A cracked or broken tooth is one of the most common reasons dentists see patients for emergencies. Patient’s often associate the problem with eating something hard and don’t realize that the problem started with a weakened tooth caused by silver fillings.
Silver fillings, called amalgam fillings, are old technology, first used in the early 1800’s. As dentistry has advanced and better materials invented, this technology has become all but obsolete. However, many of us still retain our childhood amalgam fillings. Most teeth with these fillings show some degree of stress fractures and cracks. These fillings are sturdy – so sturdy, in fact, that they are usually still solidly in place when the tooth has fallen apart around it.
How do these fractures happen? The metals in the amalgam filling contract and expand repeatedly with slight temperature changes. Over time, something has to give. Because your tooth doesn’t expand and contract with the metal filling, and it is more brittle than amalgam, it eventually develops cracks. The larger the amalgam filling, the more likely you are to have a fracture or cracked tooth syndrome.
What does that mean for your tooth? There are several consequences to these cracks. At minimum, even the smallest craze lines allow bacteria inside your tooth, greatly increasing the likelihood of tooth decay. These cracks also weaken the tooth, and lead to a complete fracture of part of the tooth. This can happen with or without associated pain. Often, these cracks cause sensitivity and a soreness when biting known as cracked tooth syndrome. This happens when the crack has propagated down the root or toward the pulp enough to affect your nerves.
Treatment: Often, it is recommended to replace amalgam fillings with white composite to help prevent further cracks from forming. Sometimes the cracks or the amalgam fillings are too big for this to help and a crown is the recommended treatment. The goal is to prevent further damage and avoid serious problems that can lead to root canals or tooth loss.
We use magnification and intraoral photographs to evaluate the damage from amalgam fillings. We use this evaluation to make appropriate recommendations for the protection of each affected tooth.