What's Wrong With Refilling A Tooth That Needs Replaced?

Unfortanly this was my dilemma last month, and Dr. Spindel explains why you shouldn't keep refilling a tooth!

"Often when removing an old filling a crack is discovered. Unless the part of the tooth that has cracked is completely removed, a permanent filling is not a great option. Currently, dentists do not have a bond or superglue that can adequately repair cracks and often when a tooth has a crack, entirely removing enough of the tooth to get rid of the crack is not possible without ruining it. In that case, a portion of the crack remains and a dentist's best choice is to "shoe the cusps" with a indirect restoration (either an onlay or crown). Covering the cusps will better distribute occlusal (biting) forces and discourage the crack from propagating. Residual cracks in teeth do not heal themselves and tend to either stay static or propagate further.

So what's wrong with just refilling the tooth with an even larger filling? Even if no crack is found,  unless a dentist can actually onlay the cusps and restore good proximal contacts with a composite filling in one session, a laboratory fabricated restoration is really the best option. If a tooth needs more than three surfaces restored, prepping, taking an impression and sending it to a laboratory is really the most predictable way to ensure a long lasting result. will make it easier to properly restore the tooth to it's proper function. Whether a  crown or an onlay is utilized, fabrication out of the mouth using a model is the best option.

That being the case, it is not unusual for patients to strongly advocate for their dentist to just "put in a filling for the time being and " I will crown it in the future, when I can afford it". That may sound reasonable, but most patients will not fix a tooth that's not broken and will wait until they develop another problem with their restored tooth, even though they were warned that it should have a crown or an onlay.

Unfortunately, sometimes when they do return with a problem, it is too late to salvage the tooth and if it sustains an "unlucky break" ( one that involves the tooth into the boney alveolar housing) the tooth may need to be extracted. At this point the tooth replacement involves an extraction and a three unit bridge or an implant replacement. Both of these options are much more expensive than a single crown would have been. Removable tooth replacement is an affordable option, but most patients prefer not to go this route if they have any other options."


Information was found here!