David F Pascoe DDS MSD
(631) 765-1919

Cerec Technology

The latest computer technology has enabled us to provide the highest level services in convenience and artistry. Using hitech CAD/CAM equipment we can completely fabricate beautiful all ceramic restorations right in our office to complete a restoration in one visit and without uncomfortable impressions. This enables us to ensure optimal contours and colors without multiple returns to a distant laboratory

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A 3D camera is used to capture an image of the tooth and the matching ceramic replacement for any missing tooth structure is designed and milled quickly to provide an immediate restoration without the need for compromise temporary restorations and multiple visits each requiring anesthesia. This brings and new meaning to "smiles by design".

This technology has blurred the lines between veneers, crowns and onlays. It enables us to remove only the damaged tooth structure and replace it. This is much more conservative and much less likely to result in the need for root canal therapy.

Finally with this technology we have a durable esthetic valid alternative to metal fillings which is much less likely to result in future tooth fracture.

Is the mercury in silver fillings poisonous?

This is far from a new issue and has been of concern to the dental profession and ADA for many years. Since my Masters Degree is in Materials Science and I have taught this at 3 universities, it is appropriate that I respond to this.

Silver amalgam fillings have never been proven to cause any disease other than a contact allergy, In a minute number of people it shows as a slight redness around some teeth. This is important because it has been used without know side effect for about 99 percent of the fillings in the entire world, maybe billions of them!!

The alternatives to silver fillings:

If one chooses not to use silver amalgam one must the consider the 3 alternatives:

Gold inlays-

Probably the best restoration but costing approximately 6 times the silver amalgam equivalent. The esthetics in certain situations are much less than ideal.

Porcelain inlays-

Very esthetic, similar in price to the gold ones. Occasionally, chipping in people with heavy bites or hard diets.

Plastic composite fillings-

These really bother me. They have been shown repeatedly in studies to show greater wear and caries recurrence than the silver. They are very esthetic, but basically just do not last as long. This is the filling most anti-amalgamists advocate. It creates alot of work for dentists.

Recommendations:

Gold or ceramic restorations are longer lasting and less toxic if you are prepared for the expense. I have always avoided large complex silver fillings which are prone to breakage corrosion and are most likely to produce the problems discussed. Crowns protect the teeth better and last longer anyway.

Small plastic composite bonded fillings are indicated in areas of low wear and esthetic consideration. This is where we have always used them.

I use very little silver amalgam in the office, but would be reluctant to ban it altogether because in the absence of evidence against it, there is no real alternative in situations where moisture is present, it works and nothing else really does.

My advice is to avoid silver filings if reasonably possible. Do not remove fillings unless you have to. This increases the exposure. In some situations for some people, it may be the only alternative. Avoid cheap crowns, they are usually made of Nickel based alloys that have been shown to cytotoxic to many patients.

The best solution is avoid cavities to begin with. This can be done, call us!

If one chooses not to use silver amalgam one must the consider the alternatives.