Common Questions #10: "I had a filling in that tooth. Why do I need a root canal and crown now?"
Updated: Jun 29, 2020
Unfortunately, even a perfectly constructed filling can be compromised because of the very function of the teeth and accidents that can occur. This does not have to do with the craftsmanship or quality of the filling made by the dentist. Fillings are the most conservative and inexpensive approach in dentistry. Under no means, is a filling considered a permanent fix for an ailing tooth.
Although, some fillings may last many years, eventually all fillings will require replacement. Patients should expect to replace fillings within their lifetime. Dental insurance accounts for this and it is for this reason that most dental insurance plans will pay for fillings to be replaced yearly. Because fillings (particularly front fillings) are at high risk of breaking some high option dental plans allow fillings to be replaced unlimited times per year.
Fillings are under constant pressure from everyday activities such as eating, clenching, and grinding. Normal wear and tear will cause fillings to chip and crack leaving the tooth exposed. After the seal between the filling and tooth is broken, food and bacteria can get in the filling causing tooth decay. Decay left untreated can infect deep inside the dental pulp of a tooth, causing a condition called an irreversible pulpitis. Once a patient has infection in the pulp of a tooth, a root canal or extraction will be necessary..
For the best prognosis, it is important to have the tooth treated prior to it becoming symptomatic. After a tooth requires a root canal, it becomes very brittle because the blood supply is removed and the tooth becomes non-vital. A crown usually is required to protect the now brittle tooth. Failure to have a crown placed immediately after a root canal can result in fracture of the tooth. A badly broken tooth or a tooth passed the root canal stage, will need to be extracted. The best solution for an extracted and now missing tooth is an implant.
We recommend patients come in for six-month dental visits which are usually included with dental insurance. Because decay is also a six-month process, exams provide a simple way for patients to stay on top of the dental health. Degraded fillings and dental decay can be detected at the inception rather than after they hurt and require limited covered procedures.