Chances are, if you are reading this right now, you have a dental filling, and that tooth filling has possibly fractured or has broken off completely.
Well, you've come to right place because I am going to break down the steps to take in order to protect your tooth until you get to the dental office.
TYPES OF FILLINGS
First, let’s recap the different types of dental fillings. Not all dental fillings are the same. Some, you can add onto while others you have to remove completely before a new filling can be placed. Lets dive in!
AMALGAM/SILVER FILLING
Amalgam fillings are made out of metal. Typically these fillings are used on you posterior teeth or back teeth. Because amalgam is a metal, it has the properties of metal. Well, what do I mean?
Amalgam expands and contracts with the temperature change in your mouth. Over the years, amalgam can create small micro-fractures within your teeth as it expands and contracts. Amalgam is a very strong material which means it is also brittle.
Amalgam starts off as a soft metal so that it can be placed into your tooth to fill in your cavity. There is a “working time” that your dentist has before the amalgam will harden due to a chemical reaction within the amalgam. The tooth is prepared so that the bottom half of the cavity is wide but the top half is narrow. This helps to lock in the amalgam once it hardens and this is how the amalgam stays in.
Amalgam does not bond to your tooth like other filling materials. Amalgam gets locked into the tooth and that is how the filling stays in place. This is called mechanical retention.
COMPOSITE FILLING
Resin composite is a resin filling material used for fillings. There are many shades for composite so your dentist has many options to choose from.
Composite is chemically bonded to your teeth, unlike amalgam. Composite can be used on your anterior teeth and your posterior teeth.
Over the years, this chemical bond between the tooth and the composite can weaken. This is called leakage. The margin where the composite meets the tooth is where the leakage can occur which means the tooth and the composite are losing their bonding.
This can weaken the composite and cause the affected tooth to fracture or the old filling to fall out.
GLASS IONOMERS
Glass ionomers are great for those who have a high bacterial load. Basically those who have tooth decay and poor oral health. Glass Ionomers are also great for kids because of its fluoride-releasing properties and it’s ability to bond to the tooth in moist environments.
Unlike composites, Glass Ionomers and amalgam filling material do not need a dry environment in order to stay on the tooth. This is why these options work great for kids because saliva control and most importantly, tongue control on kids is not easy!
NEED A FILLING REPLACED DUE TO FRACTURE/LOST FILLING?
Now let’s talk about what happens if you fracture one of these fillings or if the filling fell out,
If an amalgam filling fractures, it will most likely need to be completely replaced. Why? Because if you recall, amalgam does not necessarily bond to the tooth, it is locked into place by what we call mechanical retention. So if a piece of the affected tooth or a piece of the filling breaks, the entire filling is weakened. It may continue to fracture more until eventually the whole filling falls out. This goes for a gold filling as well due to its metal properties.
For composite and glass ionomer fillings, this is not the case. Because the material is bonded to the tooth, your dentist can potentially simply add to the existing filling and not have to remove the whole thing.
Typically, if your dentist did not place the original filling that broke, she/he might remove the entire thing before replacing it. This is because they do not know how well the original dentist bonded to the tooth.
For example, if we replace a few fence boards but we were not the ones who put in the fence posts, we don’t know if the posts will fail soon, making the entire fence fall apart. Just to be safe and to ensure the filling is solid, we will remove the entire dental filling and replace it.
WHAT TO DO IF YOUR FILLING FALLS OUT
If one of your fillings breaks or fractures off completely, the first thing you should do is schedule an appointment with your dentist immediately. If you are in pain, see your dentist for an emergency exam or call for a dental appointment as soon as possible.
You might think that a simple dental filling broke or that a piece of the filling fell out when in actuality, the tooth completely fractured and your nerve is exposed. The exposed tooth can give you an odd sensation.
This can make your tooth very sensitive to temperature. Tooth fillings are made to act as insulators and to rebuild your tooth structure. They help to protect your nerve and help to prevent further damage to the affected area.
EXPOSED NERVE AND SENSITIVE TEETH
If your nerve is exposed or the missing filling is causing your teeth to become extremely sensitive, I got something that might help. Follow these tips to reduce tooth decay, help to prevent the need for a root canal, and to avoid food particles from getting stuck where the filling fell out.
TEMPORARY FILLINGS
You have a hole in your tooth from were the filling fell out or a hole where the filling broke. Your have extremely cold or hot sensitivity on that affected side. What do you do?!
Again, the first thing you should do is call your dentist as soon as possible. Next, you can go to a drug store like CVS or Walgreens and go to the dental section. There, you will find a temporary filling material to act as a replacement filling until you get to the dental office. This material is not dental cement. It is a temporary solution to address a lost filling.
HOW TO FIX THE AFFECTED TOOTH TEMPORARILY
The temporary material comes with an instrument to pack it into the hole where your filling broke or is missing.
The material is like a play dough consistency and once it is placed, it will begin to harden. Dental wax also works great to cover the exposed tooth. This helps to protect the nerve and provides some insulation against the hot and cold sensation until you get a new filling placed.
BEHAVIOR MODIFICATIONS
Avoid eating in the affected area where the missing fillings are. Make sure to use the opposite side. Using that side to chew with can cause the tooth to fracture more, can cause the temporary filling material to fall out, or can cause the tooth to become extremely painful. Also, teeth grinding can cause more lost fillings and create more dental emergencies.
If the affected area is the only side you can chew on, stick to soft foods only. Nothing that requires you to chew like bread and nuts. Eat things like soup, noodles and frozen yogurt. Stay away from hard foods, sugary foods, and especially hard candy that can make your filling fall out.
ORAL HYGIENE
Good oral hygiene is extremely important. You do not want to get food debris getting stuck inside your cracked filling or exposed tooth. Make sure you follow the FRBR method and see your dentist regularly!
FLOSS - RINSE - BRUSH - REPEAT!
Oral hygiene is vital to proper care! It will help to prevent further damage, further decay, root canal, dental crown, and so much more! Make sure to floss first, then rinse, and then gently brush your teeth using a toothpaste recommended by the American Dental Association. Oral health goes hand in hand with your overall health.
Along with your oral hygiene routine, warm salt water rinses work wonders!
WARM WATER/ ROOM TEMPERATURE SALT WATER RINSE
In a cup of room temperature water, add 1-2 teaspoons of salt and mix.
Swish around with this salt water mixture at least 3 times a day. Don’t accidentally swallow the salt water mixture. Salt has amazing healing properties for your mouth and has been used for many years in medicine.
REDUCE PAIN WITH PAIN MEDICATION
If you can take medication such as ibuprofen and Tylenol, this will help with the pain. Ask your doctor if you are unsure. Alternating between the two medications has been shown to be very effective at managing dental pain. Your dentist might send over a prescription to you local pharmacy for pain medication. Also, clove oil is something that many patients swear by so you can buy clove oil. Again, make sure to ask your dentist what he/she recommends for pain medication.
Frequently Asked Questions
Is a filling falling out an emergency?
If a filling comes out, call your dentist as soon as you can. While it is not an emergency in the sense that you need to head straight to a dentist, you will not want to wait too long to get it taken care of. Waiting too long between filling replacements might lead to tooth deterioration and other issues. Keep the afflicted area clean until you can visit your dentist, and try to avoid eating or chewing on it.
How long can I go with a filling that fell out?
A missing filling is not always considered a dental emergency. However, if you feel pain and sensitivity around the impacted tooth, you should not disregard it. You should try to get to a dentist in a day or two at most.
What will the dentist do if one of your fillings falls out?
You could need a new filling. If your dentist believes your tooth may be fixed, you may get another filling, a root canal, a crown, or a cap. In the worst-case situation, you may require tooth extraction if decay has gone too far.
How can I find a dentist?
The American Dental Association has an amazing tool called Find A Dentist. Most patients make several phone calls to dental offices to find the right dentist for them. It is all about communication and who you feel comfortable with to work in a sensitive area, your mouth. So to find a new dentist, check out the Find A Dentist tool or you can simply ask family and friends who they recommend.
SUMMARY
You broke a tooth or the entire filling fell out, what do you do?
Call your dentist!
Maintain oral hygiene using the FRBR method explained above. Use temporary filling material that can be found at drug stores such as CVS and Walgreens. Rinse with salt water, instructions listed above.
Lastly, stay calm. Avoid chewing on that side or if that’s your only side to chew with, modify your diet to include soft foods only.
You are not alone, we are here to help
Your dentist will help you fix the issue. We are here to help you, so please make sure to call your dentist asap for possible dental treatment.
For more dental education content, check out my YouTube channel and follow me on Instagram (@Dr_Gibbz).
- Dr. Gibbz (Public Health Dentist)
Disclaimer: This article is for educational purposes only and there is no doctor/patient relationship being established by reading this article. Always consult with your dentist or primary care provider. This article is not intended to offer medical or dental advice to anyone, it is not intended to diagnose any medical or dental conditions that you may have. There are no warranties and/or guarantees being made with the information being presented in this article.
