Diamonds are Forever, Fillings are NOT
They say that true love, memories, diamonds, and even tattoos last forever. Last time I checked, however, the divorce rate in the US is out of control, diseases like Alzheimer’s can rob us of our most cherished memories, diamonds can be lost (or found to be fake!), and tattoos can be removed with lasers. But people claim that all these things last ‘forever’ because they are meant to last at least a lifetime. One thing that you won’t see on that list, however, is dental restorations.
Dental restorations, i.e. crowns, fillings, veneers, etc., do not last forever. They are man-made materials with their own inherent characteristics and limitations that are put into one of the most challenging environments imaginable. The mouth is moist, full of bacteria that are constantly attacking our teeth and restorations, and we use our teeth every single day of our lives for multiple hours a day. We chew, we speak, we bite our nails (hopefully not), we crunch hard foods, and the worst sin of all, chewing ice!!! Every single day, multiple times a day, week after week and year after year, we expect our teeth to flawlessly function for us without pain or sensitivity and look good doing it. We all want our teeth whiter, straighter, and more esthetic.
Take a simple composite (white) filling in a 15 year old’s molar who wasn’t brushing well when he had braces. If that young person lives to be 85 years old, the average life expectancy currently, then we would ideally like that filling to last 70 years! I can tell you that is highly unlikely. Wear and tear, leakage, recurrent decay, fractures, and staining can all attack that tooth and filling and necessitate repair and/or replacement. And the larger a filling is, the shorter life expectancy we have for that filling. Larger cavities necessitate larger fillings, which necessarily leaves less natural tooth structure behind. And each time a filling is replaced, it goes back bigger than before. If you read my last blog post, then you recognize this as the ‘death spiral’ of a tooth and it goes back to my analogy about dentistry as a ladder. Again, don’t skip steps on the ladder, and don’t fall off the ladder!
Thanks to modern dentistry and advances in materials and techniques, we can expect reasonably long-lasting restorations and highly esthetic outcomes of our treatments. Generally speaking, small fillings last longer than large ones. Front fillings last longer than molar fillings. Crowns, while more expensive, do typically last much longer than fillings. Of course, there are numerous variables that are different from patient to patient. Diet, hygiene habits, parafunctional habits, age, medications, and overall health all play a part in determining how long any given restoration will last. Patients who clench/grind their teeth excessively, chew their nails, or use their teeth as tools to open things are much more likely to break a restoration. Patients who suffer from dry mouth (often caused by medications), drink excessive amounts of sodas or juice, or who have poor oral hygiene are more likely to get decay around their existing fillings.
So what is the answer? What can we do to preserve our teeth and make our fillings last as long as possible? It’s simple. Proper home care is key, brushing with a fluoridated toothpaste twice a day for two minutes each time. Floss (ideally daily but do your best). Limit sodas. Treat dry-mouth with your doctor or use Biotene or Oasis products to alleviate it. Use your teeth only for things that teeth were meant to do (they aren’t scissors). And don’t chew ice, even the soft Sonic ice. I can’t tell you how many crowns I’ve done for people who have cracked a tooth chewing ice.
Fillings, even if they can’t last forever, are still a great option for small to medium sized cavities in teeth. Come see us here at My Sherman Dentist for an exam and x-rays so we can discover any potential problem areas early and address them. Putting it off until something hurts is a recipe for more expensive and invasive treatment.
We hope to see you soon!
-Dr. Davis