You’ve probably had fillings in your back teeth since your teens, or younger. Yes, those silver amalgam fillings. And I am sure your dentist has been checking them and “watching” them for a long time now…telling you that eventually they probably should be replaced. They don’t hurt you at all…no sensitivity when you bite down hard or eat ice cream…so that probably means they are fine, right?
Let me tell you a story about a patient of ours, Sue. Sue has teeth that, if you look in the mirror right now, probably look a lot like yours. She had been seeing her previous dentist routinely for some number of years until he retired. He always told her that her old fillings “looked fine” on the xrays and one day may need to be replaced. He never recommended they be treated, and so she left them as is. When she became my patient recently, I took some digital xrays, which again showed no signs of cavities…this is no surprise, because the filling itself often blocks out the view of any cavity unless the cavity is HUGE. I also took some digital PHOTOGRAPHS which you can see in this blog. Let me tell you what I know about old fillings…when the tooth surrounding a filling is discolored (gray, brown, or black), that means that mold has seeped between the filling and the tooth, and has caused a cavity. How did this happen? Over the years, the silver fillings in your teeth expand and contract with heat and cold, and eventually no longer fit snugly within the tooth. This leaves little gaps that allow food and bacteria to get stuck…sometimes these gaps are even smaller than the pick we use to check teeth for cavities, but not too small for mold to grow.
Anyway, back to Sue. This is what her teeth looked like right after I took out the old silver amalgam fillings…mold, cavities, bleeding gums because of the cavities, and a huge crack in the tooth at the middle of this photograph. All of this…and she NEVER felt pain in her tooth, which is extremely typical of cavities and cracks in teeth. In fact, once the tooth becomes painful, the treatment needed is much larger and more expensive to deal with, if the tooth can even be fixed! Whenever we see a crack like this in a tooth, we must protect it from splitting in half between the roots and under the bone by putting a ceramic crown on it for protection. Will that treatment fix the problem 100% of the time? No, not necessarily. Sometimes the crack goes further between the roots than we think, but most of the time as long as we are treating the tooth before it starts to hurt, the crown is the best treatment to add strength to the tooth.
An extra benefit to taking care of the cavities in these teeth is our ability to give patients a more natural-looking solution to those old, worn-down silver amalgam fillings. We now have great materials to use to give back strength and beauty to our patients’ smiles.
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613.271.7091.