It’s happened to many of us: You’re eating a perfectly enjoyable meal, when suddenly your tongue pokes at a foreign object in your mouth. Is it something in the food? Unfortunately not – your filling just fell 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 like open margins or uneven wear. Dental visits can also provide instruction in proper oral hygiene to control 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.
What to expect at the appointment
Good news: most dental offices will have emergency time set aside for lost fillings or other emergency dental problems.
Once at the dental office, an assistant or dentist will review your medical history and question you about your 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 and severity of loss will determine the type of restoration:
- If it is a molar or premolar, you have the choice of an amalgam (silver) filling or a tooth-colored material. If a front tooth (incisor or canine), the best aesthetic choice is a tooth-colored restoration.
- 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, 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.
Fallout: when fillings turn serious
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.
Original content by Donna M. Rounsaville, RDH,BS
