Should I Ask My Dentist for a Refill on a Root Canal?

What are root canals?

Root canal treatments are a very common procedure to treat infected or otherwise severely damaged teeth. Root canals are effective procedures that remove infected material while attempting to preserve the tooth’s remaining healthy structures.

Root canals are needed once the pulp of the tooth, the soft core in the center of the tooth, becomes infected. Left untreated, you are at a higher risk for tooth and bone loss.

How are root canals performed?

Before performing a root canal, your dentist will perform an x-ray to assess the infected tooth as well as the surrounding bone and tissue.

On the day of your procedure, you will receive local anesthetic to numb the infected area. Once that medication has taken effect, your dentist will start by drilling a small hole into your tooth until the decay becomes visible. Next, he will remove the infected pulp and other decaying structures from the affected tooth.

After all of the infected material has been removed, your dentist will disinfect the area thoroughly to prevent any bacteria from multiplying once the hole has been sealed again.

Finally, your dentist will fill the hole to restore the tooth’s structural integrity and support your overall dental health.

Why do root-canaled teeth need to be filled?

Root canals are extremely effective at removing all of the infected and decaying matter from the inside of your teeth – but this isn’t without any drawbacks.

As your dentist is drilling into your teeth, he is also removing layers of enamel and dentin, in addition to the dental pulp. Unfortunately, these layers will never grow back,
resulting in a fragile foundation for the tooth’s remaining structures.

The larger the infected surface was prior to the root canal, the more layers will be removed, and the weaker the tooth will be following the procedure.

Additionally, without the dental pulp, the tooth can no longer function as a living thing,
and becomes even more delicate.

Filling a root-canaled tooth counteracts this fragility by fortifying the tooth, protecting it from further damage, and sealing out bacterias that could cause further infections.

Restoring the teeth with fillings and crowns

After a root canal, most dentists will fill the affected tooth with a temporary filling to last until you can come back and get fitted with your permanent dental crown. Other dentists apply a permanent filling, so there is no need for a dental crown.

What is the difference between fillings and crowns?

Fillings only restore the damaged or missing portion of a tooth, as they are applied directly into cracks and holes. At Owens Cosmetic and Family Dentistry we use composite fillings, which are applied directly to the tooth in layers and cured by an ultraviolet light.

Crowns, on the other hand, cover the entire tooth. Crowns look like small caps that are placed on top of the tooth and cemented into place. As specialists in metal-free dentistry, the Owens Dentistry team only uses all-ceramic porcelain crowns to restore root-canaled teeth.

Both methods provide your teeth with additional strength, stability, and protection from bacteria. However, crowns are considered to be more sturdy and long lasting.

Fillings, whether temporary or permanent, are weaker than crowns. They are more susceptible to cracking, breaking, or becoming loose and falling out of the tooth. Once a filling breaks or falls out, you have a higher risk of developing a second infection, followed by tooth decay.

What causes fillings to break or fall out?

Eating or drinking anything that is known to harm your enamel, the thin top layer of your teeth, can also damage restorative materials like fillings. Anything sticky, sugary, or acidic leaves a film on your teeth that welcomes bacteria. After continued exposure, these bacteria start to eat away at your teeth as well as any bonding materials. Over time, this could loosen the filling, causing it to fall out.

Certain behaviors increase the risk of cracking, breaking or losing your filling. Chewing on hard food, or ice generates enough pressure to crack or loosen a filling, causing it to fall out. Poor oral hygiene also puts your filling at risk. Make sure to treat any tooth restorations, including fillings, just like your normal teeth. Brush at least twice daily, floss at least once every day, and make sure to go to your dental checkups at least twice a year to keep your fillings clean.

Other uncontrollable factors can also lead to fillings falling out. Your saliva may wear at the bonding material holding the filling to your teeth over time, eventually separating the filling from your tooth.

Your dental health and state of nearby teeth also plays a big role in your filling’s survival rate. If the same tooth or nearby tissue starts to decay, the filling may fall out.

I received a permanent filling, but it fell out. Should I ask for a refill?

Your risk of further infection, decay, and tooth sensitivity rises exponentially after losing a filling, as the tooth has lost its protection. To avoid these health complications, it is extremely important to find a solution quickly. But in some cases, refilling the tooth is not the best way to resolve the issue long term.

According to a 2004 study, the survival rate for root-canaled teeth without a crown was 96% after one year, 88% after two years, and only 36% after five years. This shows that a refill may help the tooth survive for a few short years, but is likely to fail eventually.
When deciding between fillings and crowns, there are three major factors to consider: the tooth’s remaining natural structures, the tooth’s position in the mouth, and the tooth’s function.

Teeth that only had a small amount of decay going into the root canal process will still retain a large amount of natural structures and surfaces following the procedure. As these teeth will still have some of their natural strength, they will not need as much support as a tooth that had to be completely reconstructed. In this case, a sturdy composite tooth filling will provide the necessary bit of strength the tooth needs to survive.

Front teeth that are not used for chewing, like incisors and canines, can be restored with fillings as they do not require a strong chewing surface. But, many patients choose crowns anyways as they can be tinted to match their natural teeth and blend into their smiles.

Some teeth, most notably the premolars, require a stronger surface and foundation. These teeth need the additional strength, stability, and protection crowns provide. Fillings, even after being refilled and restored, are not able to withstand the physical stress caused by chewing.

Generally speaking, crowns are the best method to restore root-canaled teeth as they will not falter under physical stress. But, keep in mind, although crowns are durable, they are not indestructible. A poor oral health regimine will put crowns at risk for failure, just like fillings.

Metal-Free Dentistry in Farmington Hills

Whether root canal or tooth extraction, fillings or crowns, the Owens Cosmetic Dentistry team will take the time needed to determine the best procedure for your smile and underlying dental health.

If you would like to learn more about root canal procedures, fillings, and dental crowns, or would like to book an initial consultation, don’t hesitate to get in touch with us. Call us today at 248-716-8623 to schedule your appointment.