White filling resin with no Bisphenol-A

Like Affinity Dental Care, most dentists nowadays do not use silver amalgam fillings anymore because of the mercury content in this material.

We only use composite resin for the fillings in both anterior and molar teeth to avoid mercury alloy. We like composite resin because of other advantages as well – tooth coloured, translucency that makes it more life-like, less drilling and removal of sound tooth structure before filling with this material, and ease of repair.

However, there are many different brands of composite resin by several manufacturers. They are not all the same in terms of chemistry and their properties.

Unfortunately, many different brands use BPA (bisphenol-A) or Bis-GMA (Bisphenol-A-Glycidyl-Methacrylate). BPA is an endocrine-disrupting chemical that affects your health in a large quantity. Considerable exposure can cause problems in the brain and prostate of fetuses and children. It can also cause behavioural issues in children. Other studies also link this chemical to early puberty, metabolic disorders such as obesity and diabetes, heart disease, high blood pressure, infertility, thyroid dysfunction, and some cancers.

Spermatogenesis impairment and male reproductive abnormalities are related to excessive exposure to this chemical.

Bisphenol-A is a commonly used chemical for plastic materials such as polycarbonate bottles, containers, or coatings of cans. Bis-GMA is not the same as BPA; it comprises only the BPA structure in a tightly bonded ether form. There are traces of BPA in those composites, however.

Suffice it to say. It is a good idea to minimize the amount we are exposed to. In Affinity Dental Care, we use a non-BPA or GMA-containing composite resin made by Kulzer Dental called Venus Pearl. Venus Pearl does not contain any of the two chemicals.

Besides this advantage, there are other benefits of this composite material as it is:

  • easy to be used to fill the cavities – it is not sticky and has a creamy consistency that makes the material easy to be applied to the cleaned cavities,
  • durable – the material’s matrix is a nano-hybrid complex (the filler is from 5 nanometres to 5 micrometres) that resists wear, erosion and crack propagation,
  • strong – It combines high flexural strength with minimal shrinkage stress. The results are long-lasting, and
  • good looking – it offers a wide range of shades and can be applied in single- and multi-shade layering techniques. The material adapts perfectly to the colour of the surrounding teeth, creating an outstandingly natural look.

We do not introduce chemicals that are known to cause harm to our patients at Affinity Dental Care cause we like to consider wellness and health for our patients.

Non-BPA Fillings

Non-BPA Fillings

Top – a molar with a silver amalgam filling. Bottom – the same molar with a white composite resin filling. Dr. Wong at Affinity Dental Care did the filling.


New Dental Implant

Modern dental implants are almost all made of titanium metal inserted into the jaw bone to support artificial teeth made with tooth-like materials. The material could be porcelain, lithium disilicate, composite resin, acrylic or zirconia. There are a few implants made with zirconium oxide, however. The titanium implants are usually greyish metallic, and the zirconium oxide ones are white. Titanium implants have a long history of success. The first titanium dental implant was placed in a human volunteer in 1965 by an orthopedic surgeon named Dr. Branemark. The white Zirconium oxide implant has a shorter history; it was first introduced in 2005.

Dental implants function like roots in the jaw bone to solidly support structures like crowns, bridges and dentures in the mouth that the patients would otherwise could not have. In order to place the implant in the bone, several surgical procedures may involve. After the implant is placed in the bone, a few months is needed for the bone to heal tightly around the implants before the implants can support functional teeth.

There are many other benefits of having the implants besides having new teeth that do not move:

  • Maintain jaw bone by reducing bone resorption of the jaw bone where the implants are located. Without the implants in the bone, the bone will gradually become smaller in dimension and density.
  • Can confidently chew more solid food without pain from the otherwise sliding, painful and unstable dentures.
  • Improved appearance and smile because implant-supported teeth can look and feel like your own teeth, having the appearance of pink gums around the teeth naturally.
  • Improved speech with the spaces having teeth and no more unstable, loose dentures
  • Improved comfort because the implants become part of you; implants eliminate the discomfort of removable dentures.
  • Improved self-esteem because dental implants can give you back your smile and help you feel better about yourself.
  • Improved oral health because implants can be placed in the bone where the teeth are missing, either immediately or after extractions. Implants do not involve other teeth as a tooth-supported bridge does. Individual implants also allow easier access between teeth, improving oral hygiene.
  • Implants are very durable and will last many years. With good care, many implants last a lifetime.
  • Convenience because implants eliminate the embarrassing inconvenience of removing dentures and the need for messy adhesives to keep them in place.

There are many shapes and sizes of implants. Conventional implants usually have a width between 3.3 mm to 6 mm. Mini-implants are long and narrow and have a width of between 2.2 to 3.00.

Lately, Keystone Dental has developed wide-body implants ranging from 7 mm to 9 mm. The wide-body implants are for immediate replacement of a molar tooth in the same sitting after a tooth is removed. A conventional implant is often not suited for immediate placement in the molar extraction socket because the smaller size cannot effectively fill up the wide of the socket of the molar after extraction. On the other hand, a wide-body one can fill up the space of the molar socket much better and, therefore, have more stability. Better stability means a better outcome in the healing process.

Wide body dental implant
Wide-body implant
Conventional dental implant
Conventional dental implant

Another nice feature of these wide-body implants is the shorter lengths than conventional implants. They only need shorter lengths because they have much wider diameters that provide more surface area for bone to heal into them. Frequently, there is not enough bone depth for a conventional implant to be inserted before it encroaches into vital structures like the sinuses, inferior alveolar nerve, lingual nerve, and blood vessels. A shorter wide-body implant can be a good option in cases like these.

The other benefits of the broad platform of the wide-body implant allow for an emergence profile suitable for a molar restoration, less food trap and more aesthetic. Because they are ideal for immediate placement in a multi-rooted molar extraction socket, therefore they require a less surgical procedure, shorter treatment time and maximized bone preservation.

At Affinity Dental Care, we provide implant treatments using conventional implants and the new wide-body implant to restore teeth with crowns, bridges and secured dentures for our patients.

Image courtesy of Keystone Dental
Courtesy of Keystone Dental

Kids’ teeth grinding during sleep

Sleep bruxism in children is characterized by grinding and involuntary teeth clenching. It is natural to be concerned if you hear your child grinding their teeth in their sleep. Bruxism in children lasts about four seconds and can occur up to six times per hour. Typically, the parents notice the condition first because they can hear the grinding noises at night.

Many kids have it, but most outgrow it without lasting problems.

If your child is around 3 to 5 years old, I would not be overly concerned about it because some scholars have indicated that sleep grinding at that age could produce physiological wear to allow the growth and development of the jaw. It can become more of a concern if you hear or notice your older children grinding their teeth at least three times per week for two months because repetitive masticatory muscle activity can cause serious health complications. Typically, the incidence of sleep grinding decreases from ten years old onwards.

Causes of Sleep Bruxism in Children

Kids grind their teeth for a few reasons:

  • pain, such as from an earache or teething
  • temporomandibular joint disorder (TMD)
  • erupting adult teeth in the mixed dentition period, typically between 6 to 12 years old
  • misaligned teeth
  • stress (worry about a test or a change in routine) and social anxiety disorder (arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching)
  • medical reasons like hyperactivity, cerebral palsy, attention-deficit disorder, gastroesophageal reflux, sleep apnea or hypoxia secondary to airway obstruction
  • taking some types of medicines like antidepressants and psychotropic drugs for anxiety
  • frequent snoring and mouth breathing, which could be a sign of upper airway obstruction
  • daytime bad habits and parafunction like lip, pen and nail-biting
  • frequent nightmare
  • second-hand smoke
  • genetic reason and personality trait (it runs in families). Studies have indicated a positive correlation between the concentration of catecholamines in the urine and sleep bruxism. Disturbances in the GABAergic and glutamatergic systems of the brain also have a positive correlation with sleep bruxism

Many times, bruxism is not noticed and does not cause problems. Often, it’s more bothersome to other family members because of the grinding sound.

But sometimes, it can cause:

  • headaches
  • worn down tooth enamel or chipped teeth
  • sensitive teeth
  • face, ear, or jaw pain
  • sleep disturbance that can cause behavioural problems and medical issues because they are not getting the rest children need

It can be challenging to pinpoint the cause of bruxism. I may use a method of elimination to determine the cause. I need to examine the patient systematically to determine the causes and risks, then provide treatment to the patient accordingly if the reasons are a concern.

Treatment for Bruxism

Most kids will outgrow sleep bruxism, but they still need to be monitored by the dentist. Grinding can damage both primary and secondary teeth and affect current and future oral health. The treatment approach can include monitoring and

  • a nighttime mouthguard
  • an examination by a pediatrician if medical reasons like tonsilitis and airway obstruction are suspected
  • reduction of the stressors – parents’ roles are vital because they could be the ones who can help to eliminate the stressors like high expectations and excessive extracurricular activities like piano lessons or sports
  • referral for mental health counselling
  • improve your child’s sleep hygiene by making sure their room is dark and quiet, limiting their time on cell phone and computer
  • Soothing bedtime activities like brushing teeth, taking a warm bath, cuddling together with your child, reading stories and soft music
  • provision of nutritious diet low in added sugars but avoid hard snacks like corn chips, popcorn and chewing gum
  • stretching exercises and facial massage techniques
  • orthodontic treatment to align the teeth and create proper arch forms that can help healthy orofacial development
  • elimination of parafunction and bad habits like nail and pen biting
  • acupuncture and photomodulation of the (acupoint) trigger points
  • Stop using a pacifier if the kid is still using it after 2.5 years
  • Hydroxyzine medication before bed for two months for older children

Combining the above treatment modalities is often needed if the condition is severe. We love to see children at Affinity Dental Care.