[rishab.k]

@ Tejas,

My Dad was admitted to the ICU few days back with dangerously low B.P. 60/20.He is otherwise hypertensive & has undergone bypass about 15 years back.He is also suffering from left hemiplegia since 4 years.Blood reports revealed infection in his blood but Doctors didn't find infection in his urine or any other place otherwise.Infection is being treated with Monocef & Targocid.
What I want to ask is that he has upper part of 2 of his teeth broken off which means the lower part is still there protruding outside the gums.Can this cause an infection of such severity?

[jassi]

Originally Posted by Tejas@perioimpl

Powered are better. However, their use is very different from normal brushes. The powered brush head just has to touch the tooth surface for 3-4 seconds, that's all. DO NOT PRESS - LITERALLY TOUCH. Otherwise over a short time you will land up with sensitivity. Also the brush head needs to be changed every three-four months as you would ideally change a regular tooth brush.

thanks for the advice Tejas - i have been using a powered one for 6-7 years now. I change the brush head once in 7-8 months, guess i will have to reduce that to 4 now. Also as far as the way to brush with powered toothbrushes goes, i use them like a regular brush i.e. i incorporate the same cleaning movements as i would with a regular brush. Don't know if it is right or wrong- although i do hear some people suggesting that you just hold the brush on one tooth for a few seconds and then move to next and let the brush do the work.
Do let me know if the above method is harmful - i do have mildly sensitive teeth (cold water) but that was from before i started using a powered toothbrush.

[Tejas@perioimpl]

Originally Posted by rishab.k

What I want to ask is that he has upper part of 2 of his teeth broken off which means the lower part is still there protruding outside the gums.Can this cause an infection of such severity?

Yes. An infected tooth has been known to be a focus of infection. Ideally get the teeth fixed by RC and post core followed by a crown. If this is not possible, then get them removed following all precautions considering your dad's condition. This basically requires anitbiotic cover before dental work is started. Let me know if you need more help. If possible take a full mouth xray called OPG and mail it to me. I'll see if there is a focus of infection.

Originally Posted by jassi

Don't know if it is right or wrong- although i do hear some people suggesting that you just hold the brush on one tooth for a few seconds and then move to next and let the brush do the work.
Do let me know if the above method is harmful - i do have mildly sensitive teeth (cold water) but that was from before i started using a powered toothbrush.

What you said, and i have highlighted in bold is the correct method.

[prince_pervez]

Hi Tejas.
I had fillings done when I was very young. 14 years old or something.
I have refilled whenever I found the molars to be sensitive.
My right molar has become sensitive again.
Last time I did a refilling was 4 years back.
Is it time to do a check up and a possible refill?
What all new and safe (non carcenogenic) substances can be
used for filling these days? And how expensive are they ?

[kalpeshc]

To add to the above query - there are two types of filling that docs are advising (at least to me), regular and LLC (something to do with Lasers !!). The LLC is double the rate of the regular and it seems that it fuses better with the tooth.

@Tejas - How accurate is this? What are the pros/cons?

[jassi]

Originally Posted by Tejas@perioimpl

What you said, and i have highlighted in bold is the correct method.

Thanks Tejas - i will change from moving the powered brush around like a regular brush and just hold it on the tooth and let it do its job as you highlighted - seems easier also

Must say - an excellent effort by you to help fellow tbhpians!! Very much appreciated

[Tejas@perioimpl]

Originally Posted by prince_pervez

Hi Tejas.
I had fillings done when I was very young. 14 years old or something.
I have refilled whenever I found the molars to be sensitive.
My right molar has become sensitive again.
Last time I did a refilling was 4 years back.
Is it time to do a check up and a possible refill?
What all new and safe (non carcenogenic) substances can be
used for filling these days? And how expensive are they ?

Ideally the filling should last you a longer time. Get an xray taken to check if there is decay beneath the old filling. Otherwise, there may be a new cavity. Also, if you are using a medium or hard brush, that may also cause sensitivity. Shift to a soft toothbrush.

The new composites are good and aesthetic. Cost varies from doctor to doctor depending on various factors and can range anywhere from 500 to 2500.

Originally Posted by kalpeshc

To add to the above query - there are two types of filling that docs are advising (at least to me), regular and LLC (something to do with Lasers !!). The LLC is double the rate of the regular and it seems that it fuses better with the tooth.

@Tejas - How accurate is this? What are the pros/cons?

There is nothing like LLC. It may be LCC (light cured composite). No one uses that term. The doctor may be using the term to impress you. It is basically a composite material which sets when it is activated with a light of a certain wave length. Thus, the doctor can sculpt the filling at his/her pace and cure the filling to final hardness when he/she is ready. Nothing to do with lasers.
Remember, lasers only always cut things, nothing else.
Pros: newer material, better aesthetics, zero mercury content.
Cons: none as such except that it does not have a self sealing property like amalgam fillings, but if done properly, not to worry. It's all theoretical, just go for the composite filling.

In my private practice, i have never done a silver amalgam filling ever (last i did was during my final year exams 9 years ago).

[prince_pervez]

Originally Posted by Tejas@perioimpl

Ideally the filling should last you a longer time. Get an xray taken to check if there is decay beneath the old filling.

Thanks doc. I'll get the x-ray done right away!

[kalpeshc]

In my private practice, i have never done a silver amalgam filling ever (last i did was during my final year exams 9 years ago).

Pros and cons of the silver amalgam please...

The cost of LCC is more than double of the silver amalgam and since I am having 7 fillings (!!) cost is a bit of a concern.

[Tejas@perioimpl]

Originally Posted by kalpeshc

Pros and cons of the silver amalgam please...

The cost of LCC is more than double of the silver amalgam and since I am having 7 fillings (!!) cost is a bit of a concern.

Amalgam:
Pros: Time tested and if done properly lasts for decades. Has a property of self sealing marginal gaps.

Cons: Unaesthetic. Newer concerns regarding mercury in the filling which may cause toxicity (highly debated topic). If you have a silver filling on two opposing teeth, there may be a risk of galvanic current produced so you may get a tiny tiny shock feeling when those teeth meet. No bonding to the tooth. Retention of the filling is by mechanical properties.

Composites are newer materials so longer term studies are available upto 2 decades not more. Does have a good bond to the tooth structure also. But composite filling is technique sensitive procedure.

[kalpeshc]

As I am not caring about aesthetics, I'll go for the silver one.

Thanks doc for everything.

[prince_pervez]

I also heard about carcenogenic properties of mercury/silver/amalgam used for filling. How true or debatable is that ?

[Tejas@perioimpl]

Originally Posted by prince_pervez

I also heard about carcenogenic properties of mercury/silver/amalgam used for filling. How true or debatable is that ?

Very debatable.

People say that "i have had fillings for dogs years and nothing has happened" and on the other hand, new studies show that even drinking a cup of hot tea or coffee can cause the the mercury from the filling to leach out.
The fact that mercury is harmful is not debated. The fact that how much mercury is released to cause toxic effects is the point of moot.
Anyways, in my book, better safe than sorry.

See the below link that demonstrates how much mercury is released from a filling after drinking a hot beverage:

YouTube - Smoking Teeth = Poison Gas

[jassi]

^^ man i am freaked now - i am not sure how many mercury feelings i have - what do i do now- get them removed and replaced?? with what? - which fillings are safe and don't involve mercury?

[vivekiny2k]

Originally Posted by prince_pervez

I also heard about carcenogenic properties of mercury/silver/amalgam used for filling. How true or debatable is that ?

I don't think it's termed carcinogenic yet. poison, yes of course.