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  • Q&A with Australian Health Practitioners

    All my back teeth have too much filling, what can be done to fix them?

    Related Topics
    Dentistry Oral Health
    I have top and bottom back teeth that are more amalgam than tooth and I grind in my sleep according to my dentist.

    Which solution should I consider?

    To replace them all with false teeth or implants or something else?
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    Dr Evan Stacey

    Dentist

    My dentistry is tailored to the indivudal needs of every patient I see. My focus is in the areas of cosmetic dentistry, dental implants and … View Profile

    Teeth that have large amaglam restorations are prone to fracturing over time, especially if you are a person that grinds their teeth. The way that amalgam is placed in large cavities creates areas of stress when pressure is applied from chewing or grinding. Eventually, part of the tooth, or even the whole tooth can fracture.

    In dentistry, one always aims to be conservative where possible, meaning that we aim to remove little to no natural tooth structure where possible. In the case of largely restored teeth, treatment generally entails removal of the amalgam filling, taking away any weakened tooth structure, cleaning out underlying decay or bacteria, and re-filling the tooth with a white, composite filling.

    The tooth then needs to be prepared for a crown, which is designed to bind all of the natural tooth structure together, and make it resistant to further damage. Crown materials such as zirconia can be up to four times as strong as natural tooth, and their long-term success is high.

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    Dr Roland Chong

    Dentist

    There are 3 questions which I think you are asking:

    1) Will heavily filled back teeth in amalgam break?
    2) Are the teeth more likely to break because of teeth grinding?
    3) Should the teeth be removed and replaced with something more reliable?

    Question 1:

    Teeth which are heavily filled have less tooth structure so are prone to cracking/fracturing and also having the pulp tissue, which is the organic matter in the core of the tooth keeping the tooth alive, die. Amalgam restorations are good restorations but if not applied appropriately parts of teeth which are not protected by the restoration will eventually break. 

    Question 2:

    Any tooth weakened from loss of tooth structure will be prone to breaking. But this becomes more apparent when excessive forces are placed on the teeth. Teeth grinding is a condition which involves rubbing your teeth together, in your sleep typically but can also happen whilst awake, sometimes there may be periods of clenching as well. Such forces placed on teeth over a long period of time will lead to cracks in the teeth and eventual teeth failure.

    Question 3:

    There is no prosthesis which will function as well as your own natural teeth. Removal of teeth which are heavily restored should only be done if they are beyond repair and restoring them to form and function cannot be done predictably. Implants, bridges and dentures have their inherent problems. Reinforcing your existing teeth with crowns or part crowns (onlays) will prolong their lifespan. But regardless of which option you choose you will still be grinding your teeth and therefore you will need something to protect your natural teeth or prosthesis. A night splint needs to be worn to alleviate the excessive forces placed on your teeth.

    Keeping your natural teeth, especially if you are young, keeps your options open. Once you remove them your options to replace them diminishes overtime and replacements often have complex problems associated with them. Finally, a comprehensive discussion aobut each option needs to happen with you and your dentist before you make a decision.

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    Dr Farida Shah(Shaik)

    Dentist

    Credentials: B.D.S.,A.D.C.,M.Sc.(University of Wollongong) Registered practitioner of Fast braces We do Oral cancer screening and complete Saliva analysis. Cosmetic dentistry... Yes we are up to … View Profile

    Along with above mentioned suggestions,needs to get breaking of grinding habbit by wearing the occlussal splint at night.Check with your dentist in regards.

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