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Failed Dental Restorations: Are dentists solely to be blamed?

By Dr Sumaiya Hasan

Dental problems can be bothering. In some cases, dental fillings can be the solution. However, just as relieved a patient feels after having the dental restoration, the relief can turn into a nightmare if the filling dislodges. While Dentistry is growing based on research and recent innovations facilitating clinical practice, dislodged dental restorations remain a headache both for the patient and the practitioner.

Comprehending the reasons for dislodged dental restorations can be difficult for common men. This often results in patients blaming the dentist for this problem. However, multiple factors play a role in causing this problem. Dentist’s skills while placing a restoration are imperative. Nevertheless, several patient-related factors have an impact on the long term prognosis of the dental filling. Few such factors are,

  1. Oral hygiene and habits of the patient:

 Regardless of how strictly the practitioner followed the protocols of treatment during the placement of a dental filling, if the patient ignores his or her oral hygiene after the procedure, not even the best filling material will last in his mouth. An unhealthy diet such as consumption of carbonated drinks and sweets frequently, harmful habits such as betel nut or betel quid, or ignoring teeth cleaning are three of the most common examples of neglected oral hygiene. This negligence has many consequences, one of which is the formation of caries around the dental filling. This ultimately leads to cavity formation and failure of dental filling.

Although the new dental materials have been developed with good strength and wear resistance, frequent consumption of betel nut or nut-cracking with fillings can lead to fracture.

  1. Preventive measures: 

Some dental restorative materials gain strength and hardness with time after they have been placed. During this time, certain precautions are necessary to allow the content to set and achieve the desired strength fully. These precautions may include avoiding chewing from dental filling for some hours or protecting them from moisture for a short while. If the patient does not follow the cares, the filling material may fail to achieve its desired properties.

  1. Bruxism: 

Some patients are diagnosed by the dentists to have bruxism, which involves unconscious grinding or clenching of teeth. It has detrimental effects on both natural and artificial teeth and also dental fillings. However, dental fillings in such patients are not as simple as they appear to the patients. Few such patients may need a comprehensive treatment plan rather than merely placing fillings where required. In the absence of such a comprehensive treatment plan, fillings may fracture or dislodge due to the high clenching forces. Often, patients are reluctant to this comprehensive treatment plan as it may require extra time and compliance at their end. However, it must be understood by them that without it, the filling may not last long.

  1. Oral Environment: 

A favourable environment is essential for the longevity of dental fillings. Certain conditions may make it unsuitable such as the medical condition named GERD (Gastroesophageal Reflux Disease), a digestive order which results in stomach acid moving up to the oesophagus and also to the mouth. The acidic environment in the mouth is neither suitable for the natural teeth nor the dental fillings. If dental fillings are required in such a patient, treatment of GERD should also be carried out for the overall wellbeing and even longevity of the stuffing.

  1. Patient’s cooperation during the procedure: 

Gone are the old times when dental fillings meant merely drill and fill. Today the procedure is performed with protocols and precision. Patient’s cooperation to achieve excellent results are of prime importance.

The longevity of dental restorations depends on multiple factors related to both the dentist and the patient. Every case is different because the factors influencing dental procedures are different for everyone. Moreover, case complexity is not similar for all patients. Dentists can play a pivotal role in explaining these factors to the patient apart from recording and conducting a thorough history and examination for composing suitable treatment plan. This can save both the patient from post-treatment disappointment and the dentist from extra efforts.

-The author is a contributing writer for Dental News Pakistan and can be reached at sumaiya.hasan3@gmail.com.

August 13, 2020

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