A dental filling is a restorative material used to repair a tooth damaged by decay. The procedure involves removing the decayed material and filling the resulting cavity to prevent bacteria from entering and causing further deterioration. While these restorations are made to be durable, they are not permanent and can occasionally become compromised or dislodged due to wear, secondary decay, or chewing pressure.
Physical Signs a Filling Is Missing
A sudden, sharp sensitivity is often the first indication that a filling has fallen out, especially when the tooth is exposed to temperature changes from hot or cold foods and liquids, or even cold air. This reaction occurs because the protective filling is gone, leaving the underlying dentin exposed to the oral environment. The loss of the filling also creates an immediate change in the tooth’s surface contour, which the tongue often detects first as a noticeable indentation or a rough, jagged edge.
Visually inspecting the area may reveal a noticeable hole or a distinct gap where the smooth filling material used to be. If the missing filling was on a chewing surface, you may also experience pain or discomfort when biting down, as the exposed area is now vulnerable to direct force. Another common sign is the persistent trapping of food particles in a specific area after eating, which indicates a void that was previously sealed by the restoration. In some cases, the patient may even find the dislodged filling material—a small, hard piece of silver or tooth-colored material—in their mouth or spit it out.
Emergency Care Until You See the Dentist
The immediate priority upon discovering a lost filling is to contact your dental office to schedule an urgent appointment, as the newly exposed tooth is vulnerable to infection and decay. While waiting for the professional repair, gently rinse your mouth with warm salt water to cleanse the area and reduce the risk of irritation or bacterial buildup. To prepare the rinse, dissolve about half a teaspoon of salt in eight ounces of warm water and swish it around the affected area for thirty seconds before spitting it out.
Managing discomfort is important, and over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate any pain or inflammation. To create a temporary barrier and protect the tooth’s sensitive inner structures, you can use dental wax, which is commonly available at pharmacies, by molding a small piece and gently pressing it into the cavity. Alternatively, a small piece of sugar-free chewing gum can be softened and pressed into the void, or you can purchase over-the-counter temporary filling material, typically made of zinc oxide, to seal the gap until your appointment.
Avoid chewing on the side of your mouth with the exposed tooth to prevent further damage or fracturing of the remaining tooth structure. Stick to a diet of soft, mild foods and avoid anything that is particularly hard, sticky, very hot, or very cold, as these can exacerbate sensitivity and potentially pull out any temporary material you have placed.
Permanent Solutions for a Lost Filling
When you see the dentist, the first step will be a thorough assessment, including an examination and X-rays, to determine the extent of damage and whether any new decay has formed since the filling was originally placed. If the tooth structure beneath the lost filling remains sound and the cavity is small, the most straightforward solution is often to simply place a new filling. The dentist will clean the area and prepare the tooth to receive a new composite, amalgam, or glass ionomer material, restoring the tooth’s integrity.
If the cavity has grown significantly, or if the tooth walls are too weakened to support another direct filling, the dentist may recommend a more extensive restoration like an onlay or a full crown. An onlay covers one or more cusps of the tooth, while a crown provides complete coverage, both offering greater strength and protection to the compromised tooth. Only in cases where the decay has progressed deeply enough to reach the pulp will a root canal be necessary before a final crown is placed to save the tooth from extraction.