Am I headed for serious problems with my teeth?

[jb220]

Basically, I'm in my mid 30's, I have one root canaled lower molar and a bunch of composite fillings. I think they're medium to large sized, but not sure. I've gotten more and more serious about oral hygiene, to the point of obsessiveness, since my root canal.

The thing is: I keep reading about how composites are leaky and fail after relatively short periods and worrying I've done irreparable damage. It used to just be a worry in the back of my mind, but its actually been causing me a lot of anxiety over the last few weeks. My last filling was in 2018, and so far I haven't needed any new work since I started flossing nightly.

I think I have at least one filling on a premolar thats facing the tooth next to it (I think you call this Class II) directly on top of, and in front, of a nerve, and a similar one on a lower molar thats almost, but not quite, to the nerve. Not sure about the rest.

Do I have to worry about it creating a direct path to the nerve if/when the fillings fail? Can oral hygiene effectively prevent or delay cavities under fillings? Should I actually consider having one or more functional fillings replaced with something sturdier like an inlay?

I keep worrying I have a lot of root canals and extractions in my future and I that I can't prevent it at this point.

 

[honestdoc]

The best thing you can do is to get regular checkups. Only through x-rays can we see cavities or defects under fillings. I always tell patients that it is best not to get cavities and many don't care until they get problems. Many people don't see the dentist until it is too late (cavities gone into the root canal space). Proper and effective oral hygiene can definitely prevent future cavities as is proper diet. Many people drink too much sugary, acidic, and or creamy beverages (lattes).

I'm a firm believer in less drilling the better. All too often I see dentists take out old fillings and putting new ones in. I have 35 year old silver fillings in my mouth. Replacing fillings unnecessarily can weaken the tooth and make the tooth more sensitive (traumatize the nerve in the root canal).

Worry what you can control. Get regular checkups with x-rays, do good OH, eat proper diet, and stay healthy. Medications can dry your mouth and can lead to teeth deterioration (saliva protects your teeth).

 

[jb220]

Thanks for responding to me, and for doing it so quickly.

I get checkups. I used to follow a Dr.'s orders to avoid xrays too strictly, but don't anymore.

Can I ask if hygiene can slow or prevent the ones under fillings?

I think my hygiene is pretty good these days. Brush in the mornings and before bed, use waterpik every time I eat anything at home, use floss and/or interdental brushes every night, and use fluoride rinse. I also try to only eat carbs during meals, and working now to minimize carbs in my diet in general. I guess my fear is that my teeth are already so damaged that when the fillings fail things will progress so quickly that they'll require a root canal and those RC's will eventually require extractions.