Is silver filling replaced by crown common? 
Author Message
 Is silver filling replaced by crown common?

I have a molar (top right second from front) with a large silver filling that
the dentist says has a cavity.  He also said that the molar has some fractures
and since the filling is large that it needs a crown. The tooth has never
bothered me and I can't see any fractures (but I don't know what they would
look like) or anything at all wrong with the tooth.  There is a slight darkness
to the side of the tooth which the dentist says could be caused partly by decay
and partly by the silver filling. I recently had some other silver fillings
replaced with white fillings but I guess those were not as large or did not
have the same type of fractures.  The new white fillings seem to be fine so
far.  Other then that I have just had other silver fillings done a long time
ago but nothing any worse then that.  I asked about replacing this one with a
white filling.  And also asked about an onlay or inlay because I learned that
involves less tooth removal.  He says it needs a crown to keep the tooth from
fracturing more.  He says if you just put a white filling on this tooth there
is a good chance the tooth would fracture and if the tooth fractures the wrong
way then you could lose the tooth.  If I don't have anything done then the
decay could get worse and then it could need a root canal.  Is it normal to get
decay on teeth that have a silver fillings?  Is this normal to have to replace
a silver filling with a crown?  I am nervous about getting a crown but I guess
I have to get one.  If anyone has any information on this type of situation I
would like to hear about it. Thanks.


Thu, 28 Feb 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Re: Is silver filling replaced by crown common?

Is it common? Yes. It is very common.

Is it necessary? That's a separate question!

Cheers,

Joel

Joel M. Eichen, D.D.S.

====

Quote:

>I have a molar (top right second from front) with a large silver filling that
>the dentist says has a cavity.  He also said that the molar has some fractures
>and since the filling is large that it needs a crown. The tooth has never
>bothered me and I can't see any fractures (but I don't know what they would
>look like) or anything at all wrong with the tooth.  There is a slight darkness
>to the side of the tooth which the dentist says could be caused partly by decay
>and partly by the silver filling.

Get a second opinion from a neighborhood, minimally-invasive dentist,
or get the crown from this guy. Choice is yours.

Quote:
> I recently had some other silver fillings
>replaced with white fillings but I guess those were not as large or did not
>have the same type of fractures.  The new white fillings seem to be fine so
>far.  Other then that I have just had other silver fillings done a long time
>ago but nothing any worse then that.  I asked about replacing this one with a
>white filling.  And also asked about an onlay or inlay because I learned that
>involves less tooth removal.  He says it needs a crown to keep the tooth from
>fracturing more.  He says if you just put a white filling on this tooth there
>is a good chance the tooth would fracture and if the tooth fractures the wrong
>way then you could lose the tooth.

One would need to look at the tooth to determine this. Therefore, no
one on the internet could argue with this diagnosis.

Quote:
> If I don't have anything done then the
>decay could get worse and then it could need a root canal.  Is it normal to get
>decay on teeth that have a silver fillings?

Yep.

Quote:
> Is this normal to have to replace
>a silver filling with a crown?

Maybe.

Quote:
> I am nervous about getting a crown

me too!

Quote:
>but I guess
>I have to get one.

Guess so. Sounds like your mind is made up, or is it?

Quote:
>If anyone has any information on this type of situation I
>would like to hear about it. Thanks.

Welcome.


Thu, 28 Feb 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Quote:

>I have a molar (top right second from front) with a large silver filling that
>the dentist says has a cavity.  He also said that the molar has some
>fractures
>and since the filling is large that it needs a crown. The tooth has never
>bothered me and I can't see any fractures (but I don't know what they would
>look like) or anything at all wrong with the tooth.  There is a slight
>darkness
>to the side of the tooth which the dentist says could be caused partly by
>decay
>and partly by the silver filling. I recently had some other silver fillings
>replaced with white fillings but I guess those were not as large or did not
>have the same type of fractures.  The new white fillings seem to be fine so
>far.  Other then that I have just had other silver fillings done a long time
>ago but nothing any worse then that.  I asked about replacing this one with a
>white filling.  And also asked about an onlay or inlay because I learned that
>involves less tooth removal.  He says it needs a crown to keep the tooth from
>fracturing more.  He says if you just put a white filling on this tooth there
>is a good chance the tooth would fracture and if the tooth fractures the
>wrong
>way then you could lose the tooth.  If I don't have anything done then the
>decay could get worse and then it could need a root canal.  Is it normal to
>get
>decay on teeth that have a silver fillings?  Is this normal to have to
>replace
>a silver filling with a crown?  I am nervous about getting a crown but I
>guess
>I have to get one.  If anyone has any information on this type of situation I
>would like to hear about it. Thanks.
></PRE></HTML>

very common, I have 14 of them.  Amalgam needs the tooth for support so it
stays intact.  A crown being a casting supports the tooth.  Once a silver
filling is a certain size, a crown is a better choice.

Charlie Ruff, DMD
Specialist in Orthodontics
Diplomate American Board of Orthodontics



Thu, 28 Feb 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Hi charlie,

not bad restorative advice from an orthodontist.  as an aside, i once attended
a party where an orthodontist's wife insisted her husband wasn't a dentist but
an orthodontist.  true story.

to chicken soup for the mouth,

Stan Goloskov



Thu, 28 Feb 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Quote:
>not bad restorative advice from an orthodontist.  as an aside, i once
>attended
>a party where an orthodontist's wife insisted her husband wasn't a dentist
>but
>an orthodontist.  true story.

>to chicken soup for the mouth,

I've heard that also.  I trained at Tufts class of 78 ortho80.  One of my
favorite teaches was Bob Chapman.  As soon as he heard I'd been accepted at the
ortho program, he said, "Giving up dentistry so soon?"

Charlie Ruff, DMD
Specialist in Orthodontics
Diplomate American Board of Orthodontics



Fri, 01 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
I am nervous about getting a crown but I guess

Quote:
> I have to get one.  If anyone has any information on this type of situation I
> would like to hear about it. Thanks.

I just had two molars crowned this last spring.  They had been filled a
couple of times over the years and the fillings had gotten quite large.
Crowns (gold) were the next logical choice for these two teeth.  I have
a few more that I will be getting done over the next year or two.  

I don't crown all teeth with large fillings at the drop of a hat, but
the longer the large filling is in service, the more likely a fracture
will develop.

In my experience, it is easier (and cheaper in the long run) to crown
teeth before they actually break apart.  The trick is knowing when it
really is "time".

Best wishes,
SWF DDS



Fri, 01 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Wow I think I found a good place to find some info finally.  Have tried other
boards and there is no activity:(((

Here is my dilema...I went in and had some restorative work done.  We filled a
bottom left wisdom tooth, replaced a silver filling with a white one on my
lower left 3rd molar from eye tooth, and also a very small filling (white) on
the upper left ..2nd molar from eye tooth.  My PROBLEM is the lower left molar.
 As of this date, I have gone in each and every week for SIX weeks now total.
My problem: Sensitivity/Pressure!  Each week for the FIVE times in a row, we
have "filed down" for making a "bite adjustment".  Last week...my SIXTH visit
she didnt want to touch that tooth and we filed the upper tooth above the and I
actually believe she just said they filed #19 and #20?  Not sure.  In any
event, she said if THIS didnt work THIS time that she was going to take the
white filling out and put a "temporary sedative filling in" for 6-8 weeks and
if that works fine we will refill it.  If not..I dont know!?????  I wonder why
they just cant fill it again?  I have no problems with hot or cold and she
keeps asking me this and then when I say no not at all she says good good.  I
love the dentist and the staff but dont want to be an annoyance in calling with
questions.  Does this "temp sedative filling" actually "mean anything"?? Do you
think she might "suspect something going on in there?"  Is filing for a bite
adjustment that many times the right procedure and that often?  Should I have
waited it out longer and do you think I might have caused more harm then good?
Im so stressed out because this tooth was fine before.  I believe she replaced
the almagram with the white filling due to a hairline fracture if Im not
mistaken.  As far as my "bite" goes...seems like each and every time it gets
better and better however the "pinpoints of sensitivity keeps changing in
areas"...its the best its been now and I can actually eat crackers etc but when
I go to bite into a steakum sandwich or thick sandwich I feel pressure again
and its annoying!  What should be my concerns if any and has anyone ever heard
of a "temporary sedative filling"??? If this right procedure?  I sure hope this
board is much more active then the last one...am stressing out here....HELP:(((



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Quote:
> and its annoying!  What should be my concerns if any and has anyone ever
heard
> of a "temporary sedative filling"??? If this right procedure?  I sure hope
this
> board is much more active then the last one...am stressing out

here....HELP:(((

Yes, temporary sedative fillings can be an appropriate way of trying to
soothe a sensitive tooth.  These filling materials contain zinc oxide and
eugenol (oil of cloves) and can last for many months.

Whether placing them in this case (as you described it) will be of benefit
is hard to say.  But if the problems you are having are not going away with
time, then a temporary sedative material may help.



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Thanks for the information.

This molar has had the same filling in it since I was a kid probably around 20
years so I guess they must have made it big.

I have never had a filling removed before until just recently when they
replaced 3 silver fillings with white fillings.

On this one that he says needs a crown he said it had fractures on all four
sides and that in combination with the large filling means it needs a crown.

I also asked why not just put the white filling and if it cracks then put the
crown.  He said he was kind of doing that on the other ones 3 that he put white
fillings on, because they were kind of large too.  On this one he said, if it
cracked down the tooth then you could lose the tooth and if it just cracked
then you would need a crown anyway.  He seems to think it would crack without
the crown.

He told me that if I wanted I could have an all porcelain crown which is what I
am thinking of getting since it will be less noticeable.

So I guess that my situation sounds normal?

LB2CA

Quote:
>I just had two molars crowned this last spring.  They had been filled a
>couple of times over the years and the fillings had gotten quite large.
>Crowns (gold) were the next logical choice for these two teeth.  I have
>a few more that I will be getting done over the next year or two.  

>I don't crown all teeth with large fillings at the drop of a hat, but
>the longer the large filling is in service, the more likely a fracture
>will develop.

>In my experience, it is easier (and cheaper in the long run) to crown
>teeth before they actually break apart.  The trick is knowing when it
>really is "time".

>Best wishes,
>SWF DDS



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Sherrie,

Your problems may be due to the new filling or only exacerbated by it.
Often a tooth will have a "sub-clinical" problem.  This means the problem
exists, but none of the symptoms are strong enough to be noticed yet.

White fillings are more technique sensitive than silver ones.  Any
imperfections are more likely to show up with a "bonded" filling on a back
tooth.  I get the impression that your dentist wishes to rule out the
possibility of the filling having a problem by replacing it with a filling
which will make a tooth feel better (if it is not already too far gone).  If
the patient feels better with the sedative filling, the tooth often will be
okay.  If the tooth still hurts, it needs further treatment (I.e. root c{*filter*}
treatment, extraction, etc.).

Not having seen you in person, I would never give a diagnosis.  I would
"suggest" that it sounds like the pulp tissue inside the tooth is dying and
you will need a root c{*filter*}treatment.  This probably has nothing to do with
the filling placed on your tooth.  It would have everything to do with
everything your tooth has experienced up to now in its life.  Every bit of
decay, every fracture line, every new filling, every exposure to extreme
temperature changes, every physical blow (i.e. blunt trauma), every, every,
every, etc.

If your bite has been adjusted this many times, your tooth probably is not
too high.  You will need to rule out TMJ problems, also.

Sounds like inflammation under the root of the tooth.  The trick is figuring
out why it is there.  See your dentist again and be patient.  Let them test,
x-ray and evaluate your TMJ as well as the tooth.

Best wishes,

Dr. Steve



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

Quote:
> If your bite has been adjusted this many times, your tooth probably is not
> too high.  You will need to rule out TMJ problems, also.

TMJ problems?

I'd say that is unlikely from the history that's been given.



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Z-guy,

Have you never had the patient with chronic TMD present to your office with
a toothache that no one can cure?  Then after placing any type of occlusal
splitting, the pain stops.  If this person has an inflamed TMJ the
contra-lateral side may present with hyper-occlusion on whichever tooth has
the most prominent cusp.

Dr. S-guy

Quote:



>> If your bite has been adjusted this many times, your tooth probably is
not
>> too high.  You will need to rule out TMJ problems, also.

>TMJ problems?

>I'd say that is unlikely from the history that's been given.



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Hi S-guy;

Quote:
> Z-guy,

> Have you never had the patient with chronic TMD present to your office
with
> a toothache that no one can cure?  Then after placing any type of occlusal
> splitting, the pain stops.  If this person has an inflamed TMJ the
> contra-lateral side may present with hyper-occlusion on whichever tooth
has
> the most prominent cusp.

> Dr. S-guy

I agree with you.  I have had personal experience with phantom tooth pain
due to TMJ issue.  Just have to mention that You Have to be aware of the
patients that will get worse(TMJ/D) with the traditional occlussional
splint.  Remember that with hyper-occlusion the traditional splint can
increase the muscle intensity and strain on the TMJ.
Sandra
Quote:



> >> If your bite has been adjusted this many times, your tooth probably is
> not
> >> too high.  You will need to rule out TMJ problems, also.

> >TMJ problems?

> >I'd say that is unlikely from the history that's been given.



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?
Hi Zugumba,

Now To open up a can of worms.  
A large bonded composite on a
lower third molar?  Especially
if the tooth is only partially
erupted.   Even with probantine
one hour preop and a 14 A {*filter*}
dam clamp how dry can you really
get the area?  

Sensitivity, I don't doubt it.  

What about adequate space to
position the halogen light so
that you can properly cure the
restoration?  How about having
adequate space to place and pack
the composite?

Look if it was a failing 20 y/o
amalgam restoration (?), how about replacing it with Royal Mineral Succadaneum?
 It is more forgiving.  
Yes, it rises up in contempt in the
face of moisture.  Yet even then
it usually seals the area, unevent-
fully.  Okay the patient develops
MS, senile dementia, seizures, and
arthritis.  At least she won't need
RCT,  crown lengthening, post, and
a PFM so quickly.

To forgive me Hans I have sinned,

Stan Goloskov  



Sat, 02 Mar 2002 03:00:00 GMT
 Is silver filling replaced by crown common?

I talked to my dentist today..she called me from her car phone.

She explained a little more to me and what she wants to do.  She said at this
point she is NOT filing down anymore bite adjustments on that 3rd lower left
molar.  At this point Im to go in and have it taken out which will take 40
minutes...I wonder why so long???  I have had a complete mouth periodontal
scaling/root planing in that time!  Anyways I wear this for 6-8 weeks and if
2-3 weeks out of that time it feels much better and no problems then she will
refill it...if it doesnt then I will need a root canal.....from my story here
what does it sound like to you all even though you dont know or can see
me...where does it look like Im heading towards?  I just dont understand why I
cant have the thing refilled.  Do you think she might have hit a nerve when
putting the white filling in?  It seems like when I had my silver filling all
those years that when I rubbed my tongue across it ...that it was much smoother
and more "even" going across the top of the tooth...I can say when it was
replaced the very first time with the white one that when I first rubbed my
tongue across it it felt like a "dip" more in a curvey way in the middle of the
tooth.  I wonder sometimes now if there just wasnt enough white filling filled
there in the first place but then yet my bite was still too high from the top
molar or the sides of that particular molar where the hairline fracture was? I
dunno...I want this over with...its stressing me out completely:((( PS*** I was
on the verge of figuring out when I can get my veneers done but now have to
wait again!:(((  She said my teeth and gums are stable enough to get them and
now I only have two #5's (one on each upper backs)...so I have really improved
on the pocket depths:)))



Sun, 03 Mar 2002 03:00:00 GMT
 
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