Dr. Susan Chen

The Mouth-Body Connection

Oral health more important than you might think

Healthy mouth

Many people don’t realize that oral health and general health are linked. But if you think about it, it makes perfect sense. The mouth is our gateway to the rest of the body, a pathway for good nutrition and healthy habits. But sometimes pathogens and toxins sneak through the body’s many defense mechanisms and hang around until the next brushing.

Good oral hygiene is an important component to maintain a healthy balance in the mouth. For example, frequent brushing keeps bacteria at bay, preventing plaque from building on tooth surfaces. Plaque eats away at tooth enamel, often causing swelling, bleeding, redness and gum tenderness, and if not treated, can lead to tooth decay, bone loss around the teeth and even tooth loss. But bacteria can travel further than your mouth. Excessive bacteria building up in pockets between inflamed gums and teeth can enter the bloodstream, exacerbating existing problems in the body and sometimes create new ones.

Your oral health might affect, be affected by, or contribute to various diseases and conditions. For instance:

  • Cardiovascular disease. Research suggest that heart disease, clogged arteries and stroke may be linked to inflammation and infections in oral cavities exposed to gingivitis and prostaglandins, a more serious form of gum disease.
  • Endocarditis. Endocarditis is an infection of the inner lining of the heart, which occurs when bacteria or other germs from another part of the body, such as the mouth, spread through the bloodstream and attach to damaged areas in the heart. Uncommon, but people with some heart conditions have a greater risk of developing endocarditis.
  • Pregnancy and birth. Gingivitis (i.e. gum disease) has been linked to premature birth and low birth weight.
  • Diabetes. Diabetes reduces the body’s resistance to infection. Research has shown that gum disease appears to be more frequent and severe among people who have diabetes—putting gums and teeth at higher risk.
  • Alzheimer’s disease. Researchers at NYU have found evidence that gum inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer’s disease.

Because of these potential links, it’s important that Dr. Chen be aware of your overall general health and know about any prescribed medications. She’ll ask about general health and be interested in any recent illnesses or chronic conditions, such as diabetes.

To help protect your overall health, practice good oral hygiene every day.

  • Brush your teeth at least twice a day.
  • Floss daily.
  • Eat a healthy diet and limit between-meal snacks.
  • Replace your toothbrush every three to four months or sooner if bristles are frayed.
  • Schedule regular dental checkups. At the end of the day, taking care of your oral health is an investment in your general health.

At the end of the day, taking care of your oral health is an investment in your general health.

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Pregnant? What You Need to Know About Dental Care

Dental care should be an important part of a pregnant woman’s prenatal plan

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With all the things going on in a woman’s body during pregnancy, gingivitis may not be on the radar of a mother-to-be…especially when she’s taken such care in her overall health. Compared to the other changes, gingivitis (i.e. gum disease) may be low on the priority list, but it does pose some risk, particularly in the second trimester. To keep healthy gums during pregnancy, special attention to dental care should be an important part of a woman’s prenatal care plan.

What is pregnancy gingivitis?

Pregnancy gingivitis is a non-destructive periodontal disease, or an inflammation of the gums affecting about half of all pregnant women. Caused by an increase in hormone levels, pregnancy gingivitis exacerbates the body’s response to bacteria in the mouth causing dental plaque to form on tooth surface. This extra plaque may cause swelling, bleeding, redness and gum tenderness, and if not treated, can lead to tooth decay, bone loss around the teeth or tooth loss.

Though rare, gingivitis can lead to a more serious form of gum disease called prostaglandins, which can increase the chance for low-birthweight, pre-term delivery and gestational diabetes. Excessive bacteria building up in pockets between inflamed gums and teeth can enter the bloodstream, travel to the uterus and potentially trigger premature labor. According to some studies, it places pregnant women at greater risk for preterm birth than alcohol consumption or smoking.

Prevent gingivitis with good oral hygiene

To control the amount of plaque in your mouth and prevent gingivitis, brush your teeth with a fluoride toothpaste at least twice a day for two minutes and floss daily, especially after meals, to reduce the bacteria that can lead to pregnancy gingivitis. Morning sickness can increase bacteria, so brushing often is important.

It’s also important for women who are pregnant to maintain dental checkups and cleaning schedules. While you might be tempted to delay your next dental appointment due to a busy obstetrics schedule, this is not the time to miss seeing your dentist.

In fact, Dr. Chen recommends making an appointment as soon as possible after confirming a pregnancy to ensure a healthy mouth and gums. As with any other medical appointment, tell your dental team about your pregnancy and the trimester you’re in before a checkup begins. Our office is family focused, so we’ll be excited to hear the good news, but we may also want to make special accommodations to ensure your comfort.

How to reverse gingivitis

In most cases, gum disease is easily preventable by keeping to basic oral health routines. But the second trimester is when gingivitis can sneak up on an unsuspecting pregnant woman. If you’re experiencing swollen, tender gums, you may be able to revers it by following these steps:

  • Visit Pine Lake Family Dentistry immediately and at least once during your pregnancy for a full checkup. Best to visit us early in your second trimester when your growing belly is likely to feel more comfortable.
  • Brush your teeth twice a day for two minutes, especially if you’re prone to morning sickness.
  • Try to floss every day, ideally after meals.
  • Use a daily warm salt water rinse to remove bacteria and sooth swollen gums.
  • Eat healthy foods with plenty of fresh fruit and vegetables and lean protein.

If treated, your gums should return to normal following delivery of your baby. Contact our office if swelling and bleeding worsens during pregnancy. We’ll work with your obstetrician to create a safe and effective treatment plan—essential for combating adverse effects of gum disease during pregnancy.

Do you have your next appointment scheduled? Call us today to set it up.

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Why Do People Snore?

Snoring causes more sleeplessness and irritability than most people realize.

snoring_64952062Snoring is one of the loudest noises people can make with their body, sometimes clocking in at 92 decibels—as much as a jackhammer!

If it happens frequently, it can cause excessive daytime sleepiness, poor concentration and attention, memory loss and headaches.

Snoring happens only during sleep, when muscles throughout the body relax, including soft tissue in the oral cavity. When those muscles relax, the airway shrinks slightly and, in some people, partially blocks the airflow causing turbulence. Instead of air flowing smoothly into the lungs, the narrow passage creates bursts of air that bounces off the relaxed tissue in the throat causing vibrations. The vibrations cause snoring.

Though annoying, snoring isn’t usually a health hazard. A nudge in the night is often all it takes to remedy the problem.

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If it happens frequently without health issues, you may be a good candidate for a snore guard.

Designed specifically to prevent snoring, the dental device pushes the jaw and tongue forward to open the airway and improve breathing. Custom fitted by a dentist, the device holds soft tissue in place to increase airflow in the oral cavity, eliminating the vibrations in the throat that cause snoring.

In some cases, snoring is a symptom of a more serious condition known as Obstructive Sleep Apnea and is diagnosed by a sleep physician.

Sleep Apnea can be a life-threatening medical disorder. It occurs when tissue in the back of the throat collapses completely, blocking the airway and causing the body to temporarily stop breathing. When the blood-oxygen level to the heart and brain drops low enough, the body momentarily wakes up, sometimes hundreds of times per night.

In this case, your sleep physician will work with Dr. Chen to create an oral appliance treatment plan, which may include a custom-fitted oral device worn while sleeping to prevent tissue from collapsing and blocking the airway.

Talk with your hygienist or Dr. Chen to help you understand why you snore so that an appropriate treatment plan can be designed just for you.

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Brushing Up! A Lesson in Oral Health

IMG_4046aAccording to the Office of the Surgeon General, more than 51 million school hours are lost each year to dental-related health conditions, largely due to pediatric tooth decay. Across America, more than 50 percent of children under the age of 17 suffer from at least one cavity. But tooth decay and cavities are easily preventable with a few basic steps: brushing and flossing.

As a dentist serving the Sammamish Plateau, I want to see the families in this community beat the statistics, so I’m focused on community wellness, promoting good oral health and prevention. Each year, I try to visit preschools and elementary schools in our community to chat with kids about how to take care of their teeth and why oral hygiene is an important part of an overall wellness routine.

Now, I realize that getting kids to brush and floss their teeth properly can be difficult for any parent—even for me! But I’ve found that talking to kids about dental health in a fun way keeps their attention and helps them make positive connections to the overall dental experience. Positive experiences equal clean and healthy teeth and gums!

My most recent school visit was at Sunny Hills Elementary School where my oldest son, Evan, is just finishing up 1st grade. Here’s how the discussion unfolded…

What does a dentist do? 

Firstly, I was very happy to learn that all the children had been to the dentist—so, many of them knew all about what dentists do, the importance of clean teeth and avoiding cavities. With a few giggles in the background, I further explained that we check the entire mouth (gums, cheeks, teeth, throat, tongue, and under the tongue) to make sure everything is healthy.

How many teeth do we have? 

Most of the kids guessed 20. While this crowd of 7- and 8-year olds were missing a few front teeth, at this age they probably have about 24 teeth—a mix of baby teeth and adult teeth, including four adult molars. But, by the age of 12 to 14, most children will have lost all their baby teeth to make room for 28 adult teeth.

What do we use our teeth for?

While the kids correctly called out chewing, smiling and talking (smart kid!), we also talked about how our teeth are designed to do different things. Our front teeth are called incisors, and they’re used for cutting and biting foods like apples, pizza and sandwiches. Our canine teeth are in the corners, and they’re meant for grasping and tearing food. Way in the back of our mouths are molars, which are used for chewing. Our mouths are very efficient processing machines!

How do we take care of our teeth? DinoDragonC

These kids were right on the money here. Nearly all of them knew to floss every day and brush twice a day. But brushing and flossing alone is only part of a healthy routine, so I like to emphasize a healthy diet and the 2x2x2 rule: brush twice a day for two minutes and see a dentist twice a year for healthy, happy teeth.

Accompanied by my friend Dino the Dragon, we demonstrated good brushing technique—gentle, small circles right where the tooth meets the gum, making sure not to scrub back and forth to protect the gum tissue. Dino was a hit!

What foods are good for our teeth? What foods are bad?

Skipping right over the obvious good-for-you foods (fresh fruits and vegetables), we had a fun chat about sugar.

While the kids guessed anything with sugar is bad, it’s the sticky, gooey foods that are extra bad—especially sticky, sour, sugary candies and treats. That doesn’t mean we shouldn’t eat them—everyone needs a treat now and then! But I like to suggest they be eaten in the afternoon, followed by a healthy meal and a good brushing before bedtime. Eating sticky candy and gooey treats after dinner and right before bed can lead to tooth decay.

And don’t be fooled by “healthy” fruit leathers and raisins—they have natural fruit sugars that are sticky, too!

The time flew by, and before I knew it, we were wrapping it up and saying goodbye. I was truly impressed by how much these kids already knew about oral health and hygiene, and credit the thoughtful, engaged and smart parents in our community. We all deserve an A+ for educating our kids and modeling good hygiene.

Working with local schools is an important entry point for providing information and oral health education to children in our community. If you’d like a visit from us, please call our office and talk to us about our oral health education program so that we can design a classroom visit just for you.

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SUMMER SALE!

Teeth Whitening Special: $125Bride_52553325

For your next summer event, graduation party or wedding, greet your friends and family with a bright white smile–a sign of good health and vitality. And it’s your best accessory!

For a limited time, we’re offering our full teeth whitening package TeethWhite_59508999at a fraction of the regular cost (reg. $200).

You’ll get:

  • a personal consultation
  • custom fitted trays
  • four tubes of whitening gel

Everything you’ll need to get a vibrant, healthy, summer smile.

Call us today to set up your consultation. Hurry! Offer ends August 31.

 

 

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Link Between Oral Cancer and HPV

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Surprising data reveals our youngsters are at greater risk than ever for developing oral cancer caused by exposure to HPV

Last weekend, I took some time to catch up on a few of my favorite TV programs: Downton Abbey (season 6 ends the series!) and Jimmy Kimmel. While Jimmy is generally comic relief from my busy week, the episode I watched from a few weeks ago inspired this blog post today. He and several of his physician friends got together to create a tongue-n-cheek (pun intended!) PSA urging parents to get their children vaccinated. While funny, the message was still loud and clear: vaccinations save lives.

As a community healthcare provider myself, I see firsthand how important vaccinations are for our children individually, but also the impact they have on our community collectively. So, in honor of Oral Cancer Awareness Month, I want to bring your attention to the importance of HPV vaccinations.

While you might be asking yourself why a dentist would be talking about an STD vaccination, the surprising answer is that HPV is a leading cause of oral cancer. And it kills.

What is HPV?

Human Papillomavirus (or HPV) is the fastest growing sexually transmitted disease in the world with roughly 200 different types. Most are beaten by the immune system over time and not a cause for concern. But two types in particular can be life threatening, increasing the risk for oral cancer substantially.

Undetected, long-term exposure to HPV-16 or HPV-18 infections are serious and linked not only to cervical cancer, but recently to oral cancer. According to the Oral Cancer Foundation, approximately 45,750 people will be diagnosed with oral cancer in 2015. More than 115 new diagnoses are made each day, and it kills one person every hour of every day. About half of those diagnosed will not survive more than five years.

While HPV infections rarely have visible symptoms, oral cancer symptoms include:

  • recurring mouth sores or lesions with trouble healing;
  • white or red patches on the gums, tongue, tonsil or lining of the mouth;
  • lumps or thickening of the cheek;
  • numbness of the tongue or face;
  • a persistent sore throat and hoarseness; and
  • unexplained loose teeth.

Alarming rise in HPV among young people

Until recently, oral cancer was predominantly seen among male smokers and tobacco users in their mid-40s and older. Since tobacco use has declined over the past decade in the U.S., the American Cancer Society sees HPV as a leading cause for oral cancer among a variety of groups.

The CDC saysHPV is so common that most sexually-active men and women will get at least one type of HPV at some point in their lives. They believe about 79 million Americans are currently infected with HPV and 14 million more people become newly infected each year.

This rise in HPV occurrences translates to an increase in cervical and oral cancers. In fact, greater than 60 percent of new oral cancer cases in 2014 were caused by HPV, according to Dr. Dolphine Oda, Professor of Oral Pathology at the University of Washington’s Department of Oral & Maxillofacial Surgery and the director of the UW’s Oral Pathology Biopsy Service. That’s an alarming statistic. But more alarming is the highest incidence of HPV oral cancer occurs in young people ages 20 to 24 years old.

Get Vaccinated. Period.

By abstaining from tobacco, marijuana, heavy drinking and avoiding HPV infection, the risk for oral cancer is reduced significantly. Prevention is the best guard against HPV-causing cancers, which is why vaccinations are so important for our youngsters. Two available HPV vaccines, Cervarix and Gardasil, are both proven to prevent HPV-16 and HPV-18 infection, reducing the risk of cancer.

The American Dental Association is following the CDC recommendation to vaccinate women aged 9-26 and for males 11-21 years old for HPV. Personally, I’m an advocate for vaccines and recommend families in my practice get the vaccinations they need to stay healthy and strong—this includes the HPV vaccine.

A quick, pain-free exam could save your life

April is Oral Cancer Awareness month. So there’s no better time to speak to our current patients (and our “not yet” patients) about the risks of oral cancer, who can get it and how to avoid it. Not surprisingly, the dental community is the first line of defense in early detection of this disease. Regular dental checkups incorporating an examination of the entire head and neck can help reduce its death rate, which is currently 43 percent within five years of diagnosis, according to the Oral Cancer Foundation.

Early detection saves lives. And your dentist is in a unique position to help identify oral cancer early, when treatments can be most successful, helping patients to get the life-saving support they need. Even people who wear dentures are advised to visit a dentist regularly to undergo a full mouth examination.

At Pine Lake Family Dentistry, we encourage all adults in our community to get an oral cancer screening at least once per year. Whether a current patient or a “not yet” patient, we’d like to invite you to our office to learn more about this devastating disease and allow us to conduct a thorough, yet quick and painless, oral cancer screening. Just five minutes can save your life!

Call us today to schedule an appointment. All of us at Pine Lake Family Dentistry look forward to seeing you!

–Dr. Susan Chen

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Powerful Jaws Can Damage Your Teeth

Believe it or not, our jaws are powerful enough to bend metal

 

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courtesy Getty Images

 

According to some dental researchers, our jaws can produce remarkable pressure, in some cases reaching over 1000 Newton (for a physics refresher, see Newton’s Second Law of Motion), or measured another way, up to 265 PSI (pounds-force per square inch). That’s enough pressure to do a lot of damage, but imagine the impact on teeth!

While we’re capable of creating that kind of pressure, most of the time our teeth never touch unless chewing. Yet, nearly every week, we see patients at Pine Lake Family Dentistry with a cracked or broken tooth—even from chewing something as soft as cake!

Though our patients may be surprised, for us, it’s a telltale sign of an existing, long-term problem: Bruxism. One of the most common dental issues we see in our office, Bruxism is excessive pressure on our teeth from grinding or clenching, most of the time unknowingly…until a tooth breaks.

Tooth enamel is the hardest tissue in our bodies, but it’s still susceptible to damage. Excessive force from grinding and clenching creates micro fractures in the enamel. Over time, as more and more pressure is applied, the fractures get deeper and deeper, until one day the tooth unexpectedly cracks. Until the broken tooth, Bruxism symptoms often go unnoticed.

painful jaws

Dentists are trained to see the signs, though. Grinding or clenching eventually erodes tooth enamel and exposes the more sensitive layer of dentin where nerves can be threatened. In addition to tiny fractures, the pressure can cause chipped enamel, short or worn-down teeth, discoloration and receding gums. Patients report pain or tightness in their jaws, sensitivity to hot or cold temperatures or unexplained earaches and headaches.

Up to 50 percent of adults suffer from Bruxism, and the single most common factor among them is stress. Demanding work environments, deadlines, difficult relationships and hectic family schedules all contribute to the tension we hold in our bodies. To release it, our muscles react by tightening, causing our jaws to contract, leading to grinding and clenching.

Whether day or night, Bruxism is difficult to control. While awake, teeth clenching is common in times of stress or intense focus (i.e. work, driving or exercise) and often goes unnoticed even with constant awareness. While sleeping, clenching and grinding is completely involuntary and often undetectable—causing substantial damage night after night. Eventually, it can lead to expensive dental work like crowns, root canals and implants. So the earlier it’s detected, the better the prognoses.

Preventative treatment is always easiest and most effective. The first line of defense is to find ways to relieve stress with a balanced diet, regular exercise and taking time to relax. If no serious signs are present, we may recommend using a custom fitted night guard as the most conservative treatment. Fitting over teeth and worn while sleeping, a night guard creates a cushion between the upper and lower teeth that absorbs the force of powerful jaws, preventing future damage.

Bruxism can also be treated with Botox therapy. Clinically approved by the FDA for Bruxism, Botox can be used to target the muscle responsible for clenching. It relaxes the jaw and reduces the force it can inflict upon teeth—if not preventing the pressure completely. While night guards protect teeth from grinding, Botox helps prevent muscles from clenching. Combined, these two treatments offer a powerful solution to a potentially serious problem.

Regular, annual dental check-ups (coupled with daily brushing and flossing, of course!), are an important step in detecting Bruxism and other serious dental issues. Talk to Dr. Chen about any sensitivity, jaw soreness, earaches and headaches. She’ll be able to detect abnormal patterns in tooth wear, fractures, muscle tightness in the jaws and joint noises—all of which are indicative of grinding or clenching.

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Leave Dental Phobia Behind

Do you get a little nervous about an approaching dental appointment? Feel anxiety creeping up as you make your way to the dentist office? Panic when faced with a dental issue that requires sinking into the dental chair?

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That’s ok. Many people do. We understand that seeing a dentist can cause some form of anxiety. For many people, it stands in the way of good oral health. But we’d like to change that for you, and show you how to leave dental phobia behind so that you benefit from the oral health you deserve and can enjoy a beautiful, healthy smile.

Fear can come from a variety of sources ranging from dental myths to a bad childhood experience or   even stories passed around about inadequate anesthetic resulting in pain. The fear often boils down to a lack of control in a vulnerable situation, helplessness or worries about discomfort.

But dentistry has come a long way over the years…particularly within the last 10 or 15 years. With substantial innovation moving it forward, modern dentistry has new technologies and techniques in place today that make dental procedures much more comfortable and nearly painless. From a greater choice in effective anesthetics to many procedure options that are much less evasive than years past, dentistry has evolved to focus on comfort as much as health.

At Pine Lake Family Dentistry, we’re committed to helping our patients overcome fear. We start with a comfortable, friendly and safe office environment with staff who care deeply about our patients’ health, wellbeing and comfort. Like Dr. Chen, our dental assistants and hygienists are experienced, well qualified and continually educated on the latest dental innovations and techniques so that our patients trust they are getting the very best care possible.

For many, the first step can be the hardest: to pick up the phone and call us. Stepping outside of our comfort zones is tough for anyone, but taking the action to call for an appointment truly is the most important part of getting past dental fear and getting the care you need.

It starts with a simple conversation. Whether it’s by phone or during a complimentary consultation, we listen. We get to know our patients and understand them—often before even sitting in the dental chair for the first exam. We take the time to understand your priorities, learn the details around any sources of anxiety, and explain how the experience at Pine Lake Family Dentistry will be different. On the first meeting, our new patients receive a personal commitment from Dr. Chen and our staff to create a new dental experience, resetting expectations and to build a relationship based on trust and communication.

Our primary concern is patient comfort and offering choices. So, Dr. Chen makes every effort to ensure you’re in control of your experience, providing guidance to make educated choices in the care you receive, and to reduce or eliminate discomfort, making sure that during any procedure that you are ready to proceed from step to step. Our patients always have a voice, are asked to communicate what they’re feeling and are empowered to make decisions.

While trust, communication and comfort are paramount for our practice, Dr. Chen and her staff take additional steps to ensure patient comfort, allowing you to choose how much additional support you may need in advance and during any dental procedure. Depending upon the situation, Dr. Chen is qualified to offer nitrous oxide, commonly known as laughing gas, for general relaxation and a variety of appropriate oral sedation methods. Careful anesthetic technique allows for near painless numbing.

At Pine Lake Family Dentistry, we do everything we can to relieve the fear our patients may have about visiting us. We take the time to listen carefully, and explain how to maintain healthy teeth and gums at home, what we find during your exam and provide the detail you need to make choices that are right for you.

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Dr. Chen and Family Featured in Plateau Living Magazine!

The November issue of Plateau Living Magazine will be hitting doorsteps this week, and many of you will see a very familiar face on the cover: Dr. Susan Chen!

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Plateau Living Magazine dedicates its pages to the exceptional quality of life on the Sammamish plateau, featuring families and businesses that make our community a wonderful place to live. Each month, the magazine features a family from the plateau, telling their stories and highlighting their interests, professions and community contributions. Its mission is to connect people to each other, and deepen relationships within neighborhoods.

The team here at Pine Lake Family Dentistry is thrilled to see the magazine feature Dr. Chen and her family, shedding light on the life of one of our most valued community dentists. Though she may be blushing from all the attention, we think it’s great to see the magazine shine a light on Dr. Chen’s passion for family and this community.

Learn more about Plateau Living Magazine on their Facebook page.

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Should You Replace Your Silver Fillings?

While silver makes for beautiful adornment, in the mouth, it can draw unwanted attention to previous dental repairs, where missing, worn, damaged or decayed teeth have been restored.

Before & After: Silver amalgam replaced by natural-looking composite fillings

Before & After: Silver amalgam replaced by natural-looking composite fillings

For more than 100 years, cavities have been commonly filled with a silver compound called amalgam—a stable alloy made from mercury, silver, tin, copper and other metals. But over time, the metals in amalgam break down, creating tiny gaps between the filling and the tooth, where bacteria sneaks in to cause further decay. It can also cause teeth to look dark, grey or dingy, making it difficult to achieve a bright, beautiful smile.

But advances in dental materials offer new ways to restore damaged teeth back to their original form and function, often with more natural looking results.

Composite fillings, a non-toxic compound made from resin and ceramic, are the leading choice for most tooth repairs today. Durable and long lasting, composites restore strength to the tooth structure by filling the damaged cavity and bonding the material to the original tooth, allowing a more conservative repair.

Conceal your dental repairs with composite fillings that mimic the color and texture of your natural tooth enamel, hiding previous dental repairs and preventing breakage—revealing a natural, healthy smile.

While amalgam fillings are deemed safe by the FDA, composite fillings are often a more appealing solution to restore damaged teeth so that you look and feel your best.

Ask Dr. Chen if composite fillings are right for you.

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