Expiration Dates: They Even Apply to Dentistry
By Eric Seidel, DMD
Have you had a recent appointment to your dentist only to hear terms like “leaky margins” or “fractures” when referring to old restorations (crown, bridge, filling)? This is a daily discussion point that we have in our office when doing either new patient or routine examinations. One of the fallacies surrounding dentistry is that fillings or crowns are meant to last forever. Although there are several factors that contribute to the life expectancy of fillings and crowns, none of them last forever. It is very important, however, that when fillings or crowns have reached their end, that they are replaced in a timely fashion so there isn’t additional harm caused to the teeth. Waiting too long to replace leaking or fractured fillings can cause the need for unnecessary root canals, fractured, broken or lost teeth. During treatment, we often take photographs to be able to educate our patients on the condition of their mouths. Remember, if it looks bad on top it’s generally worse underneath.
There are several determinants that decide the true life of a restoration in the mouth. One of the biggest is how well it was initially placed. Assuming the clinician did a great job and the patient was cooperative, the normal life of a filling can be 10+ years (I’ve even seen some at the 30 year mark). Historically, amalgam or “silver fillings”, as most people refer to them, have great longevity. The downside is that they just don’t look good, contain mercury and never really bond with the teeth which can lead to the long term fracture of these teeth. They also do not allow x-rays to pass through and therefore can hide underlying recurrent or new decay until it becomes sizable. More modern white fillings may not wear quite as well as their silver counterparts, however they are friendlier on the opposing teeth, bond and help strengthen the tooth and look great. The newer generations of white fillings last longer and look better than ever. Crowns and bridges of the past were very durable, however, the bond between the white porcelain and metal would oftentimes fail leaving unsightly metal showing through. Today’s all white zirconia or emax crowns do not have that problem. However, most crowns fail for the same reasons fillings fail, not because they are broken or come out, but rather that new “recurrent” decay forms along the margin between restoration and tooth.
The primary cause of failure is new decay, caused by lack of adequate homecare, less than frequent professional care or as important as anything…. diet. The same processes that caused tooth decay in the first place are the same ones that cause dental work to fail. Improving homecare, more frequent cleanings, additional fluoride, improved diet and the use of xylitol will all help make dental work last for a very long time. We as clinicians pride ourselves on a job well done. Nothing is more complimentary than seeing our hard work stand the test of time. This, however, is a partnership between dentist and patient as both have influence on the long term success of dental care.
Eric Seidel, D.M.D. is co-owner and general dentist at Gettysburg Dental Associates and an Invisalign Premier Provider.
Gettysburg Dental Associates
Eric Seidel, DMD | Cleveland Null, DDS
www.GettysburgDentalAssociates.com
Just Kids at Gettysburg Dental Associates
Stephanie DeFilippo, DDS | Kristin Russo, DMD
www.JustKidsGettysburg.com
353 York Street Front
Gettysburg, PA 17325
Phone: (717) 334-8193
Fax: (717) 334-0884
www.gettysburgfamilysmiles.com
