A root canal is a standard dental procedure used to restore the health and function of a severely damaged tooth. However, if the filling that seals the root canal is degraded or falls out, you are at a higher risk of re-infection and may need to visit your dentist for a refill. Find out whether you need a root canal refill or whether you may need a more durable alternative.
What are Root Canals?
A root canal is a standard endodontic treatment for infected or severely damaged teeth. Teeth can become deeply decayed due to serious chips or cracks in the crown of the tooth, allowing bacteria to infect the tooth’s pulp. This can cause intense tooth pain, sensitivity to hot and cold, and swollen gums.
While you can manage discomfort with over-the-counter pain medication and ice packs, if left untreated, damaged pulp can become a dental abscess, putting you at higher risk for tooth and bone loss.
Root canal therapy is an effective procedure that removes infected material, saving the tooth and preserving as much of the natural tooth’s remaining healthy structures as possible.
How are Root Canals Performed?
Before performing a root canal treatment, your dentist will take X-rays to assess the infected tooth and the surrounding bone and tissue.
On the day of your dental procedure, you will receive local anesthesia to numb the infected area. Then, your dentist drills a small hole into your tooth’s crown until the decay becomes visible. Next, the infected pulp and other decayed tissue from the affected tooth are removed using endodontic files. This includes the tooth’s blood vessels, nerves, and soft tissue.
After all the infected material has been removed, your dentist disinfects the area to prevent bacteria from multiplying once the cavity has been sealed again.
Your dentist seals the cavity with a latex material called gutta-percha and a dental filling to restore the tooth’s structural integrity and support your overall dental health. In most cases, your dentist may also recommend capping the tooth with a crown at a follow-up visit to fully restore the tooth.
Why Do Root-Canaled Teeth Need to be Filled?
The root canal procedure removes infected and decaying matter from the inside of your teeth – but this type of dental work isn’t without drawbacks.
As your dentist is drilling into your teeth, they are also removing layers of enamel and dentin in addition to the dental pulp. Unfortunately, these layers will never grow back, resulting in fragile protection for the tooth’s remaining structures. The larger the infected surface was before the root canal, the tooth structure that will be removed, and the weaker the tooth will be following the procedure.
Additionally, without dental pulp, treated teeth can no longer function as living parts of your body, becoming even more delicate. Tooth root fillings counteract this fragility by fortifying the tooth, protecting it from further damage, and sealing out bacteria that could cause further infections.
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 & Family Dentistry, we use composite fillings, which are applied directly to the tooth in layers and cured by ultraviolet light.
However, dental crowns cover the entire tooth. Crowns look like small caps placed on 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 to give you the most natural-looking result.
Both methods give your teeth additional strength, stability, and protection from bacteria. However, crowns are considered to be more sturdy and long-lasting.
Both permanent and temporary fillings 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 and tooth extraction.
What Causes Fillings to Break or Fall Out?
Eating or drinking anything known to harm your enamel, the thin top layer of your teeth, can also damage restorative materials like fillings. This includes anything sticky, sugary, or acidic.
These substances leave a biofilm on your teeth that breeds bacteria. These bacteria feed on the sugars in the foods you eat and produce an acidic metabolic byproduct. Continuous exposure to this acid erodes tooth enamel and 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 like nuts 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. Treat any tooth restorations, including fillings, just like your normal teeth. Brush at least twice daily, floss at least once every day, and 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. Over time, your saliva may wear at the bonding material holding the filling to your teeth, eventually separating the filling from your tooth.
Your dental health and the state of nearby teeth also play 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?
If your permanent filling has fallen out, please contact your dentist immediately. Your risk of further infection, decay, and tooth sensitivity increases after losing a filling because the tooth has lost its protection.
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 before the root canal procedure will retain a large amount of their natural structure following a root canal treatment. They will not need as much support as a tooth that had to be completely reconstructed. In this case, a composite tooth filling gives the tooth a restoration, so it looks and functions as normal.
Front teeth not used for chewing, like incisors and canines, can be restored with fillings as they do not require a strong chewing surface.
Some teeth, most notably premolars and molars, require a stronger surface and foundation. These teeth need additional strength, stability, and crowns to withstand the intense biting and grinding forces. Even after being refilled and restored, fillings cannot withstand the physical stress caused by chewing.
Generally, crowns are the best method to restore root-canaled teeth. However, although crowns are durable, they are not indestructible. A poor oral health regimen will put crowns at risk for failure, just like fillings.
Metal-Free Dentistry in Farmington Hills
Whether you need a root canal, a filling, or a dental crown, the Owens Cosmetic & Family Dentistry team can help you determine the best procedure for your smile and oral health.
If you want to learn more about root canal procedures, fillings, and dental crowns, or book a consultation, contact us at (248) 716-8623.