Q: Yesterday I saw my dentist for a regular check-up. The hygienist saw me first and said everything looked good. I was happy because I hate bad news.
The dentist came in and after a few moments and asked me if I was experiencing any sensitivity anywhere in my mouth. I thought about it then said “no”. He replied “good”.
He went on and said that my lower back molars were showing a lot of wear. When he pointed this out to his hygienist, she said she had seen the filling wearing away but hadn’t thought about it much.
He gave me a mirror and showed how those fillings were almost gone. He said I’d need to replace the fillings because of the wear, he also said there was a bit of decay at the edges of the fillings.
Both of these things he said would be fixed when he did the new fillings. I made an appointment to get those two teeth fixed but now I have questions.
How long will the new fillings last? What if I just leave the situation as it is – I don’t have any pain? I think I remember having silver fillings in those teeth and I had my dentist take them out and put in white fillings – should I have done that? I’d like to get them fixed once and for all.
A: This is a problem in people who clench their teeth. Healthy non-clenchers have little or no wear. Changing silver fillings in non-clenchers for white fillings (as needed of course) works well, but the latest research shows that white fillings in clenchers and grinders will not give long term service.
In 1986 I did my first white filling. I did it for a woman who did not show a grinding or clenching problem. Twenty-five years later the filling looks like it was placed yesterday.
Twenty-five years ago, I did a crown for a severe clencher that resisted breakdown until today. The individual wore a hole through the crown. The leakage this hole created and the patients clenching caused the crown to de-bond. Though the crown wore, there was no damage to the tooth.
Very strong and unbreakable material in the crown kept the tooth healthy despite her habit. Your tooth may have small cracks in it. A filling will not prevent propagation of these cracks and severe damage may result when the filling wears again.
Using the strongest materials and techniques will prevent future damage to your teeth. The most important part of the task is to realize that “one size does not fit all”. Treating your teeth to match the strength of your bite will give you peace of mind.