#12 What Do Dentists and the Olympic Games have in Common?

The Olympic Games have dominated TV screens for the past few weeks and sadly have come to an end. The US pulled off the win with medal count, but tied China for number of gold medals. Gold is so coveted, but did you know dentists have been using gold to restore teeth longer than the Olympic Games have been using gold to signify victory? Yep. You heard that right. In this episode Dr. Mike and Dr. Rusty chat about gold in dentistry and other common materials used to restore teeth!

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Transcript:

Welcome to DM A Dentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike are here to make dental care approachable for everyone because everyone deserves a healthy smile without the fear. Welcome back! We are back! It’s been a little while since we put out an episode, but we’re really excited to be back. I know Rusty, it’s been like a busy summer, man. Yeah, we’ve been out hiking and camping, backpacking, I think you’ve been to a couple weddings. Concerts. Yeah, all the summer things. Yeah, now mention our exciting news coming up too. We have a new podcast studio. So we’ve been in the process of moving studios, sorry, we’ve been a little behind on the content, but yeah, we’re excited. We’re almost moved into our new place. No promises. I don’t know when we’ll be done getting it ready. Yeah, new place. Yeah, so we’re still in our original studio as you can see, but I’m super excited to show you the new space as we get moving into the air and as we get set up in the new space, so can’t wait to show you all what happens. Yeah, super excited about that. It’ll be awesome, but I’m also super excited about the Olympics. It’s been great. We just finished up this past week. Yeah, and USA with the overall win. Yeah. I saw you know we… Hey. You said… You said… Yeah, we had a tight China with 40 gold medals, but we got the overall medal count because we got more silver and bronze than they did. Yeah, I think USA ended up with a total of 126 medals. Yep. China had 91, so we got them there. So beat them by a size of a amount. Overall medal count is nice, but we know it’s gold that matters, and we tied them there 40-40, but got the overall count. True. Yeah, and funny, funny you say that. The gold was first given out at the Olympics in 1904 in St. Louis, so that was like the first gold medal, which is… Yeah, yeah. Yeah, so it’s been around a long time, yeah, the common thing. Yeah. And the Olympics have obviously been around a lot longer than that, but gold, yeah, just surpassed 100 and so years, 100 and a little over that. But gold has also been used in dentistry actually for a lot longer than it’s been used in the Olympics. Gold was used, you know, at least 2,500 years ago, maybe a little bit further back than that too. Wow. Yeah, cool, very cool. Yeah, so it’s very old, isn’t it? It is. It’s been around thousands of years, and I would say the most common use was like to replace missing teeth and to help, you know, like reattach or form of a false tooth with gold, or, you know, various other things gold was used for, like, you know, thousands years ago. Gold used in jewelry, even back in the days, using like cosmetic things for a while, kind of like tooth gems today. Right. Tuth gems are a BC jewelry for your teeth. Yeah, they are. They are, seriously. They’ve got a little line in the enamel and then pops some gold in there, set it up and have a little bit of bling in the gold. Some people are still doing that today with tooth gems or various things like you mentioned. So, yeah. It’s definitely still commonly used today as well, gold. I would say most of the tooth gem type stuff are going to be like, you know, gems, diamonds, sapphire, things of that nature, but gold is definitely still common commonly used. I would say it’s more and more common within the last 100 years in dentistry. Yeah. But still definitely commonly used today. Yeah, definitely very commonly used in mouths and jewelry, things like that. I mean, I still do gold crowns and gold crowns. I do at least four to five a month. Right. And so would you say that’s what if you’re using gold in your practice today or using it mostly for gold crowns? Yeah. I would say mostly gold crowns. Yeah. That’s what we normally do. I mean, crowns, right, which is something that covers the top of a tooth. So crown is like a covering, kind of like you’d have like a porcelain crown or a cap people think of. Right. Yeah. Right. And gold, I would say definitely is going to be more common to use like for back teeth for people, right? Yeah. There’s obviously other options as well for crowns, tooth colored options that will get into a little bit more. But if you’re going to use gold in a case for a crown, why would you use gold like what’s your reasoning on that? Yeah. So like especially in back teeth, I don’t know if people like a mouth kind of operates like a hinge. So sometimes in the back, we have less space. So when we’re preparing that tooth for a crown, we need space for the tooth, but also the material. And sometimes we don’t have enough space. So gold can still be thinner than like a porcelain crown you think of and we can still be just as strong. So that’s sometimes I ask patients, hey, it’s in the back of your mouth, you okay? Have a gold because we can get away with a little bit less space. Right. So yeah, especially useful in the back teeth where kind of those very back teeth can be pretty short to begin with and allows us to keep as much tooth there as possible. And you know, some people I will say also like gold in the front like we were saying tooth gems, gold, a whole gold crown in the front. That’s totally an option as well. I’ve never done anything so so far forward that it’s right in someone’s smile with gold, but the option is certainly there and they’re definitely patients. Yeah, actually at the VA, we did some gold in the front. It’s a good idea. Correct. Like crowns in the front. I mean older people generally like gold and they’ll do it in the front. It can be beautiful. And when it’s really nicely high polished, it’s like a high noble gold with a lot of really really nice quality gold in there. It’s beautiful and it’s really nicely polished. So it can be good, but I would say a majority people would probably not choose gold, especially on a front tooth. So what other types of options are there for people that need a crown up front? Yeah. So people often say like porcelain, but we have a couple of types of, I say porcelain and quotes, but we have traditional porcelain, which is just porcelain, Emax and then zirconia. These are kind of the main three that look like teeth. Right. And zirconia, let’s start into that one. What is zirconia? Well, okay, Rusty. So zirconia, it is a metal. So I often tell people like, I don’t want metal on my mouth, is zirconia is a metal, but it’s different than the amalgam. We’ll kind of get in that later. Zirconia is a white powdered metal oxide and it’s in the titanium family and it can be pretty thin, but it can also be pretty strong, right? So like we, so yeah, that’s zirconia. I’ll let Rusty talk about the next thing. So I would say zirconia is one you would use typically again, like on a back tooth. If you have space. If you have space and it can also be on the thinner side, like it doesn’t need as much room as a porcelain crown would need. So zirconia can be pretty thin as well. Also zirconia is a really good material for people that are going to like heavily grind their teeth because it’s super, super strong. And so I think zirconia is going to be a good option in that case as well as gold, you know, for back teeth. Zirconia has come a long way recently as well where it’s more and more translucent and it means more, which means it’s more aesthetic. It looks nicer essentially because translucent is super important in a material, another tooth colored material that has great translucent is called emax. And that’s the material that I use most commonly when I do crowns. It’s formerly called lithium disillicate, but it just goes by emax and it’s basically like a tooth colored glass or a quartz material that has a lot of translucent. So you can look really nice. Yeah, absolutely. And that’s nice when you have like strength, but also aesthetics, right? Because we often think of metal is strong, porcelain is weak, but now we have, we’re kind of blending the two, which is great. And translucent is important because that material looks more like a tooth. Things like that. Yep, yep. And another reason I like emax is the way that it kind of is glued onto the tooth because with any crown, there’s like a dental glue that’s used to leave the crown in place. And with the emax material, you can actually chemically bond it to the tooth. Whereas kind of those gold and zirconias are going to be more reliant on like the physical properties or mechanical retention, mechanical retention. Yeah, mechanical. What is that mechanical? So, you know, basically for the older materials is kind of like a glue or like think of like a mortar between bricks. It’s kind of a material that goes there as an intermediate and kind of holds the tooth and the crown together as like a super glue. Huh, I mean, yeah, that sounds great. And like, I guess the opposite or not the opposite, but a different option from that would be where we say bonding, right? So bonding instead of like adding another material, bonding penetrates the tooth and crown kind of like essentially blends the molecules creating a chemical bond that is stronger. Right. Right. For sure. You know, newer things in dentistry. Yep. So we’re kind of getting into the weeds a little bit about some of the, you know, chemical properties and the mechanics of some of these materials. But why does any of this matter? Like, if you’re a patient and you need a crown, a crown is a crown. If it’s a front tooth, you’re probably going to choose a tooth colored option. If it’s a back tooth, you might have a little bit more leeway in that again, some people want gold in the front, which is totally cool as well. But why does any of this matter? Like, what is, what are all these different materials or bonding? What, what, why does any of this matter? Well, it matters. So we have different materials based on, you know, just like we have different things and electronics, iPhones like that. We kind of progress through the timeline. That’s true. Yeah. And, and I think, you know, advances in medicine is important, right? Like, the different type of materials, like these Emax materials kind of allow you to save more healthy tooth structure because we can actually chemically bond it and don’t rely just on like the physical properties. So getting into a little bit of the, the, the weedy stuff of it, but it’s, it’s just cool to see the advances and it’s a cool time to be a, be a dentist. Yeah. I mean, that’s true. And it’s nice to be able to save more tooth structure. True. But people often ask me like, you know, we, we talked about what crowns are made of. But what are like we do probably a lot of fillings? What are those made of? Like what, what comprises of that? What we call composite resin, the tooth colored natural looking filling. Yeah. So kind of like how we broke down crowns into like the metal options versus kind of the tooth colored options. I would say fillings are kind of the same way. There’s going to be two big buckets of fillings. It’s going to be a tooth colored filling or it’s going to be a metal silver amalgam type filling. Yeah. And so, you know, like you said, people often ask you a lot of times what fillings are made of. And, you know, I would say most of what we’re going to do is kind of the tooth colored option. So, you know, I would say that’s majority of what people are going to ask of what is the tooth colored? Yeah. The composite resin. Ah, okay. Because everyone pretty much knows these metal fillings, but they’re made of, we’ll talk about it in a second. But a composite resin tooth colored. It’s made of tiny particles like silica, glass, quartz, these molecules chemically cure. Once we add that blue light that we close our eyes to. But, yeah. If you add that blue light, it kind of allows it to shape it hardened. And, yeah, then that’s what that is. So, it’s made of like silica, things like that, like harder material. Yeah. So, basically processed, you know, we’re going to remove like the cavity from the tooth. And then we’re going to, you know, fill it up with this tooth colored composite resin material, shape it, set it up and just make sure everything feels just like it does when you had your normal tooth there. Yeah. Brushes, eats, flosses, does all the things just like normal. And, again, like you said, the good analogy is this composite resin is the newer, more updated version. Whereas the older kind of, you know, older version is the silver amalgam. Yeah. I mean, you can think of it like the amalgams is like when the iPhone first came out in 2007. Exactly. And then it’s kind of comparing that to today’s model. Like, it’s dramatically different. I mean, I had it. Did you have it? I didn’t have an iPhone originally. I actually just recently converted. I had an Android guy forever. But, iPhone, I’m on an iPhone. We’re not judging him. I’m sure Android’s are great. But iPhone is, I don’t know if the band. It’s been good so far. I’m not gonna lie. Guys, it took over a year for him to say that he liked it. Yeah. I do like it. It’s been great for the podcast as well. Air drop. Air drops the word. Air drops the word, yeah. I think goodness. But, yeah, you know, these, again, kind of like most patients are probably not going to want a gold crown in the front. Some do. Most patients today are not going to want a silver filling. But there’s a lot of dentists out there that still use them. It’s not a bad thing. Right. And I think there are certain circumstances that amalgam can be really useful too. Like, I liked my flip phone for a lot of free time. And you know, like moisture control. Things like that. It’s like actual, you know, reasons and then it’s decided that amalgam is very useful. It does work. And good. But most people are not going to opt for that. So most of it’s going to be tooth colored. So. Yeah. Exactly. I mean, I can’t even offer amalgam. I don’t have it. Yeah. We don’t have it in our office either. I have not done an amalgam since the dental school. Have you? The VA. Do you do them in the VA? Yeah. Fair, fair. Yeah. So I mean- The VA, we still do it. And the military is at work set these like military readiness events. And most of those are going to be amalgam feelings too because it’s a lot less materials that are needed and- That is true of bonding, the edge, you know, the count, the- And the military ones tried and true. Yeah. Yeah. And the amalgam has been around for, you know, tried and true for decades. But again, we’re not against amalgam and has its uses out there. It’s still a great material, but it’s just kind of an update to what things are done. It’s kind of like, you know, the way impressions are taken for our patients. Traditionally, impressions are kind of- A big, goopy material going in a tray that kind of sets up in your mouth. And nowadays it’s mostly digital scans, not mostly, but definitely trending that direction. My office does digital scans for all of our crowns and just overall cases and things as well. Yeah. You still have to do traditional impressions for everything. So, it’s awesome. Yep. What is Alginate made of, Rusty? ALGINATE So that’s one of those kind of goopy- Fun fact. And materials that goes, you know, to help make these models or impressions of your mouth. And it’s made of brown algae. Actually. So kind of the organic, yeah. Yeah. Exactly. The brown algae, Algiante. But, you know, guys, we missed you. We’re happy to be back. Sorry for the break. Summer gets a little crazy. Of course, we’re out there enjoying everything. And we hope you all are too. But we’re happy to be back. And again, we’re having that new podcast studio coming soon. So we’re stay tuned for that. Yeah. Bye. [MUSIC] Thank you for listening to today’s episode of DM A Dentist brought to you by Dose of Dental. And thank you for your interest in improving your oral health. If you like your questions answered by Dr. Rusty and Dr. Mike, visit us at doseofdental.com or DM us on Instagram @yourdailydoseofdental. [MUSIC]