Teeth with Fillings Starting to Crack: Should I Get Implants?
Lana asks:
I am a 47 year old female with old silver fillings in almost every tooth I have. Some of them are starting to crack and because most of the tooth is just filling material, I've been told that they will need replacing. I've had one replaced and I'm looking at 8 more - 4 on the top back and 4 on the bottom back. Would it make more sense to have implants, if I have to have that many replaced? I have not been happy with the one that was crowned - mainly because that tooth continues to be sensitive and ache at times. Thanks.
Hi Lana:
Without seeing radiographs and knowing more about your particular dental condition, your question is a difficult one to answer. For someone who is constantly getting decay, implants may be a better option than continually redoing restorations. This may change in the future, however, as new developments for caries risk assessment and prevention come into clinical practice. If the remaining parts of your teeth are intact, however, even if root canals are needed, you may be better off restoring them.
Dental implants are a wonderful replacement for natural teeth, however, they are still a replacement for natural teeth. You should sit down with your dentist and review the pros and cons of restoring the teeth that you have versus removing them and placing implants. You should discuss both the short term and long term risks for problems with both crowns and implants, and then decide what is best for you. You may even find that a combination of procedures may be the answer.
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Lana,
On the crowned tooth that continues to ache:
There are several common causes of symptoms like yours with crowned teeth. The most common is that the "bite" is just a little high causing that tooth to hit too hard when biting straight down or when chewing or bruxing (grinding your teeth or clenching.) Next is leakage under the crown (or any other restoration) that affects the nerve. Another cause is that the 'nerve' in that tooth is unhealthy and hypersensitive. The last is that the nerve (or part of it) is beyond unhealthy and has died. This usually results in a infection (abscess) by the root. These last two are treated by removing the nerve from inside the tooth and sealing the tooth from top to bottom ("a root canal") or by replacing the tooth with an implant & crown system.
Sometimes the root itself is cracked vertically, or an abscess has destroyed enough bone that the tooth can't be saved and must be removed.
We've reached the point in dentistry where implants are very predictable, and as Dr. Robins points out, a better option than restored natural teeth in many cases. You are still young, so long-term predictability is important.
Best wishes to you.
mls ;)
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