Is it worth refilling them?

[lizzy]

I have two fillings that fell out on my back two teeth next to my wisdom teeth. I circled them in the photo. They are pretty small and I am not sure what to do. I want to get a gold inlay or filling but the dentist I trust does not do that. Should I just get the white fillings done or an inlay and what kind? I also circled a small brown spot that is a cavity that I need to fix. Its the first cavity I've ever had in my life. My other fillings were done by a bad dentist who gave me unnecessary work. But the two I am talking about are small and they actually look like a normal tooth except when I look under sunlight I can see the two lines. What should I do. I wish I trusted the white filling material but it doesnt last long. What is your opinion? It does get tiresome because my tongue is constantly traveling there. Should I just leave them? The reason I trust my dentist is because he uses a microblaster and that will preserve my teeth better. Also can I chew gum when I get them fixed?

Im really sad because I trusted a bad dentist and did all the things your not supposed to do. Wish I had gone to a good dentist from the beginning

 

[Dental cure and care]

Based on all considerations your trust in your dentist’s techniques, the condition of your teeth, and available filling options the best course would be to proceed with either high-quality composite fillings or ceramic inlays after addressing the cavity. Discuss with your trusted dentist about getting high-quality composite fillings or ceramic inlays for both cavities while ensuring prompt treatment for the existing cavity.

 

[lizzy]

Based on all considerations your trust in your dentist’s techniques, the condition of your teeth, and available filling options the best course would be to proceed with either high-quality composite fillings or ceramic inlays after addressing the cavity. Discuss with your trusted dentist about getting high-quality composite fillings or ceramic inlays for both cavities while ensuring prompt treatment for the existing cavity.

thank you, yes its sad because those are from unnecessary fillings from a bad dentist. They do bother me. Is composite better than porcelain?

 

[lizzy]

here is the detailed analysis:

1. Current Concerns​

1. Two Small Fillings That Fell Out
   • These fillings were placed by a previous dentist you no longer trust.
   • They appear small, and the tooth structure looks mostly intact except for minor defects.
   • You’re worried about the longevity of new restorations.
2. One Small Brown Spot (New Cavity)
   • This is your first genuine cavity.
   • You’re concerned about its progression and want a durable restoration.
3. Choice of Filling Material
   • You’re interested in gold inlays/onlays, but your trusted dentist doesn’t offer them.
   • You’re hesitant about using composite (“white fillings”) due to longevity concerns.
   • You trust your current dentist’s minimally invasive technique (microblaster), which helps preserve healthy tooth structure.
4. Post-Filling Care
   • You’re curious if you can chew gum after the restorations are placed.
   • You’re worried about potential complications and want to do this “the right way.”

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2. Possible Treatment Options​

A. Composite (“White”) Fillings​

1. Advantages
   • Less Invasive: Minimal tooth preparation is needed, especially when using microblaster (air abrasion).
   • Immediate Placement: Typically done in one appointment without the need for a lab.
   • Aesthetics: Blends in with the natural tooth color.
   • Cost: Often more affordable than gold or ceramic inlays.
2. Disadvantages
   • Technique-Sensitive: Must be properly bonded under dry conditions, or it may fail prematurely.
   • Longevity: On average, can last 5–10 years (sometimes longer), but this depends on skill of the dentist, bite forces, and oral hygiene.

B. Gold Inlay/Onlay​

1. Advantages
   • Durability: Gold restorations can last 15+ years and often longer.
   • Biocompatibility: Very gentle on opposing teeth and well-tolerated by the body.
   • Excellent Fit: If done by a skilled lab, gold can adapt extremely well to the tooth.
2. Disadvantages
   • Availability: Fewer dentists and labs provide gold restorations nowadays.
   • Multiple Visits: Usually requires at least two appointments (prep + final cementation).
   • Cost: More expensive, both for materials and lab fees.
   • Appearance: Some people don’t like the gold color in their smile.

C. Ceramic/Porcelain Inlay/Onlay​

1. Advantages
   • Good Aesthetics: Can closely match natural tooth color.
   • Reasonable Durability: With proper bonding, porcelain or ceramic can last a long time.
   • Custom-Fabricated: Like gold, it’s made in a lab or with an in-office milling machine (CEREC).
2. Disadvantages
   • More Brittle: Ceramic can chip or crack if not well-designed or if you have a heavy bite.
   • Cost: Similar or sometimes more expensive than gold, depending on the lab and region.
   • More Than One Visit: Usually requires at least two visits unless the office has same-day milling.

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3. Treatment Planning: Step by Step​

1. Examination & Preparation
   • Your dentist will check the depth and spread of the small cavities/filling defects.
   • A microblaster or air abrasion system can remove decayed tooth structure gently and preserve healthy enamel/dentin.
2. Choosing the Restoration
   • If you want gold:
     • You’d need to seek out a dentist who has experience with gold restorations.
     • Expect to have a temporary filling in place after tooth preparation while the lab makes the gold inlay/onlay.
   • If you go with composite:
     • Likely a single appointment if all looks straightforward.
     • Your dentist will bond the composite after cleaning and preparing the area.
     • A good bonding technique plus minimal tooth removal is key to success.
3. Fitting and Finishing
   • For gold/ceramic:
     1. First visit: tooth prep + impressions or digital scans → temporary filling placed.
     2. Second visit: final restoration cemented/bonded.
   • For composite:
     1. One visit: tooth prep + bonding + curing → final polishing.
4. Post-Treatment Care
   • Composite fillings set immediately after the curing light, so chewing gum is generally okay shortly after, though many dentists advise waiting a couple of hours (especially if you had anesthesia and risk biting your cheek/tongue).
   • Inlays/onlays require the cement to set fully; your dentist may instruct you to avoid very sticky/hard chewing for at least 24 hours.

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4. Timeline​

• Immediate/Short Term (1–2 weeks)
  • If you choose composite: likely completed in one appointment.
  • If you choose an inlay/onlay: about 2–3 weeks from prep to final placement, depending on the lab’s turnaround.
• Long Term (Months to Years)
  • Gold/ceramic inlays/onlays can offer greater longevity if done correctly.
  • Composite can also last well if maintained properly, especially if the cavities are small and your oral hygiene is good.

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5. Risk Assessment (If Not Treated)​

• Decay Progression: Even small cavities can grow, leading to deeper decay or nerve involvement.
• Fracture: Areas where fillings fell out can become weak points that may crack under biting pressure.
• Gum Irritation or Infection: Open margins (gaps) can lead to plaque accumulation and gum inflammation.
• Increased Cost Later: Delaying treatment can lead to more extensive (and expensive) procedures in the future.

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6. Practical Tips & Reassurances​

1. Trust in Minimally Invasive Techniques
   • Your current dentist’s use of microblasting indicates a conservative approach, which is ideal. Preserving healthy tooth structure is always beneficial.
2. Get the Fillings Done Sooner Rather Than Later
   • The longer you wait, the higher the chance of further decay or tooth damage.
3. Maintenance Is Key
   • Good oral hygiene (brushing twice daily, flossing, using fluoride rinses) and regular check-ups can help any filling last much longer.
4. Chewing Gum Afterward
   • If you get composite, you can typically chew gum later the same day once numbness is gone.
   • If you get an inlay/onlay, follow the dentist’s instructions—avoid sticky foods for about 24 hours if recommended.
5. Don’t Feel Bad About Past Dental Work
   • Unfortunately, many people have had less-than-ideal dental experiences. The important part is you’re taking proactive steps now.
   • Communicate openly with your new dentist about your concerns, especially about longevity and materials.

Thank you so much! It is very hard for me as I went to a really bad dentist who gave me 8 unnecessary fillings without telling me exactly what he was doing. They all fell out and I have been in the process of refilling them. I had one very small spot that I regret filling but my new dentist who I trust said he used a microblaster tool. And I am praying and hoping it remained the same and didnt get bigger after being refilled? What do you think? I also wish I had just left it and not filled it as it was so minor.

As you can see there are the two spots on my teeth that need to be filled because I am constantly feeling them. I would prefer gold but the only dentist who does them does inlays and I dont know if he uses a microblaster tool as these fillings have barely any residue left from the previous filling material. I suppose I could ask the dentist I trust and see what he advises. But because of my bad past experience with white fillings Im kind of scared. Any thoughts would be welcome and thank you so much for your previous advice.

 

[Dental cure and care]

thank you, yes its sad because those are from unnecessary fillings from a bad dentist. They do bother me. Is composite better than porcelain?

If you prioritize durability, aesthetics, and long-term investment in your smile, porcelain may be better.
If you are looking for cost-effectiveness, quick application, and reversibility, then composite could be considered better.
Consulting with a qualified cosmetic dentist will help determine which option aligns best with your dental health needs and personal preferences.

 

[lizzy]

If you prioritize durability, aesthetics, and long-term investment in your smile, porcelain may be better.
If you are looking for cost-effectiveness, quick application, and reversibility, then composite could be considered better.
Consulting with a qualified cosmetic dentist will help determine which option aligns best with your dental health needs and personal preferences.

I think that the white fillings might be bad because once it fails does the dentist need to drill more? If you get an inlay and it pops out it should be pretty easy to redo without drilling so much I would think?

 

[Dental cure and care]

I think that the white fillings might be bad because once it fails does the dentist need to drill more? If you get an inlay and it pops out it should be pretty easy to redo without drilling so much I would think?

Both white fillings and inlays serve important roles in dental restoration, their failure modes differ significantly regarding repair processes. Composite fillings usually necessitate more drilling upon failure due to their direct application on teeth and potential for surrounding decay. Conversely, inlays allow for easier re-cementing with minimal additional drilling unless significant underlying issues exist.
The choice between these two options should involve discussions with a dental professional who can assess individual circumstances such as cavity size, location, patient preferences regarding aesthetics and longevity, as well as financial considerations.

 

[lizzy]

Both white fillings and inlays serve important roles in dental restoration, their failure modes differ significantly regarding repair processes. Composite fillings usually necessitate more drilling upon failure due to their direct application on teeth and potential for surrounding decay. Conversely, inlays allow for easier re-cementing with minimal additional drilling unless significant underlying issues exist.
The choice between these two options should involve discussions with a dental professional who can assess individual circumstances such as cavity size, location, patient preferences regarding aesthetics and longevity, as well as financial considerations.

thanks for the reply. I also thought that composite fillings might be bad because when they fail they require so much drilling to replace. I think I will choose inlays. I just hope I can still chew gum normally with them. My biggest fear is my dental work failing which I have suffered in the past.

 

[Dental cure and care]

thanks for the reply. I also thought that composite fillings might be bad because when they fail they require so much drilling to replace. I think I will choose inlays. I just hope I can still chew gum normally with them. My biggest fear is my dental work failing which I have suffered in the past.

It’s understandable to have concerns about dental work failing based on past experiences. to face this fear

1. Ensure that you select a dentist who has experience with restorative dentistry and specifically with placing inlays.
2. Adhering to post-procedure care instructions will significantly reduce the risk of complications.
3. Regular brushing, flossing, and dental visits will help prolong the life of any dental work you receive.

Opting for inlays can provide you with a durable solution that minimizes future drilling needs if replacements are necessary while allowing you to enjoy activities like chewing gum without significant concern.

 

[MattKW]

1. Have to totally disagree here. Inlays are inherently more destructive than composites because inlays are an INDIRECT procedure that requires much more removal than a DIRECT conservative composite (or even an amalgam). See attached - for the same base of decay width (purple arrows), you need a wider entry hole for an indirect inlay (red arrow) compared to direct composite (green arrow).
2. Either procedure should work well if appropriate for your cavity; some fillings or inlays can last a lifetime. I have 6 fillings in my teeth all initially placed 50 years ago. Recently the cusp of the biggest filling broke off and I had a gold onlay placed.
3. Generally direct fillings are better suited for small to medium cavities, and indirect inlays for large cavities but often as onlays (covering the cusps).
4. It concerns me that your cavities have been prepared by air abrasion alone. Any type of filling material (except gold) requires a minimum thickness for strength. It's similar to pouring concrete - 1 inch of concrete will crack and fail. So will thin composites or thin amalgams or thin ceramics. Conventional and conservative drilling allows for much better depth and thickness control than air abrasion.

 

[lizzy]

1. Have to totally disagree here. Inlays are inherently more destructive than composites because inlays are an INDIRECT procedure that requires much more removal than a DIRECT conservative composite (or even an amalgam). See attached - for the same base of decay width (purple arrows), you need a wider entry hole for an indirect inlay (red arrow) compared to direct composite (green arrow).
2. Either procedure should work well if appropriate for your cavity; some fillings or inlays can last a lifetime. I have 6 fillings in my teeth all initially placed 50 years ago. Recently the cusp of the biggest filling broke off and I had a gold onlay placed.
3. Generally direct fillings are better suited for small to medium cavities, and indirect inlays for large cavities but often as onlays (covering the cusps).
4. It concerns me that your cavities have been prepared by air abrasion alone. Any type of filling material (except gold) requires a minimum thickness for strength. It's similar to pouring concrete - 1 inch of concrete will crack and fail. So will thin composites or thin amalgams or thin ceramics. Conventional and conservative drilling allows for much better depth and thickness control than air abrasiond

The sad thing is I never had cavities, I went to a bad dentist and got unnecessary fillings. They all fell out so now I just have holes. I had the smallest little spot and the new dentist used air abrasion to fill it but it was so small I wish I had just left it alone. I tried to show my mom and friend the photo of the two teeth I circled but they say it is fine and nothing is wrong. It was definitely drilled there but very little. I feel it for sure. I dont know what to do. I want to try gold because Ive had such bad experience with the fillings falling out. I dont know what to do? Maybe I should just get the regular fillings but even my dentist who is good told me they only last 15 years. At the same time I dont want more tooth structure removed. And once they fall out, would an inlay be easier to replace?

 

[MattKW]

Perhaps you misunderstand me.
If the cavities are small, then direct fillings with composite or amalgam are fine.
If it's a large cavity, then direct composite will last longer than amalgam because it glues to the enamel.
An inlay offers no advantage over direct fillings except in special circumstances.
In the attached pic of a standard filling, the red arrow shows the thinner and weaker wall compared to the blue arrow width. The force of the opposing tooth (black arrow) tends to push the cusps apart, so over time it would be expected that the thinner cusp would fracture.
That's when you would consider an onlay which goes over the cusp ("cusp-capping") or a full coverage crown.
None of the 6 fillings in my head (2x composite, 4x amalgam) had failed after 50 years, but the cusps of the tooth with the largest amalgam (and hence thinnest walls) broke this year. So I had an onlay. You can do onlays in ceramic or gold; I just like gold.

 

[lizzy]

Perhaps you misunderstand me.
If the cavities are small, then direct fillings with composite or amalgam are fine.
If it's a large cavity, then direct composite will last longer than amalgam because it glues to the enamel.
An inlay offers no advantage over direct fillings except in special circumstances.
In the attached pic of a standard filling, the red arrow shows the thinner and weaker wall compared to the blue arrow width. The force of the opposing tooth (black arrow) tends to push the cusps apart, so over time it would be expected that the thinner cusp would fracture.
That's when you would consider an onlay which goes over the cusp ("cusp-capping") or a full coverage crown.
None of the 6 fillings in my head (2x composite, 4x amalgam) had failed after 50 years, but the cusps of the tooth with the largest amalgam (and hence thinnest walls) broke this year. So I had an onlay. You can do onlays in ceramic or gold; I just like gold.

Very interesting, I prefer gold too but the dentist that does gold inlays, I have never been to. And the dentist I trust does not use gold. So I am still in limbo about what to choose? I have another filling that is big that is filled with a white composite now. When it falls out in the future I want to get a gold filling there. I hope that is possible?