Dental Fillings: When is it Time for Replacement?

Dental fillings have been some of the most commonly performed treatments in dentistry. This restorative technique is more than 150 years old at this point, and a few changes have occurred since the early days of practice. One of the most significant has been the transition from gold fillings to amalgam fillings (also called silver fillings) to tooth-colored fillings. One of the aspects of treatment that hasn’t changed much is the perception patients have of fillings being permanent restorations. Here, we discuss the reasons why a filling may need to be replaced and the benefits of doing so sooner rather than later.

Indications for Replacement

Often, there is an idea that a filling may need to be replaced if a tooth becomes symptomatic. In most cases, even this comes as a surprise to the patient; going back to the idea of fillings being permanent. In reality, many fillings fail long before tooth sensitivity or pain develops. For this reason, every routine dental examination involves close observation of fillings and other restorations. What are we looking for?

  • Cracks or chips around the filling. This is especially relevant with amalgam fillings, due to the inclusion of metal in filling material. The composite metal in amalgam expands and contracts when we chew and when we consume hot and cold foods. Natural enamel does this as well, but not at the same rate. Therefore, separation eventually occurs between the margins of the filling and natural tooth structure. This is also referred to as a leaky filling.
  • Routine exams include x-rays that provide us with the closest observation of the entire tooth structure. Decay around the filling or on another area of a tooth that has a filling usually involves a repair process that removes the existing restoration and replaces it with an updated, larger restoration. In this situation, an onlay or crown may be the most appropriate treatment.
  • Just like enamel can erode, so can fillings. This is true of both tooth-colored fillings and of amalgam fillings. When a filling wears down severely, its ability to prevent further damage is significantly diminished.

There are numerous reasons to replace old fillings, including a desire to remove amalgam from the mouth. To learn more about the process of filling replacement, call our Grayslake office at (847) 223-5200.