How Does Decay Happen Under Fillings?

When a filling is placed, it’s bonded to your tooth in such a way that a seal is made to keep out bacteria and food particles that can cause decay and infection. If the seal between the filling material and your tooth wasn’t properly made during the bonding process—or begins to break down over time and isn’t repaired—tooth decay can begin to develop underneath the actual filling material.

Signs of decay underneath a filling are similar to those of normal tooth decay, including:

• Toothache
• Tooth sensitivity
• Pain
• Bad breath or a bad taste in your mouth
• Black or brown staining on the tooth

You may not experience symptoms until the cavity has significantly progressed, which it’s why it’s important to get regular checkups with your dentist. He or she can evaluate your fillings to ensure there are no problems such as decay forming underneath a damaged dental restoration!

Treatment for Tooth Decay Under an Existing Filling

If you do have tooth decay under an existing filling, how will your dentist treat the problem?

First, your dentist will take x-rays, which can help determine whether or not there’s developing tooth decay underneath the filling [1]. While your dentist will conduct an oral exam as well, x-rays can help see between teeth and underneath the surface of your teeth to identify decay that can’t be seen with the naked eye.

In the event that there is decay under your filling, your treatment will all depend on how advanced the decay is. In some cases, the old filling can be removed and a new filling can be placed. In others, you may not be able to get a new filling and instead, you’ll need a dental crown or root canal therapy to correct the problem [2].

Your dentist can let you know what to expect during your appointment based on their findings!

Don’t Ignore Symptoms of Tooth Decay!

If you’re having symptoms of tooth decay, even if there’s a filling there, don’t hesitate to reach out to your dentist for assistance. There may be a problem with the filling that needs to be corrected, or you may have tooth decay underneath the restoration. Your dentist can identify the issue and recommend the proper treatment to get you back to normal!

Sources:
1. http://www.ada.org/~/media/ADA/Publications/Files/patient_52.ashx
2. https://www.medicinenet.com/problems_with_dental_fillings/article.htm#deterioratin
g_fillings

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While home care habits are vital to proper oral health, your dentist also plays a crucial role in keeping your smile healthy, beautiful, and free of problems that could cause long-term damage.

What harm could avoiding those regular teeth cleanings be causing?

Buildup of Unseen Plaque and Tartar

While regular brushing and flossing do remove plaque from your teeth—which can harden into tartar if not removed—your toothbrush and floss won’t be able to remove every trace of plaque from your mouth.

Whether you’re missing some areas on your teeth when brushing and not realizing it or can’t quite work floss into those tight spaces between your teeth, plaque doesn’t take long to build up in the oral cavity.

Even with daily brushing and flossing, plaque can accumulate, and professional teeth cleanings remove this unseen plaque [1]. If left unchecked, plaque can not only harden into tartar, but lead to tooth enamel damage and gum inflammation that can influence the onset of tooth decay and gum disease.

Development of Oral Health Problems

From gum disease to oral cancer, problems in the oral cavity can go undetected until spotted by a professional. One of the reasons regular teeth cleanings are so important is because they don’t just clean your teeth—they give your dentist a chance to examine your smile and ensure there are no problems that need to be addressed.

Routine teeth cleanings help prevent cavities and gum disease, problems that, as they progress, become more serious and more expensive to fix down the line [2]. Your dentist can also conduct an oral cancer screening during your regular appointments, a quick and painless exam of your oral cavity to ensure there are no abnormalities to be concerned about.

How Often Do You Need to Get Your Teeth Cleaned?

While most oral healthcare professionals give a guideline of every six months to get your teeth cleaned, your dentist can let you know how often you need to come in to protect your smile.Everyone is different, and your unique oral health will determine whether you need to come in every six months or more or less often to maintain your oral health [3].

If it’s been a while since you’ve gotten a professional teeth cleaning or you have questions about your oral health, it’s time to get in touch with your dentist. Teeth cleanings take less time than you think, and are a painless way to have a beautiful, bright smile for life!

Sources:
1. https://medlineplus.gov/ency/article/001957.htm
2. https://my.clevelandclinic.org/health/diseases/16914-oral-hygiene
3. https://www.ada.org/en/press-room/news-releases/2013-archive/june/american-

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Unfortunately, tooth decay can still happen underneath a filling, especially if the filling has been cracked, worn, or otherwise damaged. In these cases, bacteria can enter your tooth and a new cavity can start again.

What are the signs you might have a cavity forming underneath your filling?

You Have a Toothache

You may have mild to severe pain radiating from one of your teeth. For some people, this pain will extend outward into their jaw or can even cause headaches. A toothache isn’t only a sign of a cavity forming underneath a filling—it could signal a cavity in one of your other teeth as well. Other symptoms of a toothache include a bad taste in your mouth, a fever, or swelling [1]. Be sure to see your dentist as soon as possible if you have any of
these symptoms!

You Have a Discolored Spot on Your Tooth

If your filling is a composite resin filling, it should match the natural color of your teeth and not stand out in any way. However, if you have a cavity forming underneath your composite resin filling, the filling may look darker or have a yellowish appearance, which could be a sign that the filling material is damaged and needs to be replaced.

Your dentist can evaluate the integrity of your fillings during your regular checkups to ensure they’re intact and doing their job [2]!

The Filling May Have Fallen Out

For some patients, it’s obvious when a filling falls out, but for others, this isn’t so. When a filling becomes damaged, it’s possible that the entire restoration can fall out. You may have seen pieces of the filling or the whole filling may have come out. While this may or may not be accompanied by pain, if you suspect your filling has come out, it’s time to see your dentist.

A new cavity can form in your tooth once the filling is gone, so don’t delay in getting it replaced!

Your Tooth Is Sensitive

Although it’s estimated that more than 12 percent of Americans have sensitive teeth, teeth that are sensitive to temperature can cause severe pain and are typically a sign something else is going on with your smile [3].

If you experience pain when drinking a cold beverage, sipping hot soup, or even eating sweet or spicy foods, you could have a cavity and not know it. Only by following up with your dentist can you know what the root cause of your tooth sensitivity is.

Is It Time to Have Your Fillings Checked Out?

If you’re seeing any of these signs, you could have a cavity forming underneath a damaged
filling. Your dentist will simply remove the old filling and put a new one in to stop further decay and keep your smile healthy. Don’t delay in getting your fillings checked out during your regular dental appointment!

Sources:
1. https://www.mouthhealthy.org/en/top-dental-symptoms
2. https://www.ada.org/~/media/ADA/Publications/Files/patient_52.pdf?la=en
3. https://www.scpr.org/blogs/southla/2013/03/01/12763/survey-1-in-8-americans-has-
sensitive-teeth-condit/

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But how exactly is a dental abscess treated? Your dentist may recommend the following
treatment options depending on how severe your tooth abscess is.

Draining the Abscess

First, your dentist or endodontist—a dentist who specializes in saving teeth—will need to drain
the abscess of the infection. Your dentist will gently lance the abscess to rid it of any pus and
other material before moving on to actually treating your tooth.

If your dental abscess was caused by gum disease, at this point your dentist may recommend a
deep cleaning (also called a root planing and scaling) to treat your gum disease and prescribe a
course of antibiotics to prevent the infection from coming back.

Root Canal Therapy

If the original infection was the result of infected nerve tissue (also called the pulp) inside the
tooth, root canal therapy may be able to help. An infection in the center of your tooth can
happen as the result of decay, an injury, or a cracked or chipped tooth.

When a dental abscess is present, the infected pulp will need to be removed and the tooth
sealed in order to fix the issue and stop the infection from returning. Depending on your unique
case, you may or may not receive a dental crown once the procedure is complete to protect
your tooth.

However, for some people, root canal therapy may not be possible to save the tooth. If your
dentist suspects the tooth can’t be saved, he or she may recommend extraction.

Tooth Extraction

Some patients will need to have their tooth extracted as a result of their dental abscess. Your
dentist will discuss the options with you beforehand to ensure the form of treatment is in your
best interest.

Your dentist can also talk with you about replacing your tooth after the extraction. It’s
important to replace your natural tooth as the loss of a tooth can also cause loss of jaw bone
and shifting teeth, which can change your smile over time.

A dental abscess can be very painful and should be evaluated by a dentist as soon as possible.
Whether the infection originally began in your tooth or in the gum tissue, your dentist can help
to drain and treat the abscess to provide you with relief and get your smile healthy again!

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Gold has many advantages for restoring teeth: it’s biocompatible, meaning there’s an extremely small chance the body would react to it. It’s not considered to be toxic to the body, resists corrosion, and is durable and versatile.

Although the demand for gold used in dentistry has dwindled, it’s still used today. When is gold used for smiles?

For Smaller Cavities

The use of pure gold in dentistry is rare; typically, it’s mixed with other metals to form what’s called gold alloy. However, pure gold is occasionally used for very small cavities in the mouth. Gold fillings also last the longest of all the filling materials available. As a result of this and other factors, gold tends to be one of the more expensive materials used to restore teeth, so gold isn’t as popular today when there are other dental filling materials available that are less noticeable and less expensive.

Inlays and Onlays

Gold alloy, which is a mixture of gold with other metals including silver, copper, and zinc, is used for inlays and onlays in large cavities.

When tooth decay is too extensive to support a normal filling but not extensive enough for a dental crown, your dentist may use an inlay or an onlay to restore the tooth. Both of these treat larger cavities without dental crowns, appearing as something between a crown and a filling.

While an inlay typically covers the space at the center of the tooth, an onlay may cover the additional sides of the tooth in addition to the center. Onlays are sometimes called partial crowns because of their extensive coverage.

Dental Crowns

Gold alloy may also be used for dental crowns. There are numerous advantages to using gold for a dental crown as opposed to ceramic:

 Gold seals very well, reducing the chance that bacteria would affect your tooth.

 Gold requires the smallest amount of healthy tooth tissue to be removed compared to other materials when placing the crown.

 Gold is very resistant to corrosion and wear, giving it the potential to last for decades.

 Patients tolerate gold very well and tend to not react to it.

Although gold dental crowns are generally only reserved for teeth that are in the back of the mouth, some people don’t mind having a noticeable gold tooth and will opt for a gold crown in the front of their mouth.

Gold certainly has its advantages when used in modern dentistry, although it’s not as popular today as it was even decades ago. Dentists still use gold for the appropriate applications in dentistry to help protect and restore teeth, especially for fillings, inlays and onlays, and dental crowns.

If you’re curious about the advantages of using gold to restore your smile, talk to your dentist about why this material would be used and if it’s right for you!

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Cavities that result from tooth decay don’t form overnight. There are stages of cavity formation that happen before you notice pain or that gaping hole in one of your teeth. This is why visiting your dentist is so important—they’re experts at spotting tooth decay before it has a chance to become a full-blown cavity!

Here are the stages of tooth decay that will form a cavity if left untreated.

Demineralization

Your enamel relies on minerals to stay strong. This is why certain nutrients such as calcium and vitamin D can help strengthen tooth enamel while harmful foods such as those that contain sugar will weaken tooth enamel.

In fact, tooth enamel is porous, so acidic substances can weaken tooth enamel for periods of time—this is why waiting for 30 minutes to brush after a meal is important.

When demineralization of the enamel happens, this means your enamel has lost some of its nutrients, such as calcium, and is now weakened by this as well as plaque. The enamel will wear away in a process called demineralization. Tooth decay is still preventable at this stage in the process.

Demineralization will often manifest as white areas on the teeth—don’t get this confused with dental fluorosis. These white spots may actually mean a cavity is on the way!

Enamel Damage

Now that the enamel has been demineralized, it will actually start to deteriorate. At this stage in the process, healthy minerals aren’t able to restore the enamel to its original state. The decay will continue without treatment, and you may see the white spot turn into a brownish area where the enamel is being eaten away by plaque, bacteria, and harmful acids.

During this stage, your cavity will be visible on an x-ray and your dentin will also become exposed, which can result in increased sensitivity and perhaps pain. A filling can treat your cavity at this point to protect the tooth from further damage.

Soft Tissue Damage

After the decay has eaten through the enamel, it’ll begin to affect the softer tissues of the tooth, such as your dentin and pulp. Dentin is the layer underneath your enamel. If the decay moves to this level, you may begin to experience pain and sensitivity and the only treatment that’ll remedy your tooth decay is a filling.

However, if your cavity is left untreated and continues to progress, it can eventually reach the pulp of your tooth. This is where all your nerve tissue lies and is essentially the heart of the tooth. If the decay reaches the pulp, an infection can quickly ensue and can cause a severe toothache as well as kill the nerve tissue inside the tooth.

If this happens, root canal therapy will likely be needed to save the tooth. Don’t wait to seek treatment if you suspect you have a cavity!

Visiting your dentist regularly can help you prevent tooth decay and catch your cavity in the demineralization process. Cavities are painful and often irreversible without a filling, so don’t wait to have your teeth checked out by a professional dentist!

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Although your dentist is the best person to evaluate your smile for treatment, let’s talk about
whether your cavity will need just a filling or if a root canal would be your best form of care.

When a Filling Is All That’s Needed

If your tooth isn’t discolored and you’re only experiencing minor pain or sensitivity, your dentist
may be able to repair the tooth with a simple filling.

When tooth decay happens, bacteria eat through the first layer of your teeth, the enamel. The
decay may progress to the second, softer layer, the dentin, and results in a cavity. If your cavity
has not progressed to the third layer of the tooth—the nerve tissue—a filling should suffice.

Getting a filling is a relatively simple procedure and you and your dentist can talk about what
filling material would suit you best. Although your filling will need to be replaced at some point
in your life, it shouldn’t get worse with the proper home care and dentist visits!

When Root Canal Therapy Could Help

Some people may have cavities that are beyond repair or be experiencing other symptoms that
will result in the need for a root canal. For instance, if your cavity is large enough or deep
enough that it would be impossible for a filling to repair your tooth, root canal therapy may be
the most appropriate form of treatment.

If your tooth is discolored in any way, such as having a brown or yellow hue that’s noticeably
different from the other teeth, the nerve tissue inside your tooth may be dead. In this case, a
root canal is the best treatment. If you’re experiencing severe tooth sensitivity or pain, you may
need a root canal.

Fortunately, a root canal isn’t much different from getting a filling these days. Technology has
made it possible for your root canal to be performed with no pain and you’ll be able to save
your natural tooth!

Which Do You Need?

If your cavity is a relatively normal size and not accompanied by discoloration, pain, or
sensitivity, you may just need a filling. However, if your cavity is large, has cracked your tooth,
or is causing you pain and sensitivity, your dentist may recommend root canal therapy to save
your tooth.

Whether you need a filling or a root canal, you’ll still be able to save your natural tooth, which
is the most important thing. When you can keep your natural tooth, you’re saving a part of your
smile that would otherwise need to be replaced with a cosmetic dentistry option!

If you’re seeing evidence of a cavity, don’t delay in making an appointment with your dentist.
Prompt treatment can prevent your cavity from turning into a problem that needs root canal
therapy to fix!

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Tooth enamel can be weakened through a variety of means, such as aggressive brushing, acidic foods
such as sugar, and genetics. Enamel can’t grow back or be replaced, so it’s imperative to protect your
tooth enamel while you can.

So how can you strengthen tooth enamel?

Cut Back on Sugar

Sugar is the enemy of your tooth enamel. It works quickly with the bacteria in your mouth to eat away
at tooth enamel. Sugar is present in sweets such as cakes and candy to simple carbohydrates such as
white break or crackers. Minimizing your sugar intake can be helpful to strengthening your tooth
enamel.

If you want to enjoy sweets from time to time, be sure to drink water with your food and rinse your
mouth out afterwards. Water can act as a buffer between your tooth enamel and the harmful acidic
sugar, so it can help curb damage.

Get Enough Nutrients

Having a nutritious diet is the pinnacle of having strong tooth enamel. Be sure to get an adequate
amount of calcium and vitamin D in your diet. Fruits, vegetables, and healthy fats can help keep your
tooth enamel healthy.

Fluoride, whether consumed in drinking water or in dental care products, can help strengthen your
teeth and protect against the cavities that often come with enamel damage. You can talk with your
dentist about your sources of fluoride and whether or not they’re appropriate for your smile.

Brush Properly

Although brushing your teeth is important to prevent oral health problems, brushing the right way is
essential. Here are some crucial tips to follow to protect your tooth enamel while brushing:

 Never brush aggressively. Hard brushing isn’t needed to get the plaque off. Be gentle!

 Wait 30 minutes to brush. If you’ve just eaten, wait at least a half hour before brushing your
teeth to prevent enamel damage.

 Use a soft-bristled toothbrush. Again, those firm bristles just aren’t needed to get your smile
clean.

In addition to all these things, you should brush twice a day and don’t forget to floss! Dental checkups
can also help you to have strong enamel.

Get Treatment

If you have any oral health problems, it’s essential to get treatment to protect your enamel. For
example, grinding your teeth is extremely damaging to your enamel. Your dentist can help treat this
problem to protect your smile. Gum disease, cavities, and other oral health issues can all impact the
health of your enamel. Whatever it is, getting treatment may be able to help protect your enamel from
further damage.

How healthy is your enamel? Your dentist can take a look at your smile and tell just how healthy your
tooth enamel is and if you need to take protective measures to keep it healthy. Everyone can
incorporate the above tips to strengthen enamel and have a stunning smile for life!

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Expected Life Based on Material

Silver amalgam fillings were most commonly used in dentistry for over 150 years, but now, composite
resin fillings are making a fast replacement. These fillings are not only considered safer alternatives to
silver amalgam, but the color also matches your natural teeth. Many people prefer this type of material
to shiny silver fillings.

But how long do these fillings last, exactly? The exact length of time is impossible to predict, but here’s
what you can expect based on your filling’s material:

 Silver amalgam filling. These can last for up to 15 years, although they should be regularly
checked by your dentist during your bi-annual appointment for cracks or damage. This is
because a damaged silver filling can expose you to mercury and should be repaired or replaced
as soon as possible.

 Composite resin filling. Although these fillings will match your natural teeth, they don’t last as
long. They may last for up to 10 years, although some people will need them replaced in as little
as 5. It all depends on your oral health.

 Gold filling. Less common than silver amalgam or composite resin, gold fillings are your costlier
option and won’t match your natural teeth, but their life expectancy is up to 30 years!

Regardless of which dental filling you have, it’s important to remember that it will need to be replaced
at some point. It’s also crucial that you take care of your dental filling to not only extend its life, but to
protect your smile from further damage.

How to take Care of Your Dental Fillings

Taking care of your dental fillings isn’t that much different from taking care of your teeth. Brushing and
flossing are important as well as visiting your dentist. It’s important to not engage in harmful practices
such as biting your nails, grinding your teeth, and chewing ice. All of these habits can harm your fillings!
Getting dental checkups is also essential. Your dentist can let you know how well your filling is holding
up. If there are any problems, your dentist will be the first to spot them and you can work to repair your
filling to fully protect your teeth.

If you have dental fillings, it’s easy to think that your teeth are set for life. However, keep in mind that
your filling will need to be replaced at some point. By keeping up with your dentist visits, you can know
exactly when to replace your fillings to keep your smile protected and prevent the need for future
fillings!

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Although tooth-colored fillings are widely used today, what should you do about your old silver fillings? Here’s what you should know if you’re thinking of replacing this material for your cavities.

Unless There Is Damage Present

Your amalgam fillings shouldn’t need to be replaced unless there’s damage present. This
includes chipped or cracked fillings, decay that continues to come back, and gaps in the filling. Your dentist can help you determine if there’s a reason to replace your silver filling by doing a dental exam that will reveal any potential wear, damage, or problems.

If there’s nothing wrong with your silver filling, your dentist probably won’t recommend that you replace it. A silver filling that’s still intact and shows no damage is best left alone. Removing it may even expose you to more mercury than just leaving it in, so talk with your dentist about what condition your filling is in and what the best treatment is.

Using Composite Fillings

If your silver filling shows damage or you’re just set on changing the filling, your dentist should be able to help you find a better restoration that you’re more comfortable with. Tooth-colored fillings, or composite resin fillings, are virtually indistinguishable and bond directly to the tooth, making them a more efficient, safer solution.

Your dentist can help you determine when and if your silver filling needs to be removed and replaced with a composite one. If your dentist recommends against removing the amalgam filling, you can still choose to replace it, just know that your dentist doesn’t think this is the best course of action at this point in time.

Benefits of Tooth-Colored Fillings

Composite fillings require that less of your tooth’s healthy tissue be removed. In silver fillings, tooth tissue that’s not affected by decay needs to be removed to properly put in the amalgam filling. With tooth-colored fillings, only the damaged area is removed, ensuring that more of your healthy tooth and its natural structure is left alone.

Tooth-colored fillings also last longer, are safer, cosmetically appealing, and help strengthen the damaged tooth. They bond directly to teeth unlike silver fillings, and so ensure that your smile is as seamless as possible, making those unsightly amalgam fillings a thing of the past. The best part is that no one will even notice your composite fillings, making your smile look more uniform and complete.

Do you have amalgam fillings and have considered getting them removed? If your silver fillings are in good condition, you might not need any treatment at this point. A skilled and experienced dentist can help you determine how your fillings are holding up and whether or not they need to be replaced with composite fillings!

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