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Expected Dental Challenges - 30-40 Years Old

This is the period that fillings done when a person was a teenager begin to need replacement.

Most fillings done during the teenage period for those who are now in the 30-40 year old age group were metal fillings. Metal fillings break down due to corrosion which opens small holes at the edge of the filling where the metal meets the tooth surface. All fillings of every type wear out. It is better to replace a filling when it begins to fail at the edge where the tooth meets the metal rather than waiting until there is a large hole in this area. This minimizes the size of the replacement filling keeping the tooth as strong as possible.

There are several types of filling materials these days. Of course, there is traditional silver amalgam. This is a mixture of several kinds of metal that has the unique property of being easily moldable at room temperature and then setting with a minimum of expansion or contraction and becoming hard within a few minutes, also at room temperature.

Silver amalgam has been around for over a century now and is still a viable option. Indeed, the question of placement of silver amalgam actually created dentistry in the latter part of the 19th century as a separate field distinct from Medicine. At that time, gold was really the only long lasting filling material for teeth. Silver amalgam came along as a lower cost alternative to using gold. The profession split on the question of whether the silver amalgam then available should be used on teeth, and the new--separate from Medicine--profession of Dentistry was created. Interestingly, the use of silver amalgam is again controversial. The Canadian Dental Association has some nice information available on the net as well as the American Dental Association on the subject of amalgam. I will address this subject later in one of these articles. Suffice it to say for now that silver amalgam is still a viable choice to fill teeth. As well, gold can be used and is the most long lasting material we have. Obviously, it is expensive and of course, it is not white. There are several other alternatives for filling teeth that are white. These alternatives include composite resin, and several kinds of porcelain. Again, I will address the advantages and disadvantages of the various materials for filling teeth in a later article.

For today’s presentation, there are several choices of materials that can be used to fill teeth. They are not the same and there is a choice to be made concerning which one to use. Until about 20 years ago, composite resin really lacked the strength to be considered strong enough to fill posterior teeth. For that reason, most people above about 30 or 35 had our teeth filled as teenagers with silver amalgam. After 20 years or so, the older alloys usually have holes at their edges caused by corrosion. Many newer alloys have the addition of a small amount of copper which slows the process of corrosion.

For those who have held out on beginning the at least daily flossing habit before, recession of the gums (and the bone underneath the gums) can become a problem during the 30-40 year old period. Floss is a required part of the daily or better yet, twice daily home cleaning of teeth process. If the area between teeth is not cleaned at home on an at least daily basis, the gums between the teeth remain inflamed because the plaque on the surface of the teeth releases acid. The swollen (inflamed) gums have powerful cells that make up the immune system lurking about for long periods underneath the surface of the gums. Those cells are meant to remove whatever is causing the acid in the area (the dental plaque on the teeth), but cannot reach the plaque because it is outside where the blood supply can extend. Those cells, if they are in the area long term, begin to dissolve bone. This process is called periodontal disease. Inflammation of the gums from plaque and hardened plaque (tarter—also called calculus) is made more severe by the chemicals in tobacco smoke.

By the 30-40 year old period, most of us have started a regular pattern of flossing, so this period is very similar to the 20-30 period except that old fillings are starting to wear out and have to be replaced.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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