Share Still by far the most common reason for fillings is decay. Sugar and bacteria combine to create acid. This acid attacks the enamel and as the enamel dissoves the bacteria progress deeper into the tooth or around the old filling. It’s the result of a simple chemical reaction. The less the quantity of sugar (and just as importantly) the less frequently you take the sugar, the slower the decay will progress.
As the bacteria approach the core of the tooth (the pulp) you will get sensitivity from hot, cold or sweet food and drink. Initially the pain may only last a few minutes but as the cavity gets deeper the pain lingers longer each episode. At a certain point the nerve tissue of your tooth becomes irreversibly damaged and either root canal treatment or extraction will be required.
As a simple rule, the earlier a cavity is diagnosed, the greater your chance of saving the tooth easily. A good analogy I often discuss with patients is if you have a slate loose on the roof, don’t wait until there is water in the bedroom. It will always be simpler and less costly to fix the slate and prevent more extensive and expensive damage.
The seal of old fillings can eventually leak and need to be replaced. Different materials have different mechanical properties and abilities to withstand the rigours of the day-to-day mechanical and chemical loads that consistently batter your teeth while eating and sleeping.
It really is a remarkable achievement that these materials survive the wear and tear we give them for so long, but eventually either the bond of the filling to the tooth, the filling material itself or the surrounding tooth structure fails from chemical attack or mechanical load. The bigger the filling compared to the tooth, the higher the risk of failure and the greater the need for a stronger alternative.
“The filling is fine but the tooth around it has broken.” With the forces we put on our teeth for many years, eventually something has got to give. Enamel and dentine are immensely strong and able to resist biting forces, but a cavity or filling always weakens the integral crystalline structure of the tooth.
If a cusp (corner) of the tooth breaks, or the fracture extends onto the root, this will determine the survival and the choices of material and techniques your dentist can offer. Each time a filling has to be replaced, it is likely to increase in size. Early detection of a failing filling will reduce the size of the replacement. The stronger the replacement filling, and the better your oral hygiene and diet, the longer it will last.
Remember that regular inspection and early detection will always increase your chance of successful replacement and reduce your fees.
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