Cracks and Fillings

A dentist noted that there were cracks in my upper left teeth 24 and 25 (see photos attached). She suggested that their amalgam fillings be replaced with composite fillings. I have the following questions: I don't feel any pain from these two teeth. However, do old amalgam fillings cause cracks in teeth, and do composite fillings not cause cracks in teeth ? i.e. should I replace old amalgam fillings with composite fillings ? When removing an amalgam filling, will there be loss of the natural tooth material, other forms of damage and weakening of the tooth ? Should I be worried about all this ? I have read on the internet that superficial cracks in the enamel do not require treatment. Do they ? However, I am worried that such cracks will deepen. I have also read on the internet that such cracks can be repaired with composite fillings. If we use a composite filling to repair a crack, where should it be applied: just to cover up the crack and its surrounding area ? the entire occlusal surface ? or the entire surface of the tooth ? In case later , an onlay or a crown is required, will this composite filling have to be removed ?

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Answer: cracks on fillings

By Sarah h
Dental Professional

When old amalgam restorations are removed, a small amount of tooth structure is lost, however it is not healthy tooth structure.  Amalgam expands and contracts at a higher rate than our natural tooth structure, that is why small cracks develop over the years.  Resin bonded fillings are bonded to the teeth and mimic our natural tooth structure with expansion and contraction.  Removing the amalgam and placing composite will not guarantee you will not ever need a crown in the future, however it will slow down the crack and hopefully prevent any further damage to the tooth.  This is a very common procedure.  Amalgam restorations also leak, so more than likely there is decay under your current fillings that needs to be removed.  The entire amalgam restoration will be removed along with any decay before placing a new resin bonded restoration back in the tooth.  If a crown is needed in the future, the composite resin would be used as a buildup in order to ensure there is enough solid tooth structure for the crown to hold onto, restoring the tooth back to full function.

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