They are not meant to last a lifetime

Decoding the lifespan of dental fillings

By: Assoc. Prof. Dr. Noor Azlin Yahya, Dr. Sofya Zulkiffli

In the world of dental care, the longevity of dental fillings is a topic of interest. Contrary to popular belief, dental fillings are not designed to last a lifetime. Understanding the intricacies of their lifespan and the influencing factors proves crucial for both patients and dentists, especially when considering the economical and cost-effective aspects, aiming for fillings to endure as long as possible.

Recent research reveals that diverse types of dental fillings exhibit distinct lifespans. Amalgam fillings, for instance, showcase a remarkable longevity of around 15 years or more, while tooth coloured fillings such as composite resins have a comparatively shorter shelf life, lasting approximately 10 years. The percentage of replacement for composite fillings tends to be higher, possibly due to material properties. Nonetheless, composite remains the material of choice, particularly for front teeth, owing to its aesthetic or tooth-coloured properties.

The durability of dental fillings emerges as a complex interplay of various factors, with patients’ related aspects taking centre stage. Variables such as caries risk status, parafunctional habits, general health, and aesthetic demands collectively contribute to the overall performance of dental fillings.

High caries risk status, commonly associated with inadequate oral hygiene, frequently results in the failure of dental fillings. This failure is primarily due to decay occurring beneath the fillings, leading to the formation of gaps or cavities. This issue is notably common in the spaces between teeth, where patients often overlook regular flossing. Whereas, parafunctional habits, such as unconscious grinding and clenching, can accelerate the wear of dental fillings, especially in the case of composites, which are softer compared to amalgam. Over time, composite fillings may develop fractures, necessitating replacement.

Additionally, individuals experiencing dry mouth as a medication side effect may face an elevated risk of tooth decay due to the reduced protective benefits of saliva. In the age of social media, heightened patient awareness has spurred a desire for the ideal smile, often prompting unnecessary dental interventions in pursuit of a “Hollywood smile.” Materials such as composite can be prone to staining, especially from the consumption of coffee, tea, or tobacco, resulting in the need for more frequent replacement of fillings within a shorter timeframe.

The role of dentists emerges as equally crucial in ensuring the extended life of dental fillings. Dentists are entrusted with making well-informed decisions regarding when and how to intervene, along with the strategic choices of when to repair or replace fillings. Keeping pace with current trends, particularly embracing minimal intervention and preventive approaches, becomes pivotal in enhancing the overall durability of dental fillings.

Recent research highlights a concerning trend where more fillings are being replaced without proper diagnosis. Often, the process of replacing a filling inadvertently enlarges the cavity, posing potential risks. This emphasizes the need for dentists to exercise caution in the replacement process, ensuring that the cavity does not expand beyond its initial size.

The selection of filling materials and techniques holds the key to the success of dental fillings. For example, dentists must meticulously consider variables such as the type of dental composites, bonding systems, and polishing systems to optimize the longevity and effectiveness of composite fillings.

However, the allure of attractive prices sometimes leads to the acquisition of materials from unofficial agents or websites. This raises doubts about the originality of the materials and their ability to perform on par with genuine products, underscoring the importance of obtaining materials from reliable sources.

In unravelling the mystery behind the lifespan of dental fillings, it becomes evident that a holistic approach, involving both patients and dentists, is necessary to ensure the longevity and success of dental restorations.

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The authors are Restorative Specialists at Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, and may be reached at dr.sofyazul@um.edu.my