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What to Do If Your Filling Falls Out: Don't Panic, Just Call the Dentist!

Donna M. Rounsaville, RDH,BS

Wondering what to do if your filling falls out? It has happened to many of us: You are eating, and you feel that foreign object in your mouth. Is it something in the food, or did my filling fall out?  A phone call to the dentist is your first step. At the dental office, the dentist will determine the necessary treatment.

Prevention

Regular dental care is recommended to detect potential problems with fillings. The dentist can identify open margins or uneven wear before you realize there may be a problem. Dental visits can also provide instruction in proper oral hygiene to control bacterial plaque, a leading cause of tooth decay. Decay that forms around the margin of a filling will compromise that restoration. Without regular care, you could suddenly be wondering what to do if your filling falls out.

Restorations or fillings all have a breaking point and will eventually fail and need replacement. No filling will last forever, and regular visits to the dentist will help determine when is the best time to be proactive and replace a restoration. However, a filling may fall out unexpectedly, and you may be faced with pain, discomfort, and a possible emergency situation. According the American Dental Association, many factors can contribute to a filling becoming chipped or broken. It can be attributed to tooth wear from grinding or clenching, to bacteria leaking into the margins of the fillings and causing decay or to the simple fact that the restoration needs replacement. Either way, left untreated, a lost or chipped filling could lead to a root canal and possible loss of the tooth.

What to Expect at the Appointment

There is no need to panic about what to do if your filling falls out. All dental offices will have emergency time set aside in the daily schedule for lost fillings or other dental problems; therefore, you will be seen on the day you call. If you need care on the weekend, the office will have a contact to call in case of an emergency. Once at the dental office, an assistant or dentist will review your medical history and question you about your concerns and symptoms. An X-ray will be taken, and the dentist will examine the tooth and X-ray to determine the best treatment. If the tooth can be restored with another filling, the dentist will discuss your options for filling materials. If a referral to another dental professional is warranted, the dentist will guide you through the process. Sometimes, the tooth may need a root canal and a crown or cap to restore the integrity of the tooth. On rare occasions, a lost filling may require the tooth to be extracted.

Filling Choices

If the tooth is restorable, the location of the tooth will determine the type of restoration. If it is a molar or premolar, you have the choice of an amalgam (silver) filling or composite and glass ionomer (tooth-colored) material. If a front tooth (incisor or canine), the best aesthetic choice is a composite and glass ionomer filling. The back teeth experience the greatest chewing forces, and very often the amalgam filling is the stronger material and will last longer. Many dentists, however, will place exclusively tooth-colored restorations due to patient preference.

If there is extensive loss of tooth and the ratio of tooth structure to restoration inclines heavily to the latter, a crown or cap is your best option. In the case of the crown, if the dentist has time, he can place a temporary crown or sedative filling to protect the tooth. The permanent crown preparation, impression and placement will happen at subsequent visits.

Rarely, when your filling falls out, it will reveal a deep cavity or exposure to the nerve of the tooth. In this case, the only option is to have a root canal followed by placement of a crown. In very rare situations, the loss of a filling or fractured tooth may be so severe that the only option is extraction. If this happens, the oral surgeon and dentist will present a treatment plan to replace the tooth. The options can be a fixed or removable bridge or a dental implant.

What to do when your filling falls out or your tooth breaks? Don't panic, but do contact your dentist immediately. The decision for the best treatment will happen after a thorough examination of the tooth and a consultation. Not seeking immediate care could result in pain, discomfort and even loss of the tooth.

Learn more about lost fillings and other dental emergencies in the Colgate Oral Care resources.

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