By Chestnut Dental Associates
June 16, 2018
Category: Dental Procedures
Tags: fillings  
MetalDentalAmalgamStillaSafeandEffectiveToothFilling

With all the new tooth-colored fillings for cavities, it's easy to overlook metal amalgam. While this mainstay of dental care for over a century might not be as attractive as composite resins or glass and resin ionomers, it still has the advantage of strength and durability.

Amalgam is a stable metal alloy usually made up of silver, tin, copper and mercury. The metals are proportioned and mixed precisely to guard against “free” mercury molecules, which could pose a health hazard. The mixture is pliable at first, but then sets hard once molded into the prepared area of the tooth.

Besides strength, amalgam's other advantages include low cost, high resistance to wear and biocompatibility (not toxic to the body or allergy-producing). At the same time, it can require more tooth structure removal to accommodate a filling and cause higher sensitivity to temperature for a while after installation. Its main disadvantage, however, is appearance — it's now considered unacceptable from an aesthetic point of view to use it in visible areas like the front teeth.

Because of this, materials resembling natural tooth color are coming into vogue, especially as their strength improves. Still, dental amalgam continues to play a useful role, especially in less visible back teeth with higher chewing forces.

One past concern about dental amalgam is the inclusion of mercury in the alloy. As mentioned before, mercury is hazardous in a “free” form when not knit microscopically with other metals; as such it can emit a vapor that could enter the bloodstream and damage the nervous system. But after several studies by various organizations, the American Dental Association has concluded amalgam's precise mixture prevents the mercury from taking this form: although some vapor is given off during chewing it's far too low in concentration to pose any danger.

Dental amalgam continues to be an effective choice for fillings. Whether it's the right choice for you will depend on the type and location of a tooth to be filled, and whether durability is a higher concern than appearance. If we do recommend an amalgam filling, you can be assured it's a safe and lasting choice.

If you would like more information on your choices for dental fillings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Silver Fillings — Safe or Unsafe?

By Chestnut Dental Associates
June 06, 2018
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

FourTipsforPreventingPrematureLossofBabyTeethFromToothDecay

Most often, all of your child’s primary teeth will eventually be replaced by permanent teeth, but you shouldn’t consider them less important — there are serious consequences for losing a primary tooth prematurely. Besides providing a means for a child to chew food and speak clearly, primary teeth also save space for the permanent teeth to erupt; a premature loss could lead to malocclusions (bad bites) that may result in costly orthodontic treatment later.

That’s why it’s important to fight tooth decay in primary teeth. By keeping them healthy and in place until it’s time for their departure, their permanent replacements have a better chance of erupting into their proper positions.

Here are 4 tips for preventing tooth decay in primary teeth:

Begin daily oral hygiene when teeth first appear. Begin brushing with fluoride toothpaste as soon as the first primary teeth come in. Brushing removes bacterial plaque, the primary cause of tooth decay, and fluoride strengthens enamel. Because they tend to swallow toothpaste rather than spit it out, use just a smear of toothpaste for infants and toddlers, and a pea-sized amount for ages two and older.

Start regular dental visits by the child’s first birthday. By beginning regular checkups around age 1, we’ll have a better chance of discovering developing tooth decay or other problems early. You’re also setting a good foundation for what should be a lifelong habit for optimum dental health.

Limit sugar consumption. The oral bacteria that cause tooth decay feed on leftover carbohydrates like sugar, so you should limit intake especially between meals. One culprit to watch out for: a bedtime bottle filled with formula, milk or fruit juices, all of which contain carbohydrates (sugar). Water or no bottle at all is a better alternative.

Consider topical fluoride or sealants for extra protection. In some circumstances, we may advise protecting the enamel of newly erupted teeth with an applied sealant. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.

Taking these measures and remaining vigilant to the first signs of decay can go a long way toward preserving your child’s teeth. Their future oral health depends on it.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dentistry & Oral Health for Children.”

By Chestnut Dental Associates
May 24, 2018
Category: Oral Health

Dentist VisitFind out the importance of visiting your dentist for routine checkups.

If you want to maintain a healthy smile, visiting our Downingtown, PA, dentist, Dr. Carl Horchos, should be a no-brainer; however, if you aren’t coming in for routine checkups and you feel like your teeth and gums still look and feel great, you may wonder why you even need these checkups. We are here to explain what goes into your six-month cleanings and how they help you maintain good oral health.

What happens at a routine dental checkup?

Every six months you should visit your Downingtown general dentist for routine cleanings and checkups to protect your smile from dental issues. Of course, if you are someone who is at a high risk for decay, gum disease, or other issues, you may need to come in more regularly.

If it’s your first time coming into our office, then we will also take time to really get to know you and your health. This means having you fill out paperwork regarding your own detailed medical history (everything from chronic health problems to hospitalizations to medications you are currently taking). This will allow us to understand your specific health needs so we can provide you with safe, effective care.

One of the most integral parts of a dental checkup is to clean your teeth. Even if you brush and floss regularly there are still areas you might miss. This is where our dental hygienists come in and can remove plaque and tartar from your teeth. Remember, once plaque hardens into tartar it can’t be removed with a simple at-home toothbrush, only we have the special tools to get rid of tartar. These twice-a-year dental cleanings can help keep decay and gum disease at bay.

Besides giving you a clean, radiant smile we will also take time to examine your teeth and gums to look for any warning signs that could mean that you are dealing with problems. We will check the gums to make sure there are no warning signs of gum disease. We will also perform a quick oral cancer screening to look for lumps, lesions, and other suspicious growths that could be cancerous.

About once a year your Downingtown family dentist will also recommend getting X-rays, which can detect decay, bone loss, and other issues that we may not be able to see with the naked eye. X-rays are a great way to really see what’s going on with your smile and to determine if you require dental treatment. Remember that the sooner we detect a dental problem the easier it is to treat.

Chestnut Dental Associates is dedicated to helping you maintain that beautiful smile. No matter whether you need to schedule that six-month checkup or you are dealing with dental issues, our expert dental team in Downingtown, PA, is here to help.

By Chestnut Dental Associates
May 17, 2018
Category: Dental Procedures
Tags: dental implants  
ImplantscanSupportaTotalToothReplacementRestoration

You may be familiar with a dental implant used to replace a single tooth — but implant technology can do much more. Implants can also support other restorations including total teeth replacement on a jaw.

The reason they're so versatile is because implants replace the tooth root as well as the visible crown. We use a metal post, usually made of titanium, which we surgically implant in the jawbone as a root substitute. Because of a special affinity with titanium, bone around the implant grows and adheres to it and creates a durable bond.

With a single tooth replacement (the implant's original purpose when they were introduced in the 1980s) we attach a life-like porcelain crown to the individual titanium post. But with their continuing development we've adapted implants for other applications, like using a few strategically-placed implants as a stable platform for removable dentures or fixed bridges.

We're now able to use implants to support a full prosthetic (false) dental arch. Though similar in appearance to a removable denture, this particular prosthesis is permanently joined to the supporting implants with retaining screws.

Of course, the application requires careful pre-planning, which includes making sure you have enough healthy bone to support the implants. We'll also need to determine how many implants you'll need (usually four to six for this application) and create a surgical guide to place them in the best location for supporting the prosthesis. A dental technician will then create the prosthesis to match your jaw ridge contours and facial structure.

Using implants this way has a benefit other types of restorations can't provide: they may help stop future bone loss. The jawbone life cycle depends on stimulation from the attached tooth as you bite and chew — stimulation that ends when you lose the tooth. Traditional dentures and other restorations can't replicate that stimulation. Implants, on the other hand, directly encourage bone growth and can stop gradual bone loss.

If you need some form of total teeth replacement, consider one supported by implants. You may find they'll provide an excellent long-term solution to both function and appearance.

If you would like more information on the different applications for dental implants, please contact us or schedule an appointment for a consultation.





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Chestnut Dental Associatess


Chestnut Dental Associates
150 East Pennsylvania Avenue Suite 400
Downingtown, PA 19335
Phone : (484) 364 - 4292
Fax : (484)-593-4792
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