Every day I face this scenario. Have a look at the photo on the left. This is a digital photograph of a tooth with an old amalgam (silver) filling in it. Look how the edges of the tooth around the filling look blue or gray. That’s bacteria that leaked between the filling and the tooth. Can you see any crack lines on the outside of the tooth?? Yes, you can see that! Now…imagine how much bacteria is living between the tooth and that 20+-year-old filling. You might think the patient belonging to this tooth says it hurts to chew on, right? Wrong…no pain at all. In fact, the patient (and I) could only see how bad this tooth looked when my treatment coordinator took a photo of it and enlarged that photo to fill our 40” TV screen!
So of course, this filling needs to be replaced. I take out the filling, remove all of the bacteria-filled decay…and there is a big crack in the tooth, running all the way across the tooth (it’s that line between the more yellow part of the tooth and the black part of the tooth). The picture on the left is the same tooth I showed you in the picture before, just after I cleaned out the old silver filling and decay. If we “just put a filling” in this tooth, imagine that the filling material is like a wedge between two weakened walls of tooth. Every time this patient chews, the two sides of the tooth flex. So now imagine the filling is in the tooth (because that’s what this patient requests)…and when the freezing wears off, the tooth hurts. The patient is unhappy…after all, it didn’t hurt before.
What patients often don’t understand is if left alone, not only would this tooth be sore, but would eventually split in half! And at that point, it would have to be removed. Now that we know how weak this tooth is, we can strengthen what remains with a crown. However…we still can’t be sure about that crack inside the tooth…was it enough of a crack for small amounts of bacteria to leak through into the nerve of the tooth, and infect it? The only way we know is if the tooth stays sensitive for a long period of time without improving. Then further treatment is needed.
How can I avoid this the next time? Or avoid it entirely?
Ask your dentist to take digital photographs of your teeth to examine them in a magnified view. That way…any defects in fillings or teeth can be detected early, and treated early, before major problems happen. We would always be happy to examine YOUR teeth in this way, so speak to one of our treatment coordinators about a consultation appointment.