Dental fillings serve as a common restorative treatment, effectively repairing teeth affected by decay and restoring their original form and function. While these restorations are designed to protect the tooth from further damage, they do not render the tooth entirely immune to future problems. It is possible for a tooth that has received a filling to develop an infection, though the infection typically originates within the tooth structure itself rather than the filling material. Understanding the potential for such infections, along with their signs and necessary treatments, can help maintain oral health.
How Fillings Can Get Infected
An infection associated with a dental filling usually stems from issues around or beneath the filling, or within the tooth’s internal pulp. Secondary decay, new cavities forming at the filling’s margins, is a primary cause. These gaps allow bacteria and food particles to penetrate the tooth’s outer layers and reach the dentin. As bacteria proliferate, they can irritate or infect the tooth’s pulp, which contains nerves and blood vessels.
Failing or fractured fillings are another pathway for infection. Fillings can chip, crack, or loosen over time due to chewing forces, grinding, or material degradation. These compromises create spaces where bacteria can accumulate, leading to new decay or exposing the dentin. If the initial cavity was very deep, the filling’s proximity to the pulp can lead to chronic irritation or inflammation, potentially progressing to infection even without new decay.
In rare instances, infection can arise if infected tissue was not completely removed before filling placement. Residual bacteria can remain trapped, multiplying and leading to infection. Physical injury or trauma to a filled tooth can also damage its internal structure or compromise the pulp. This creates an environment conducive to bacterial invasion, making the tooth vulnerable.
Recognizing the Symptoms
Recognizing symptoms of an infected filled tooth is important for timely intervention. Persistent pain is a key indicator, often throbbing, sharp when biting, or constant. This differs from temporary sensitivity after a new filling, which typically resolves within days or weeks. Increased sensitivity to extreme temperatures or sweet foods that lingers after the stimulus is removed also suggests an underlying issue.
Swelling and tenderness in the gum tissue around the affected tooth are additional signs. Gums might appear red and inflamed, and touching the area could cause pain. In advanced stages, an infection can lead to pus or an abscess, appearing as a small, pimple-like bump on the gums near the tooth. This abscess may drain, leading to a persistent bad taste or foul breath resistant to regular oral hygiene.
Visible damage to the filling, such as a crack, chip, or looseness, can indicate a compromised restoration allowing bacterial ingress. Less commonly, a spreading infection can also present with systemic symptoms. These may include a low-grade fever or swollen lymph nodes in the neck or jaw, signaling the infection has progressed beyond the tooth and is impacting overall health.
Treatment Options and Prevention
If an infection around a dental filling is suspected, prompt dental attention is important to prevent worsening. A dentist will diagnose the issue and recommend the appropriate course of action based on the infection’s severity and cause. For minor issues like early secondary decay or a compromised filling, replacing the old filling might be sufficient to remove infected tissue and seal the tooth.
If the infection reaches the tooth’s pulp, root canal therapy becomes necessary. This involves removing infected pulp from within the tooth, cleaning and disinfecting the internal chambers, and then filling them with sterile material to prevent future bacterial growth. In severe cases where the tooth is extensively damaged or the infection is too widespread, extraction may be the only option to eliminate the source. Antibiotics might be prescribed to control the infection, especially with significant swelling or systemic symptoms, but they are typically an adjunct to a dental procedure addressing the physical source.
Preventing filling infections relies on diligent oral hygiene and regular dental care. Brushing twice daily with fluoride toothpaste and flossing once a day removes plaque and food particles, significantly reducing new decay around fillings. Routine dental check-ups and professional cleanings allow dentists to detect and address secondary decay or failing fillings early, often before infection takes hold.
Avoiding habits like chewing on hard objects (e.g., ice) or using teeth as tools can prevent fillings from fracturing or chipping. For those who grind or clench their teeth, a custom-fitted nightguard can protect fillings and natural tooth structure from excessive stress. Limiting sugary and acidic foods and drinks also minimizes decay that could compromise existing fillings.