Dental Fillings: Common Concerns and Best Practices

Q: Dental Fillings: Common Concerns and Best Practices

Hello, Miss： Thank you for your inquiry. Here are my responses and recommendations： 1. If there are no uncomfortable symptoms after the filling, you can simply monitor the situation without needing to reopen and refill. 2. The white filling material is generall

Cavity treatment issues?

Hello, doctor.
I would like to ask a few questions:
1.
If a tooth does not require a major filling (as the previous dentist indicated), but the dentist still decides to drill and refill it, could there be any complications or side effects from this?
2.
I have heard that silver fillings are more durable, especially for deeper cavities.
I have a tooth with a very deep cavity that was previously treated with medication before being filled again.
However, one dentist chose to use a white filling instead of a silver one.
I would like to know if white fillings are more prone to cavities in the future, especially considering the depth of the cavity, or if they require more frequent replacements.
3.
I have two adjacent teeth that needed to be refilled.
One dentist unexpectedly made the gap between them so tight that I could no longer use dental floss.
This was quite surprising, as I didn't expect such an approach to filling cavities.
Now, I seem to be facing a similar situation with another pair of adjacent teeth that were refilled, and I find it difficult to use dental floss between them.
It takes a long time to get the floss in, and I can't get it out without cutting the floss off the holder.
Has the dentist effectively sealed the gap between my teeth, or is it just a tight fit? I am trying to determine if this dentist was negligent or if they intentionally sealed the gap like the previous dentist did.
If it's the latter, I really should consider finding a new dentist.
4.
I would like to ask if it is better to refill a cavity as soon as possible.
Is it worse to wait until it hurts when eating before getting it refilled? I had an X-ray taken because I felt something was off while using dental floss, and the dentist said everything was fine.
However, I ended up needing a refill two months later when it started to hurt while eating.
Is it common for some cavities to only be identified for refilling when they cause pain during eating?

mimi, 30~39 year old female. Ask Date: 2011/11/25

Dr. Zeng Guanghui reply Dentistry

Hello, Miss: Thank you for your inquiry.
Here are my responses and recommendations:
1.
If there are no uncomfortable symptoms after the filling, you can simply monitor the situation without needing to reopen and refill.
2.
The white filling material is generally made of resin, which is more aesthetically pleasing than silver fillings but has lower hardness.
It may fracture if you bite down on hard objects, so it is not advisable to eat very hard foods after a resin filling.
3.
If the cavity is located between the teeth, it is important to maintain the original space after filling to allow for proper flossing.
4.
Once a cavity is present, it is recommended to have it filled promptly to prevent bacteria or food debris from damaging the underlying dentin or affecting the dental pulp.
Wishing you peace and happiness!

Reply Date: 2011/11/25

More Info

Understanding dental fillings and the associated concerns is crucial for maintaining oral health. Let's address your questions one by one, providing clarity on each issue.

1. Consequences of Unnecessary Re-treatment: If a dentist decides to re-treat a tooth that was previously deemed stable, there can be potential consequences. Over-treatment can lead to unnecessary removal of healthy tooth structure, which may weaken the tooth and increase the risk of fractures or further decay. Additionally, the process of drilling and filling can irritate the dental pulp, potentially leading to pulpitis or the need for root canal treatment in the future. It's essential to communicate openly with your dentist about why they believe a re-treatment is necessary, especially if another professional had previously assessed the tooth as stable.

2. Material Choices for Fillings: The choice between silver (amalgam) and white (composite) fillings often depends on the location of the cavity and the depth of the decay. Silver fillings are known for their durability and strength, making them suitable for larger cavities, especially in the back teeth where chewing forces are greater. On the other hand, white fillings are aesthetically pleasing and bond well to the tooth structure, but they may not be as durable as silver in deep cavities. If a deep cavity is filled with a white material, it is essential to ensure that the filling is placed correctly and that the tooth is adequately supported. While white fillings can be more prone to wear and may need replacement sooner than silver fillings, they do not inherently lead to more cavities if properly placed and maintained.

3. Interdental Space and Flossing Issues: If a dentist has filled cavities between two closely spaced teeth and you find it difficult to floss, this could indicate that the filling material has encroached upon the interdental space. Properly placed fillings should allow for easy flossing. If you are struggling to use dental floss, it may be a sign that the filling is too high or that the space has been compromised. This situation could lead to plaque accumulation and subsequent decay if not addressed. It’s advisable to return to your dentist to discuss your concerns and possibly have the fillings adjusted to ensure proper spacing for effective oral hygiene.

4. Timing for Dental Repairs: When it comes to cavities, the general rule is that the sooner they are treated, the better. Waiting until you experience pain can lead to more extensive damage, requiring more invasive treatments like root canals or crowns. X-rays are a valuable tool for detecting cavities before they become symptomatic, but not all cavities are visible on X-rays, especially if they are located between teeth. Regular dental check-ups are essential for monitoring your oral health and catching issues early. If you feel discomfort or notice changes in your teeth, it’s crucial to seek dental care promptly rather than waiting for pain to escalate.

In summary, maintaining open communication with your dentist about your concerns and treatment options is vital. If you feel uncertain about the treatment you are receiving or if your concerns are not being addressed, seeking a second opinion can provide additional reassurance and clarity. Regular dental visits and proactive care are key to preventing complications and ensuring long-term oral health.

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