Replacing Outdated restorations
Chances are you picked up this brochure because you have been told by your dentist you need to have an old filling or crown replaced.
You may be wondering why this is necessary. Often, patients are unaware that replacement of an outdated restoration is necessary,
especially when they have not experienced any pain or problems. It is important to understand what to expect from your dental restorations
(fillings and crowns) and why they sometimes require replacement.
There are many reasons for replacing restorations. In fact, most dental problems may not be evident to patients. When you consider the daily
stresses exerted on your teeth, it is not surprising that restorations eventually wear out and sometimes need to be replaced. Sometimes,
however, patients believe the old adage, "If it doesn't hurt, don't fix it." If left untreated, however, dental problems can lead to more expensive
dental procedures and eventual tooth loss.
Why Replace Outdated Restorations?
There are a number of reasons. They may include any of the following:
Although there are a number of factors that affect the life of a dental restoration, the average silver filling, crown or bridge may last from five
to 15 years depending upon the size. The average composite (plastic tooth-colored filling) may only last half as long. Forces constantly
exerted on the fillings by chewing and grinding cause them to wear down. In some cases the porcelain or gold in crowns actually wears
through from constant grinding by the opposing teeth!
Fillings may start to leak around their edges due to wear and trauma. Often leakage on the biting surface of a crown goes unnoticed by
patients. This allows bacteria a ready access to the deeper areas of the tooth. Once the bacteria are inside the tooth or crown, they cannot
be removed and decay may begin rapidly again. Worst of all, this damage is often unseen and there may be no symptoms until the decay
has reached the nerve (pulp) of the tooth. Amalgam fillings tend to leakafter time thus leaching out mercuryinto the body.
Increased exposure to the elements that caused the original cavity make it possible to get another cavity in the same tooth near the original
filling. (Even the best filling is not as smooth and impervious to decay as healthy tooth structure.) If a tooth is not kept clean, decay can
start near the edge of the filling or in another site on the tooth. Even if a tooth has a crown covering it, decay can still start at the edges
where it rests on the tooth, causing an abscess, which leads to root canal or extraction.
A great deal of force is placed on your teeth every day. The average human bites with several hundred pounds of pressure per square inch.
This biting pressure can result in tiny cracks in the tooth. Chewing on very hard substances, such as ice or nuts, can crack a tooth or liling.
Often, your dentist can tell when these cracks cave undermined another portion of the tooth or gone too deep.
If the cracks are not repaired in time, the tooth may reak or chip. Sometimes this will necessitate a larger, more costly restoration. Often,
these teeth will require crowns. Cracks can also form in the porcelain of a crown. Thus, chipped porcelain may eventually break off, as well.
Your dentist may feel it is better to schedule a replacement crown before this happens.
Over time, fillings begin to tarnish (if they are silver) or stain (if they are composites). While this may not cause any direct harm to the tooth
immediately, it does detract from the esthetics of the mouth. Thus, some patients may wish to replace their outdated silver fillings with more
esthetic ones made of tooth-colored composite or porcelain.
Periodontal ( Gum) Disease:
Many patients are unaware that most teeth are lost due to gum disease - not decay. If left untreated, periodontal disease progresses, and
the gum tissues move lower on the root. Eventually, bone is lost and teeth become loose. In such cases of periodontal involvement, your
dentist may find it necessary to remove an old crown next to a loose or missing tooth and replace it with a new bridge.
In advanced cases of gum disease, a tooth may be lost, requiring crown and bridge treatment. This is a new bridge.
A Final Word
Remember that it is in your best interest to have small dental problems corrected early so they will not become much larger dental problems
later. We are happy to work with you to provide the best possible care for your teeth, so you can keep your smile for a lifetime.