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REPLACING OUTDATED RESTORATIONS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of an outdated restoration is necessary, especially when they have not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.
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Why Replace Outdated Restorations?
There are a number of reasons. They may include any of the following:
Wear:
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!
Leakage:
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.
Recurring decay:
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.
Cracks:
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.
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Chips:
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.
Esthetics:
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.
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