I recently had the frustration of being told I have a new cavity, formed where an old filling had worn down. My instinct was frustration: a moment of, “I thought I fixed that already!”
A patient understandably assumes, having left that cavity in the past, it was a blip that was remedied and eventually forgotten. Unfortunately, secondary tooth decay (also known as secondary caries) is prevalent. These form as a cavity (or tooth decay) develops within or under a cracked or improper filling.
Lack of Durability in Enamel Alternatives
An area of a tooth that has been at some point filled is much more likely to have a cavity form there, and that fact comes down to the lack of durability with enamel alternatives. Human teeth and enamel are some of the hardest substances and maintain themselves throughout the human body as biological products. As such, no substance can properly mimic all enamel’s properties and strength. Today the most common fillings are resins and glass, and despite their success at blending into the mouth via their white/cream color, they will inevitably decay.
When Cracks Arise in a Dental Filling
Cracks, visible and invisible, will eventually form in the filling. This occurs due to lost elasticity and wear from the digestive properties of saliva and the force of continual chewing. It also occurs due to lost mineralization of the teeth. Once drilled into, the microscopic chemical balance of the tooth is disrupted and is difficult to return to its whole state.
Often, little is done to ensure the restrengthening of the tooth, and it will remain vulnerable to force. Once a crack exceeds 50 microns, saliva can begin to seep into the fillings, possibly bringing with it decay-causing harmful bacteria. Because of the small size of these cracks, visible or not, they are unable to be properly cleaned with a conventional toothbrushing apparatus. They are too small and often too deep. Not only that, but secondary tooth decay can even be invisible, forming underneath the cracking filling. These kinds are only detectable using X-rays at a dental office, so it is extremely important for everyone, but especially those with many fillings, to see a dentist regularly.
Preventative Care Is Key
That is not to say there is not anything one can do to prevent cavity refillings every time one goes to the dentist. The best care is preventative care, so proper dental hygiene from an early age is essential. Flouride treatments, be they clinical or from drinking water, also help prevent cavities from forming in the first place, eliminating the problem. If, however, you already have cavities, much of the advice still applies. Proper dental care, fluoride and regular checks from a dentist all help prevent the decaying fillings from getting unmanageable and painful. Limiting the consumption of sugary foods also helps. Keeping your body healthy will also help, as dental health is heavily linked to the health of the body. A study done in May of 2022 by Rutgers University heavily links enamel and dentin weakness to diabetes. The softening of these properties allows for quicker cavity formation and quicker decaying of fillings.
Dental Amalgam Fillings Left Behind
Secondary tooth decay has become much more common in recent years, since the dental community’s move away from dental amalgam. Dental amalgam, in its malleable and metal state, has natural anti-microbial and anti-bacterial properties and is very resistant to cracking. Even when decay was left behind under the tooth, be it the usual amount or improper drilling, the amalgam itself would kill and stave off a secondary infection. However, concerns over dental amalgam’s mercury content, and its garish black-silver appearance, have made it a decreasingly popular choice when filling cavities today.
Call To Learn More
As disheartening as hearing that the best solution is prevention, for those of us with fillings already, there is hope on the horizon! Next week we will be laying out new technologies that seek to combat secondary dental decay through inconspicuous antimicrobial fillings. If you would like to learn more or schedule a visit with our experienced Westtown Dental Care team, please give us a call at 484-887-0777. Dr. Sara Bekyan is pleased to offer comprehensive dentistry in West Chester, Pennsylvania, also serving Broomall, Edgmont, Exton, Glen Mills and Paoli, Pennsylvania. We look forward to hearing from you!