Many of us as children have gotten silver fillings or amalgams placed in our teeth. Most of the time they have lasted a really long time and haven't given us any problems. So, one day you go to your dentist and they mention that you have a filling that you need to replace and you wonder why.
Its normal to be skeptical when something has been in your mouth for so long and has never bothered you. So why bother it? I just wanted to take a minute to show you why your dentist might be recommending to replace and old filling. Here is life of a silver filling:
When its placed the very first time it is usually because bacteria ate the sugar that you had left in your mouth and made acid. That acid made a cavity in your tooth. The dentist might have removed that part of your tooth that was decayed leaving a hole in your tooth. A silver filling is placed sealing that area from the outside world of your mouth. That means bacterial, sugar and saliva stay out.
Over the years this filling serves us very diligently. Crushing food 3 or more times a day (and sometimes working overtime at night as we grind our teeth) all in a dark, moist environment with varying amounts of sugar and acid (depending on what we eat and how we clean our teeth) day in and day out for years. You can see that can easily cause wear and tear over the years.
When we see something that might pose a problem we let the patient know and give them some treatment options. If caught early it can be a simple filling replacement. If not treated early it can be more invasive treatment like root canal treatment, crowns or even it get to the point we can't save the tooth and have to extract the tooth.
Here are some old silver or amalgam fillings and their different stages of wear.
In this picture you see the filling coming apart and not sealing the tooth anymore which is evident from the gaps between the filling and the tooth. This allows bacteria, sugar and saliva to flow into those cracks and seep into your tooth causing a cavity. At this stage you can usually just replace the filling.
In this picture you see the similar pulling away of the filling causing a gap. There is also a small fracture line seen. This happens when bacteria and sugar seep into the cracks and start causing decay. Now you have an inflexible metal filling on a squishy base in your tooth. Every time you bite down, the metal filling acts like a wedge pushing into your tooth and causing it to split apart... and that is where those fracture lines come from. At this stage you still might not feel any symptoms but there are obvious problems brewing.
In this picture you see the old silver filling, the gaps around the side, fracture lines and decay not only under the filling but next to it too as seen by the darkness seen below the surface. At this stage, depending on how far the fracture line has spread and how much the decay has destroyed the tooth our treatment options start to become limited and fall into the more invasive and expensive side.
This is what we are trying to avoid. If we notice fracture lines, and decay and fillings that are no longer sealed this could happen. A tooth can fracture. In this picture we were able to save the tooth with a crown. However, it is best when we are able to control the situation instead of treating it after something has happened.
When you come to our office we can take pictures of your fillings so you can see for yourself what state they are in. Also, its completely normal to need to have a filling replaced from normal wear and tear. The best thing to do is never get a cavity but... we are all human right? In conclusion, take care of something when its small so it doesn't snowball into major treatment and save yourself some time in the chair and money in your wallet.
Dr. Ila Mankad is a general dentist in Brentwood California. She wants to teach patients the not so secret ways of achieving a healthy mouth.