When should we replace dental fillings?

  • After removal of dental amalgam fillings:
  • 1 – white chalky stain
  • 2 – pulp chamber
  • 3 – dental tattoo, healthy but pigmented dental tissue

Fillings are methods of replacing the altered dentin resulting from the caries process.

Caries is the result of bacterial attack and is the stage following dental demineralization.

The bacterial concentration may be increased in certain areas of the oral cavity, especially in those that are difficult to sanitize, particularly in the interdental spaces.

The first stage of the caries process is demineralization of the surfaces concerned.

Thus, through demineralization, the tooth discreetly changes color, which may escape the untrained eye.

In hidden areas, this process is well masked by soft tissue or proximal tooth surfaces.

With the progression of the caries process, loss of substance also occurs, at which point most patients present themselves to the doctor, especially if the loss of hard tissue is also accompanied by some degree of sensitivity to liquids of extreme temperatures.

Coronal filling is also known to patients as a filling and is intended to restore the morphology of the affected tooth after the doctor has removed all the altered hard tissue.

The materials have a resistance over time which can be influenced by the filling method chosen, the respect of the operating times, the quality of the surrounding tissues, the degree of damage to the tooth and the care the patient takes when it comes to personal oral hygiene.

During mastication, great forces are produced in the dental arches, which are then transmitted to the underlying bone.

The masticatory forces, the nature of the food and the teeth being treated influence the durability of the filling.

Replacement of the filling is recommended in the following situations:

Tooth sensitivity – is the sensation of mild, moderate or even severe pain when the tooth in question is in contact with liquids or foods that are extreme in temperature, hot or cold. Most often, the cold thermal stimulus produces more pronounced pain.

Pain may occur when another, recurrent caries process has developed under the filling, or it may occur if the original cavity was very deep and no pulp chamber protection material was used at the time of filling.

In the first case, the filling is removed and the carious process is carefully cleaned and in the second case, again, the filling is removed and a thermal protection material is applied. In both cases, the next step is the definitive filling of the cavity and follow-up of the evolution over time.

Marginal staining – blackening of the margins of the filling is a sign suggesting that micro spaces are appearing at the interface between the restorative material and the tooth surfaces through which bacterial penetration occurs.

Most often, these marginal stains suggest secondary caries.

Damaged fillings – loss of restorative material should be corrected as soon as it is found as it can lead to altered occlusal relationships and over time, temporomandibular joint pain.

Most often, in the case of loss of filling material, it is recommended to remove the entire filling and rebuild the filling.

If the restoration is no longer indicated to be restored with composite material, one can opt for prosthetic, aesthetic and more resistant reconstructions.

Leave a comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.