Frequently Asked Questions

I hear that silver fillings are half mercury, doesn't that make them dangerous?
First I want to say that we live in an environment that bombards us with information. The trick is to tell proven science from opinion or pseudoscience. I have a scientific background and it's hard for me to tell what literature is real science. It's easy to read good writing and get emotionally caught up in it. That doesn't mean it's science. A list of hundreds of physicians who support an idea at the end of an article does not make something scientifically supported. To be science one wants to see articles written in peer reviewed scientific journals cited as references. This is the easiest way to tell real science from opinion. In my opinion, patients are relying on me to provide proven, scientifically supported treatment. If I introduce treatment based on ideas alone, I don't believe I would be holding up my end of the agreement. So, finally, my answer to the question. Amalgam or silver filling material is indeed about half mercury. Elemental mercury, mercury in a pure form, is poisonous. Mercury in silver fillings is combined with other materials. Many people compare silver fillings to table salt. Salt has two basic ingredients, sodium and chloride. Chloride by itself is poison, but combined with sodium it makes table salt. There has never been a scientific study showing that people with silver fillings are any more likely to develop any disease or any other condition. Silver fillings have been around since 1603 and began being regularly used in France in the early 1800's. Newer studies show that silver fillings outlast white colored or composite fillings, sometimes by a large margin. Silver fillings have a bacteriostatic characteristic, meaning that it's not easy for bacteria to grow under them. The American Dental Association has concluded that amalgam and composite materials are safe and effective for tooth restorations. So, I believe silver amalgam filling material is a viable option for dental restorations, however most patients choose the tooth colored fillings. Tooth colored fillings are, by far, more esthetically pleasing.

What is the difference between a denture and a bridge?
The basic difference in that one is removable and the other stays in the mouth "permanently". The "bridge" stays in the mouth and the "denture or partial denture" is removable. One common disadvantage of both is that the bone where the teeth are missing will slowly melt away. The jaw bones support facial aesthetics. Plastics surgeons say if there is a single thing one can do to keep looking young, it's to keep your teeth.

Do you take out wisdom teeth?
Yes we do remove wisdom teeth. Our low dose dental CT gives us a 3-D image so we can see exactly how impacted wisdom teeth are positioned and where your vital structures lie. Dr. Miller has extra training in impacted extractions and he travels to several bay area offices to perform their oral surgery. He did a "mini residency" at UOP Dental School as well.

Do medications for osteoporosis cause oral surgery problems?
It is true that oral surgery introduces some risk for patients who have been taking medications for osteoporosis and osteopenia. The risk is considered low, but the complications can be severe. The scientific data suggests that after taking oral bis-phosphonates for three years or more, a risk is introduced. Examples of these medications are Fosomax and Boniva. Bis-phosphonate medications given Intravenously carry higher risks and need to be evaluated differently. There is no test that is considered 100% reliable to predict ones risk. There is, however, a test that gives us some information about ones bone metabolism. CTx stands for Serum C-terminal crosslinked Telopeptide, a marker used to measure bone metabolism. A low value indicates that bone turnover is low and thus less likely to recover from trauma. Some believe this test is predictive, others believe it's better used to evaluate patients recovering from the complications and still others question it's validity. It's an easy blood test, and it does give us information about how ones bone heals, so I like to use the test. For a discussion on this topic go to:

Do you take my insurance?
We work with most insurance companies and Barbara & Jamel are very good at getting the most of your insurance benefits.

Is Dr Miller an Oral Surgeon?
Dr. Miller is a general dentist with comprehensive training in minor oral surgical procedures. These include dental implant placement, bone grafting in preparation for implant placement, impacted wisdom teeth extractions, gum grafting and more. Dr. Miller is an independent contractor performing oral surgery for several Bay Area dental offices. He completed a mini oral surgery residency at University of the Pacific under Dr. Garibaldi and his team. He has also earned Diplomate standing in the American Dental Implant Association and Mastership standing in the International Congress of Implantologists.

Same Day Implants, Implants In A Day, All-on-4® and Other Full Arch, Single Day Full Arch Immediately Loaded Implants
Yes, teeth placed on implants the same day is possible. As you can imagine, every case is different, so we'd need to evaluate your specific situation. Generally speaking, cases where we place several implants at one time are the best candidates for teeth in a day. Many patients assume that smaller cases, involving one to four implants, would be easier to restore immediately. The fact is that when several implants are connected together they act as one unit, which makes it more difficult to move any single implant. This restriction of movement is key for "teeth in a day" treatment.