy for the dentist to place.

There are, however, some disadvantages. It is a metal, and it looks like metal, not tooth. It starts out silver, and as it ages, it turns black – not very aesthetic. It also tends to expand slightly over the years, and has a tendency to crack teeth when the filling is large. The aspect of dental amalgam that gets the most attention is the mercury content.

Studies have repeatedly shown that the mercury is bound up in the filling and only released in minute amounts, far below any level that might have an impact on one’s health. From an environmental standpoint, the amount of mercury released into the environment from dental sources is a small fraction of that from industrial and power plant (coal) sources.

Never-the-less, mercury is a toxic substance. People are understandably nervous when it’s placed in their mouths. The use of amalgam has declined substantially recently due to the development of better dental materials to be used in its place. Our practice has all but eliminated the use of amalgam.

An excellent recourse for further information on this topic is American Dental Association web site.

Yours in Health,

Dr. Bill Greenberg

Exciting new technology for early oral cancer detection

We at Mt. Holly Family Dentistry have always conducted an annual comprehensive oral cancer screening for all of our patients. We have recently incorporated a breakthrough technology that will allow us to see things we’ve been unable to see previously.  By detecting potential problems earlier, we’ll be providing our patients with the best oral health care currently available.

Over the (many) years since I graduated dental school, I’ve taken thousands of hours of continuing dental education all over the country. One institute stands out. The Las Vegas Institute for Advanced Dental Studies (LVI) is an amazing place. This is far and away the premier locale for state of the art cosmetic, neuromuscular, prosthodontic, and occlusal studies in the world.

I’ve just completed the entire core curriculum at LVI, consisting of eight courses, four of them involving bringing a patient to the course and treating them there. At the most recently completed course, the culmination of the educational journey, we completely restored our patients entire dentition – full mouth reconstruction. There are only about 600 dentists in the world who have completed this curriculum.

Not only did we create a comfortable bite, correcting the uneven chewing surfaces and rebuilding worn and broken down teeth, but we crafted a beautiful smile as well. Our patient was thrilled. You can see why. Not only does she feel great, but she looks 10 years younger. To be able to accomplish this kind of dentistry in a comfortable, predictable, and efficient manner is amazing.

Yours in beauty and health,

Dr. Bill Greenberg

Here is one reason why we need to take x-rays as part of a complete dental examination. On visual inspection, all looks good. The x-ray shows a huge cavity that has probably been growing for years. I has remained undetected because it didn’t hurt, and this patient has refused our repeated recommendation to have x-rays taken at her check-ups. Now, instead of having a small filling, she needs a root canal and a crown to fix this problem.

I know we’ve all been conditioned to fear radiation in any form. It’s understandable. The fact is, these days the amount of radiation from a dental image is extremely low. Digital x-rays use as little as 10% of the dose of traditional films. The amount of radiation that is scattered to other parts of the body (which is really the main concern) is so low that lead aprons aren’t really necessary anymore. Yes, we still use them, but there is nothing for them to protect against anymore.

Yours in health,

Dr. Bill Greenberg