My facial (buccal) fillings keep falling off

[markowich]

Hi,

I was not able to find similar problem on the forum so I decided to make a post. I hope someone can help me with my problem.

In a period of couple of months my dentist has replaced the same buccal fillings for the third time and it fell off again. You can see the dentine exposed on teeth 4 and 5 on the picture (enamel eroded). He explained that there is problem with the materials because a large portion of my dentine is exposed and this composite fillings don't stick well on this kinf of flat surface. I would need some advice if there are more suitable materials for these kind of situatins. I am concered because I think that every time in this procedure I loose some healthy tissue and my tooth is more and more exposed.

I am very grateful for any piece of advice from a dental expert,

 

[Dr M]

Good day

Unfortunately the fillings on these buccal surfaces have a tendency to come loose, especially with a hard brushing method.
I always advise my patients to rather use a soft tooth brush as well as to use the circular method when brushing, instead of scrubbing these areas.
One way to increase the bonding between the filling and the tooth is to maybe cut away a larger area on the tooth to provide a sufficient area for the filling to " stick ", but you risk damaging healthy tooth structure unnecessarily.

 

[markowich]

Good day

Unfortunately the fillings on these buccal surfaces have a tendency to come loose, especially with a hard brushing method.
I always advise my patients to rather use a soft tooth brush as well as to use the circular method when brushing, instead of scrubbing these areas.
One way to increase the bonding between the filling and the tooth is to maybe cut away a larger area on the tooth to provide a sufficient area for the filling to " stick ", but you risk damaging healthy tooth structure unnecessarily.

Dear Sir or. Madam,

I appreciate your prompt reply. The issue is that they do not fall off during brushing. I also use the softest possible Curaprox toothbrush. In 2/3 times I have mentioned they fell off while eating or drinking and they havent lasted more than couple of days, so I am thinking if there is a fundamental problem with the material being used. Are you referring to the "retention grooves" that I have came across in the literature?. Thank you and best regards.

 

[Dr M]

Good day

Yes. Retention grooves is one way to increase retention for the fillings. Your dentist can try this next time.
Are the composite resin fillings done under rubberdam isolation? Moisture contamination can lead to decreased bonding strength

 

[markowich]

Good day

Yes. Retention grooves is one way to increase retention for the fillings. Your dentist can try this next time.
Are the composite resin fillings done under rubberdam isolation? Moisture contamination can lead to decreased bonding strength

Again thank you very much for all the information. I really appreciate taking the time. Best regards!

 

[honestdoc]

Dr M makes some really good points. Another point I like to add is teeth abfraction which can occurs when the teeth "flexes" during grinding and clenching. Like Dr M mentioned, the fillings have a strong tendency to come loose. I find that even with the best retention and optimal bonding environment, fillings can still separate from the tooth. Options are to leave it alone, restore them again, and if the teeth deteriorates further, consider crowning them. I highly recommend custom bite guards to minimize stress to the teeth.

 

[markowich]

Dr M makes some really good points. Another point I like to add is teeth abfraction which can occurs when the teeth "flexes" during grinding and clenching. Like Dr M mentioned, the fillings have a strong tendency to come loose. I find that even with the best retention and optimal bonding environment, fillings can still separate from the tooth. Options are to leave it alone, restore them again, and if the teeth deteriorates further, consider crowning them. I highly recommend custom bite guards to minimize stress to the teeth.

Also thank you for taking the time and sharing your advice. Will definetly look into it.
Best regards!