Tooth wear is based on the environment. In the same way that cars used for races require more repair than those used for display purposes, tooth wear depends on what we expose our teeth to. For instance, if you grind your teeth during night (bruxism), they will wear over time without you being aware of it.
An intact tooth is the best
The most durable tooth is one without any fillings. Most people have amalgam fillings which function fine. However, with age, the amalgam filling changes its form so it does not fit the tooth anymore.
A cavity alongside the fractured amalgam filling
Amalgam cannot bind itself to the tooth. A dentist will usually make the cavity wider at the bottom than at the top so that when the amalgam sets, it swells and becomes “trapped” in the cavity. Amalgam is good at resisting bite forces, but over time small cracks in the tooth are created, increasing the risk of fracture. The bigger the filling, the greater the risk.
A side view of a tooth with caries (left), detected during a routine dental examination. The tooth (right) with the caries and bacteria removed. If the tooth were to be filled with amalgam at this stage, the amalgam would simply fall out.
The dentist is, therefore, forced to remove healthy tooth substance in order to make the cavity bigger at the bottom.
A cavity filled with amalgam (left). Over time the amalgam swells up (right), creating a risk of fracture to the tooth.
A tooth with a large old amalgam filling. A crack is visible and the wall of the tooth will soon fall off (left). Another example (right) where the wall has broken off. A crown or dental onlay will greatly reduce the risk of fracture. Tooth fractures also quite often lead to root canal treatment.
The first time a cavity is filled with amalgam, it usually lasts a long time – 20 years is not uncommon. When an old filling needs to be redone, the prognosis is not always as good. Even the unfilled parts of the tooth are often damaged, forcing the dentist to remove more of the tooth. The longevity is now greatly reduced. A crown or dental inlay/onlay will improve the prognosis of the tooth.
Molars in the lower jaw with big, old amalgam fillings.
After treatment with bonded ceramic crowns/onlays.
Modern techniques make it possible to restore teeth back to how they originally looked, putting a smile on the patient’s face again.
In the early stage of a cavity, composites are much better, and more aesthetic than amalgams. At Snö we do not provide amalgams as an alternative.