Ask the Editors

Editors of THE DENTAL ADVISOR provide clinically relevant answers to questions we receive from attendees at lectures and online. The answers provide useful information and often highlight products that have been evaluated clinically.  
If you would like to ask a question, please click on the "Submit Your Question Here" button, fill out the form and submit it. We will try to respond by email or by posting your question and our answer on our website.
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Featured Questions

Q

Our waterlines seem to be clogging much more than usual. What is the proper maintenance protocol to be sure we don’t have clogged lines during patient care? Is there something we should be checking daily or weekly?

Submitted: May 3
A
Water quality is a big issue in dentistry.  What is most likely clogging your waterline system is the accumulation of biofilm. A major problem is not following the instructions-for-use and maintenance of the water treatment system.  Some systems require periodic shocking of the waterlines, while others require specific source water. Our advice is that you have a complete understanding of your treatment process and equipment used in your office.
Q

Does the bond decrease over time and why?

Submitted: March 7
A
In laboratory testing, bond strengths of some bonding systems may decrease as a result of thermal cycling; however, some bonding systems actually show increased bond strength with thermal cycling. Clinically, some research suggests that total-etch bonding agents may experience decreased bond strength as a result of water penetration (water trees) and also enzymatic degradation. When using a self etched system it is important to to rub the liquid thoroghly onto the enamel to get a good bond.
Q

Why is the bond to dentin even higher than enamel?

Submitted: March 7
A
Dentin (whether etched with phosphoric acid or by self-etching systems) partially because of the dentinal tubules, provides better mechanical bonding than enamel.
Q

There was a time when getting a bond of 20 MPa to enamel and dentin was considered a success. Now I read that some bonds to enamel and dentin are in the 30s and more. Why are the bonds that high?

Submitted: March 7
A
Newer bonding agents with higher bond strengths to tooth structure and other substrates contain variations of MDP. This phosphate-based monomer has a high affinity for tooth structure, metal and ceramic oxides and this results in a higher bond.
Q

Have you had patients complain of a bad taste with composite fillings?

Submitted: October 25
A
  Yes! Our editors and consultants have commented that their patients occasionally notice a bad taste following placement of resin-based materials (sealants, composites, bonding, resin cements, etc.). This is most likely due to the solvents and low molecular weight monomers present in most resin-based dental materials. The bad taste should resolve with a couple of rinses of water or within the hour. If your patients are commenting on bad taste for days or weeks following placement of composite fillings, this could be a sign there is something else wrong. If this is the case, be sure to check the following: Is the composite fully cured? Have you tested your curing light lately to be sure it is doing an adequate job? Is the curing technique and angle of the curing probe being closely monitored? Are you "dipping" your instrument into a resin wetting agent to prevent composite from sticking? Are you using compatible bonding agents and composites?
Q

Have you found a pink colored composite that will help hide the discoloration of an endo tooth that has darkened at the root?

Submitted: June 14
A

Submitted by: Brent Kolb

Answered by: Brent Kolb

There are many gingival colored composites available today. The most opaque I found is Creative Color Pink (Cosmedent).  It is intended as a pink opaque composite.  

Others available include, Wave Flowable (Gingival Shade, SDI North America Inc.), Master-Dent Flow (gingival pink, Dentonics), and Amaris Gingiva (VOCO).

Our consultants and editors evaluated Amaris Gingiva. Here is a link to that report:

https://www.dentaladvisor.com/clinical-evaluations/evaluations/amaris-gingiva.shtml

Here is a link to a publication in Dentistry Today.  It features a nice clinical case report.

http://www.dentistrytoday.com/aesthetics/4728-solving-aesthetic-challenges-due-to-gingival-recession