It is not always necessary to replace a whole filling. Each tooth situation is different so your dentist will need to assess it and discuss the various options and materials with you. If you change dentists regularly, this will probably lead to more fillings being replaced.
Staying with a dentist for a long time and visiting them regularly allows little things to be monitored to see if they genuinely need to be replaced instead of replacing them immediately.
New dentists are unable to see how things have changed in your mouth over time, so when they first see you they might find something that looks like it needs replacing, when in fact the reality it that it has been exactly like that for a number of years.
Your choices are:
- If it is very small and not causing or going to cause any problem, it may just be smoothed.
- If there is a lot of decay around and under a filling, the whole filling will need replacing.
- If part of a tooth pings off – generally the side of a molar tooth with a large filling in the middle, the tooth can often be repaired if the remaining filling is solid.
- If the filling that remains is loose, it will certainly need taking out and replacing.
- Repairing a white filling (composite) by bonding more composite to it or using a sticky glass ionomer cement (GIC) is often possible instead of replacing the whole thing. This is good because it preserves as much tooth as possible, however once a composite filling has been set for some time this becomes more difficult and unless some natural tooth is available for bonding, it may be stronger to replace the whole thing.
- Repairing an amalgam, if enough tooth is present to get a good strong bond, can also be done with composite or GIC. That said, in general, I personally find it is better to repair amalgam with amalgam by cutting a little mechanical lock to hold it in place, though if you want to swap to a white filling this might be a good time to consider it.
- If most of the tooth is gone, or is weak it may be necessary to progress to an inlay/onlay or a crown instead to restore the tooth.