Spring Lake Dental Group

Tooth Colored or Silver Restoration: Which is Better?

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

We, at Spring Lake Dental Group, we pride ourselves on patient education. We want you to know whenever you have an appointment; what we are going to do, why we are going to do it, how we are going to do it and how much it will be based upon your dental insurance (if you have insurance.) Our staff and business team are experts on advising you of your choices and the indications and contraindications of each of these choices. They are also very conversant about dental benefits and the limitations of your policy. Knowledge on your part is power, right?

We offer various different restorative materials to successfully restore your health and smile, but the most common question is whether to restore a tooth with a tooth colored filling or a silver amalgam filling. We offer both options and feel that both are superior restorative materials in the right situation. It is all about treatment planning and patient education. No doctor that works at Spring Lake Dental Group is intimidated by questions. Feel free to ask!

There are many dental practices in the United States that do not offer silver amalgam restorations for various reasons. They have really gotten lot of bad press lately in the media because of the fact that they contain mercury (in the chemical reaction that turns them from a soft malleable material into a hard, functional restoration.) The American Dental Association has done exhaustive work in reviewing all scientific material concerning the risks of amalgam restorations containing mercury and has made the recommendations to the dental community. They concluded that silver/tin/mercury (amalgam) restorations are an adequate restoration to place in human dentitions as a restorative material when indicated.

A quick history of the benefits and risks of choosing between tooth colored and silver restorations would have to include the indications and contraindications of each material. Let’s just say that next week’s blog will include those indications and contraindications. My advice to my patients today would be to have a face to face conversation with your care provider. Every situation is different and the art and science of dentistry is to figure out what is best for you. We, at Spring Lake Dental Group look forward to having those conversations with you!

Oral Piercings

Author: Dr. Rima Solanki, DMD

Oral piercings or tongue splitting may look cool, but they can be dangerous to your health. That’s because your mouth contains millions of bacteria, and infection and swelling often occur with mouth piercings. For instance, your mouth and tongue could swell so much that you close off your airway or you could possibly choke if part of the jewelry breaks off in your mouth. In some cases, you could crack a tooth if you bite down too hard on the piercing, and repeated clicking of the jewelry against teeth can also cause damage.

If you pierce your tongue, lips, cheeks or uvula (the tiny tissue that hangs at the back of the throat,) it can interfere with speech, chewing or swallowing. It may also cause:

  • Infection, pain and swelling- your mouth is a moist environment, home to huge amounts of breeding bacteria, and an ideal place for infection. An infection can quickly become life threatening if not treated promptly. It’s also possible for a piercing to cause your tongue to swell, potentially blocking your airway.
  • Damage to gums, teeth and fillings- a common habit of biting or playing with the piercing can injure your gums and lead to cracked, scratched or sensitive teeth. Piercings can also damage fillings.
  • Hypersensitivity to metals- allergic reactions at the pierced site are also possible.
  • Nerve damage- after a piercing, you may experience a numb tongue that is caused by nerve damage that is usually temporary, but can sometimes be permanent. The injured nerve may affect your sense of taste, or how you move your mouth. Damage to your tongue’s blood vessels can cause serious blood loss.
  • Excessive drooling- your tongue piercing can increase saliva production.
  • Dental appointment difficulties- the jewelry can get in the way of dental care by blocking x-rays.

If you already have piercings:

  • Contact your dentist or physician immediately if you have any signs of infection—swelling, pain, fever, chills, shaking or a red-streaked appearance around the site of the piercing.
  • Keep the piercing site clean and free of any matter that may collect on the jewelry by using a mouth rinse after every meal.
  • Try to avoid clicking the jewelry against teeth and avoid stress on the piercing. Be gentle and aware of the jewelry’s movement when talking and chewing.
  • Check the tightness of your jewelry periodically (with clean hands). This can help prevent you from swallowing or choking if the jewelry becomes dislodged.
  • When taking part in sports, remove the jewelry and protect your mouth with a mouthguard.
  • See your dentist regularly, and remember to brush twice a day and floss daily.

Of course the best option is to consider removing mouth jewelry before it causes a problem. Don’t pierce on a whim. The piercing will be an added responsibility to your life, requiring constant attention and upkeep. Talk to your dentist at Spring Lake Dental Group for more information.

What You See

Author: Kimberly N. Powell, DDS, MS

During your hygiene appointments, a clinical and radiographical evaluation is performed by your dentist. Radiographs will show gray scales from white to black depending on the object density. The more dense an object is, the less the x-ray beam hits the film/sensor and is absorbed by the object making it appear bright/white. Objects that are less dense will not significantly obstruct the beam from hitting the film/sensor and will appear dark/black. When looking at the oral cavity radiographically, all shades aren’t equal. The enamel and dentin of a tooth appear gray with the dentin being slightly darker. The pulp chamber and root canal show a distinctively darker gray compared to the enamel and dentin due to the lack of density. An amalgam/silver filling will appear a bright white, and composite/tooth-colored filling appear a softer white. When evaluating healthy tooth structure, the only really dark area on a tooth is where the nerve resides. Decay destroys tooth structure making it less dense and appears dark gray to black on the radiograph. Although the size may vary, what is now seen on the tooth is pathological not physiological and needs to be treated before further damage is done. While things look just gray on the radiograph, a colorful picture is being reflected for the clinician.

Dental Hypersensitivity

Author: Dr. Alison Vitelli, DMD

Did you know July is National Ice Cream Month? I totally get why! HOT North Carolina summer days call for delicious COLD ice cream to cool you down. But, OUCH! Suddenly, your teeth are hurting?  You may wonder why. As with any other condition in our body, multiple reasons can cause tooth sensitivity.  The most common one being gum recession.  This means that the level of the gum has come down, now exposing dentin tubules along the root of the tooth and this area is no longer protected by enamel and that hurts!  Recession can be caused by aggressive brushing, habits or excessive biting forces (clenching or grinding your teeth).  At its initial stages, recession can be extremely uncomfortable but not deep enough to need extensive treatment.  As with any dental treatment, Spring Lake Dental Group strives to be as conservative as possible and tooth sensitivity can be treated by different means. My recommendation to my patients is applying a small amount of any sensitivity toothpaste (active ingredient: potassium nitrate) along the gumline of the sensitive teeth after brushing and flossing.  This should be repeated 2 times a day for 2 weeks, without rinsing or eating at least 30 minutes after applying it.  Usually, this helps resolve or significantly decrease the sensitivity.  If the symptoms are persistent even after trying this then other treatments should be considered including fillings to cover the exposed area or repositioning the gum tissue to its natural anatomical position.  Other reasons for tooth sensitivity can include cavities, fractures on the enamel, defective fillings among others so an accurate dental examination should be done before any definitive treatment.

If you are experiencing tooth sensitivity, please call us today to schedule your next visit and speak with your dentist about your options!

North Carolina Missions of Mercy

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

The North Carolina Dental Society is coming to Fayetteville’s Crown Coliseum on Friday, August 3 and Saturday, August 4, 2018 with the community outreach program, ‘Missions of Mercy’. This is a free clinic to the citizens of North Carolina who have no dental insurance and do not possess the needed funds to seek local dental care. The clinic does more than just pull teeth. They provide dental screenings, dental cleanings, digital radiography as well as definitive dental procedures such as fillings,  transitional partials, full dentures and extractions. There is a great need for our community to contribute and support this effort. Volunteers are needed to all areas. You do not have to be in the medical field in order to assist in this worthwhile endeavor. The clinic needs volunteers to assist in areas such as registration, escort services, set up and tear down, etc. if you have the heart to give your time and talents, please go to the website of the North Carolina Dental Society and click on the ‘MOM Clinic’. There you will find a volunteer link to submit your information. When you attend, know that you will see your friends from Spring Lake Dental Group assisting in this amazing opportunity to give back to our wonderful community.



Philips QuickPro In-Office Whitening

Are you interested in a brighter, whiter smile? Spring Lake Dental Group is so excited to introduce a new option for teeth whitening that can get your teeth up to 4 shades whiter in just 30 minutes.  

Introducing Philips QuickPro Whitening!


The Process

This is a simple application of a 20% hydrogen peroxide paint-on varnish with an additional sealant layer that helps to keep the hydrogen peroxide layer in place. It allows you to leave the office after the application and go about your day. Just brush or wipe it off 30 minutes later to reveal a noticeably whiter smile!

Is This Right For You?

This option is ideal for those who want to brighten their smile before an event or for those who don’t have the time to do whitening treatments at home. Because the special sealant layer helps to prevent sensitivity, it is also suitable for those who have increased tooth sensitivity from traditional whitening strips or tray whitening. Just like with all other whitening treatments, it is not recommended for women who are pregnant or nursing.

If you are interested in this new whitening option, please give us a call to set up your 30 minute appointment today!

Anxiolysis Treatment Options

Author: Dr. Alison Vitelli, DMD

Dental anxiety is very common among our patient population.  It can range from certain dislikes (smells, tastes, or sounds) up to a paralyzing fear of even the anticipation of stepping into the office.  It is our duty as dental health professionals to help you through your anxiety, and there are many ways to achieve a pleasant experience at the dental office.  

For me, it always starts by knowing what triggers your dental anxiety. This allows us to determine what to avoid and possible ways to intervene.  Some ways to manage the anxiety at the dental office include simple distractions to help get your mind away of what we are doing (this usually works great with patients who have minor dislikes.)  But for moderate anxiety, we recommend the use of nitrous oxide, commonly known as “laughing gas” or oral sedation.

Nitrous oxide is an excellent adjunct to the treatment since it has proven its efficiency and safety.  It is safe to use in pediatric patients as well as adults. It is administered in a combination with oxygen. The the patient is responsive but relaxed.  The benefit of nitrous oxide is that it does not get stored in the body, so you can keep going on with your day as soon as you get done with your treatment.  

A way to achieve moderate sedation for patients with more severe anxiety is with the oral administration (pill form) of a sedative.  In our office we provide the option of administering a one-time dose of Triazolam (brand name: Halcion) which allows our patients to experience a deeper sedation. Now, comparing it to the nitrous oxide, the moderate sedation requires the presence of a family member or friend who can drive the patient home and follow up the post-operative instructions.  Since the Triazolam does get metabolized in the patient’s system and the effects last even after the dental treatment is completed, it is extremely important this is taken into consideration.

As with any medical protocol, we would determine and let you know if you are a good candidate for any of these anxiolysis treatments.  Never be embarrassed to tell us about your dental anxiety. We are here to help you and we strive to help every one of our patients get the best dental treatment and the best experience in our office.  

If you suffer from dental anxiety and any of these treatment options sound right for you, please speak with your hygienist or dentist at your next visit or call us today 910-497-3200!

Silver Diamine Fluoride: An Option For More Effective Dental Care

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

Spring Lake Dental Group is increasing your options for treating active decay, in a way that will give you more ways to practice preventative oral care. It is a liquid material that is used to arrest dental caries and is marketed under the name “Advantage Arrest” from Elevate Oral Care (www.elevateoralcare.com). The active ingredient in this product is Silver Diamine Fluoride and it is applied to teeth that have active decay. It penetrates only 25 microns into healthy teeth but has the ability to penetrate active decay up to 2 milliliters. As we all know, dental caries is a bacterial infection that produces acids that break up the tooth enamel and dentin structure. This medication kills the active bacteria and arrests the further development of any additional tooth destruction. It has been cleared by the FDA as a desensitizing agent for adults over 21 years of age but is being used off-label for many different indications. Some being, for young children with rampant decay where you are trying to eliminate further decay, prevent pulpal death or where behavioral considerations make traditional dentistry difficult. It is also useful in patients with very complex prosthetic dentistry such as, crowns and bridges with active decay around margins of the restoration and you have elected not to replace or re-do the restoration.

It seems like an amazing product and I am sure you are asking why it has not become more widespread in its use. Well, with any material, there is always an upside and a downside. The downside of this product is that the stained active decay picks up a dark brown to black hue once treated. This unaesthetic staining can be a large detractor to patients acceptance to its use. But as with all treatment planning in dentistry, having an informed conversation with your dentist and hygienist can help you to understand the risks and benefits of using this material. For that child that presents with multiple large carious lesions throughout his or her mouth, using this product in a well thought out program of preventative care, it can be an invaluable tool. Plus, for that elderly veteran living on a fixed income, redoing his complex prosthetic work may be an undo strain on his family budget.

We have incorporated this technology into our program of preventative dentistry so that our patients can potentially benefit. At your next visit, please speak with your dentist or hygienist about this product and see if you or your family could benefit from its cavity arresting ability.


Author: Dr. Rima Solanki, DMD

Do you ever wake up with sore muscles or a tender jaw? This may be due to a phenomenon known as bruxism, where one grinds their teeth during the night. Bruxism is usually attributed to anxiety, stress, abnormal bite, sleep disorder or temporomandibular joint (TMJ) disorder.

Teeth grinding can be caused not just by stress and anxiety but by sleep disorders, an abnormal bite or teeth that are missing or crooked. A study in the November 2016 issue of the Journal of the American Dental Association suggests that; teeth grinding is also associated with alcohol and tobacco use. People who drink alcohol and smokers are approximately twice as likely to grind their teeth.

The symptoms of teeth grinding include:

  • Dull headaches
  • Jaw soreness
  • Teeth that are painful or loose
  • Fractured/cracked teeth

Your dentist can fit you with a mouth guard to protect your teeth during sleep. In some cases, your dentist or physician may recommend taking a muscle relaxant before bedtime. If stress is the cause you may need to find a way to relax through meditation, exercise, counseling, or by practicing yoga.

If any of these symptoms sound familiar to you, speak with your dentist today about your options,  910-497-3200!

Ross White!

Author: Kimberly N. Powell, DDS, MS

There was an episode of the NBC comedy, Friends, where Ross goes a little overboard in whitening his teeth.  The results were “glow in the dark” teeth! A beautiful smile with brilliantly white teeth is desired by a large number of the dental population.  This goal can be accomplished by several methods including bleaching trays, in-office express whitening, whitening strips, dental varnishes, rinses, and toothpastes.  Most people want their teeth brighter as quickly as possible. In-office procedures like Zoom use a gel applied to the teeth activated by a LED light to achieve this result, whitening teeth up to eight shades in one visit!  There are dental varnishes that can be applied to the teeth in office (patient can leave after application), stays on for 30 minutes and is brushed off, resulting in whiter teeth up to four shades! Although some find the whitening trays to be a little cumbersome, others prefer them.  The prescribed whitening gel is either expressed in a custom tray or already saturated in prefabricated ones and worn for up to an hour depending on concentration. There are also over-the-counter products that can achieve great results. Whitening strips produced by Crest, whitening toothpastes by Colgate, Crest, Sensodyne (to name a few), and even whitening rinses are some products that can produce the results you may want.  However, tooth sensitivity is a side effect that should definitely be considered before starting treatment. Also remembering to avoid excess beverages, food, products that can stain your teeth like red wine, coffee, juices, tobacco, etc. If there is an interest in dental whitening, consult your dental professional on the options that may be best for you. If you are interested in whitening your teeth, call us today at 910-497-3200 for more information!

“Be true to your teeth, or they will be false to you.”