Advice on a few daunting dental procedures and when to get a second opinion on undergoing them.

By Bora Chang
Updated July 06, 2006
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You may not be at your most rational while sitting in a dentist’s chair. So when your dentist says you need a gum graft or that all your fillings should be replaced, you may panic. But if you know ahead of time what’s being suggested, you can give a sensible answer. Here are a few daunting dental procedures and advice on whether you need them.

Replacement Filling

Generally, if an amalgam filling (made of silver, tin, copper, and trace amounts of mercury) is breaking down, a dentist will replace it with a composite one (made of plastic and glass). While amalgam fillings may last longer, composite fillings insulate the teeth better from temperature changes, and because they can be matched to the color of your teeth, they look better.

When you need it: If an X-ray shows a broken amalgam filling. “Old amalgam fillings can wear and crack over time, which can allow bacteria to seep in between the tooth and filling, creating cavities,” says Katherine de Luna, a dentist in San Francisco. And despite the fact that some critics believe the mercury in amalgam fillings could be a health hazard, according to the American Dental Association, “no health consequences from exposure to such low levels of mercury released from amalgam restorations have been demonstrated.”

Get a second opinion if: A new dentist says that all your old fillings need to be replaced.

Gum Graft

If your gum lines are receding—because of overbrushing, not enough brushing and flossing, or a bad bite—your dentist may suggest a gum graft. Typically, your dentist or periodontist transplants a piece of skin from the roof of your mouth to the edge of your gum line.

When you need it: If receding gums have exposed your roots, leaving you extremely sensitive to heat and cold. The teeth most prone to root exposure are the lower front teeth and the premolars, located right behind the canines.

Get a second opinion if: Receding gums aren’t causing discomfort.

Laser Technology

Some dentists now use lasers instead of old-fashioned drills to clean out decayed teeth. Lasers are precise, rarely require anesthesia, and reduce healing time, according to Bruce DeGinder, a dentist and president-elect of the Academy of General Dentistry. And unlike drills, which require multiple steps, lasers prepare the tooth for a filling in one step.

When you need it: You don’t need to have laser work, but you might want it if you have small cavities or hate getting novocaine.

Get a second opinion if: Your X-rays show a very large cavity. “Because lasers are sources of heat, if you have a big cavity close to the nerve, the laser can irreparably damage the nerve of the tooth,” says Julie Barna, a dentist in Lewisburg, Pennsylvania.