When should a filling be replaced?

There is no substitution for a natural healthy tooth. Dental fillings are intended to replace tooth structure and restore a tooth damaged by decay (a cavity) back to its normal function and shape. Silver (amalgam) and tooth-colored (composite) fillings last a long time, though they can develop decay when the integrity is compromised by open margins, fracture, or recurrent decay. In this blog, we discuss the signs and symptoms that indicate your filling may need to be replaced in order to prevent further complications.

Amalgam fillings are made of an alloy (mixed metals) that expands and contracts. They have no bonding properties, and so to place an amalgam filling, the hole in the tooth may need to be larger. Because of these two factors, fractures frequently occur. There are three types of cracks that are commonly associated. Craze lines are superficial with no treatment needed. Fractures extend along other parts of the tooth and may require a filling replacement or crown. Cracks extend toward the root and can require a root canal and crown or, if too severe, extraction.

A filing needs to be sealed to the tooth. If the seal between the tooth and the filling breaks down, food debris and bacteria can seep down under the filling and cause recurrent decay. If the decay is treated early, replacing the filling is adequate. If not, a crown and even a root canal may be needed. The biggest mistake you can make is waiting to do something about a broken or unsealed filling until it is painful. Doing this will only make the treatment more involved and often times more expensive.

Regular dental exams and X-rays are used to evaluate dental fillings. You will not be able to tell on your own when your fillings start to fail. Just as a car mechanic will change the oil, correct your alignment, or change your tires, a dental checkup will help you identify small concerns to fix as you go in order to avoid a critical emergency.

Pay attention to any bite or temperature sensitivity in teeth that have fillings. This can be an indicator for some of the problems listed above. You know your teeth better than anyone. Your observations are most valuable when evaluating a filling for replacement. If replacement is needed, know you are doing what is best to prevent future dental calamities and make an appointment to see the doctor.