At least once per week, we see a patient who has a broken tooth where there was once an old silver filling.  Sometimes, there will have been some type of trauma that caused the tooth to break.  Olive pits, un‐ popped popcorn kernels, hard candies, and chewing ice are some of the top culprits.  Other times, the tooth just seems to break under everyday circumstances.  Soup, sandwiches, and cereal have all been implicated at one time or another.  Sometimes we even discover fractured off teeth that people didn’t know were broken.   That’s what cameras are for.

So what is happening to all of these broken teeth?  Why are they breaking?  Is it the silver filling’s fault?  No.  Is it the tooth fairy’s evil twin?  No.  More than likely, it’s just another part of growing up.

Let’s start with the old time silver filling.  Many of us had multiple silver‐mercury amalgam fillings placed in our teeth when we were kids or teenagers.  Why?  Probably because we had developed cavities from poor hygiene (How many kids do you know that floss daily?) and too many fermentable carbohydrates (Sugar, soft drinks, cookies, etc.) in our diet.  In other words, we didn’t take great care of our teeth and our dentists did what they could to save our teeth from further damage…silver fillings.  Back in the day, those fillings could not be chemically “glued” into your teeth, so, in order to keep them in place, grooves, undercuts, nooks, and crannies had to be cut into the teeth to help the silver‐mercury stay in place.  A tad bit more than just damaged and decayed tooth structure had to be removed to make it all work.

Fast forward ten to twenty years.  We put an amazing amount of stress on our teeth under normal circumstances when chewing, not to mention other destructive habits such as clenching under stress and grinding our teeth in our sleep.  People crack perfectly healthy teeth all of the time.  When you add in a metal filling that has eroded through the years, you can see why we diagnose a lot of broken teeth.  We also see quite a few patients walk in with a white piece of tooth in their hand.

So what is the key to preventing all of this?  Regular exams, cleanings, and dental x‐rays will help your dentist monitor the condition of your old silver fillings.  To best prevent pain and toothaches, it is a good idea to address these old fillings before they break.  If treated in time, the old mercury‐silver fillings can sometimes be replaced with new fillings.  Often, if most of the tooth under the filling is broken down, a crown or onlay (Imagine a tooth colored jigsaw puzzle piece that is glued into your tooth,) can be used to restore the tooth to health.  The sooner the tooth is stabilized, the less likely it will need a root canal.

Most people, myself included, went through a stage of life where they needed a bunch of fillings, all around the same time.  Subsequently, those very same fillings will all tend to break down around the same time.  To spread things out, we often try to address and fix the worst one or two teeth every year so that problems and toothaches can be avoided.  This approach helps to avoid a visit where there are twenty‐two broken teeth in need of serious attention.

Thanks for reading.  Until next time, keep smiling.

‐Questions or comments can be sent to Drs. Parrish at ParrishDental@aol.com.