Why Replace a Filling?
Fillings don't last forever. They can become discolored. For example, amalgam or silver fillings corrode and tarnish. Composite, tooth-colored fillings pick up stains, and yellow or darken over time. When you chew, your teeth and any fillings in them are subjected to tremendous pressures. Even if no other problems develop, some fillings will wear out over time and will need to be replaced. A filling will need to be replaced earlier if it falls out, leaks or cracks.
Food debris and bacteria can seep down under a filling that is cracked or leaking. Since you can't clean there, the bacteria feed on the food debris and form the acid that causes tooth decay. Decay under a filling can become extensive before you notice it or it causes you pain. This is why you should have your fillings checked regularly and get them replaced when problems are found.
Fillings That Fall Out
Fillings can fall out for several reasons:
You chew too hard on a large filling, and break the filling or the tooth.
A filling material was used that cannot restore the tooth to its proper form and function. For example, if you have broken a large piece of your front tooth, a porcelain (tooth-colored) crown is probably the best treatment choice. In some cases, a dentist may place a composite filling instead. This may look good or acceptable. However, if the composite is too large, a strong biting motion may break the plastic material.
The cavity is contaminated with saliva when the filling is placed. For composite resins, this will disrupt the bonding of the material. As a result, the bond will not stick well to the tooth and it may fall out.
Cracked Fillings
Both amalgam and composite fillings can crack, either soon after they are placed or after the fillings have been in place for some time.
Cracks can occur soon after a filling is placed if the filling is higher than the rest of the tooth surface, and must bear most of the force of biting. Cracks also can occur over time, as the forces from chewing and biting affect the filling.
Small cracks also can occur at the edges of a filling. These usually are caused by wear over time. These cracks often can be repaired.
Leaking Fillings
A filling is said to be leaking when the side of the filling doesn't fit tightly against the tooth. Debris and saliva can seep down between the filling and the tooth. This can lead to decay, discoloration or sensitivity.
Both amalgam and composite fillings can leak. An amalgam filling sometimes leaks slightly after it is placed. You would notice this as sensitivity to cold. This sensitivity decreases for the next two to three weeks. Then it disappears altogether. Over that period, the amalgam filling naturally corrodes. The corrosion seals the edges of the filling and stops any leaks.
A composite filling could be contaminated with saliva. This would weaken the bond between the filling and the tooth and allow for leaks. Other times, there may be small gaps where the tooth and filling meet. These gaps are caused by shrinkage when your dentist places the filling. Sensitivity after receiving a composite filling may disappear over time. If it doesn't, the filling may need to be replaced.
Fillings also can leak as a result of wear over time. These fillings should be replaced.
Worn-Out Fillings
Some fillings can last for 15 years or longer. Others, however, will have to be replaced in as little as five years. Your dentist can determine if your fillings are worn enough that they need to be replaced.
Clenching and Grinding
If you clench or grind your teeth, you may have more problems with your fillings. The forces placed on your teeth can lead to tooth sensitivity and extra wear on your fillings. Clenching or grinding also can cause your teeth and fillings to crack or develop small craze lines. These are fine cracks you can see if you shine a light on your tooth.
Keeping Your Fillings
Although some fillings can last for many years, the average life of an amalgam filling is five to seven years. Some can last 15 years. Composite fillings may not last this long.
Your dentist will examine your fillings at your checkup visits. You may need X-rays if your dentist thinks a filling might be cracked or leaking, or if decay is occurring under the filling.
When to make an appointment with your dentist:
If a tooth is sensitive
If you see a crack
If part of a filling appears to be missing
To help your fillings last, you should visit your dentist regularly for cleanings, brush with a fluoride toothpaste, and floss once a day. If you have many fillings or very large fillings, your dentist may prescribe a fluoride gel you can use at home. The fluoride will help strengthen your teeth and prevent future cavities. Your dentist or hygienist also can apply a fluoride varnish around the edges of these teeth at your checkup visits.
Replacing a Filling
Before removing your old filling, your dentist will discuss treatment options with you. It is often possible to repair an old filling instead of removing it and replacing it completely. However, if the entire filling has to be replaced, the dentist may reevaluate what filling material to use. Talk with your dentist about your preferences for appearance, form and function. Then he or she can select the material that is best for you.
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