A seal has fallen: reasons for what to do

Update: December 2018 There are probably few people who
really love dental treatment. The majority with
reluctance, anxiety or even fear go to the dentist outside
depending on age. Both adults and children want a doctor
rather, restored the tooth, and one would go home. However later
for some time it happens that the seal falls out. Why is that
what is happening and what needs to be done?

Common causes of loss of a seal

There are many reasons for the fact that the seal
falls out, and all of them can be divided into three large groups:

  • medical errors;
  • patient fault;
  • features of the material used.

Let us consider in more detail each of them.

Iatrogenic errors

Unfortunately, one of the reasons why tooth fillings fall out is
is a medical error. Non-compliance may play a role here.
techniques of working with materials, lack of time for bona fide
work and lack of competence of the doctor, and sometimes
human factor (fatigue, inattention).

Due to the fault of the doctor, the seal may fall out in the following cases:

  • violation of the rules of preparation of cavities – for reliable
    retention of filling material in the tooth must be observed
    the main patterns of boron treatment of enamel and dentin. Special
    This is true for tooth decay, which affects the tooth walls or
    cutting edge of the front teeth (grades II and IV)
    Black). Removing necrotic tissue and creating a cavity for
    stomatology, the dentist must pay attention to
    the area of ​​the bottom and walls were proportionate. Otherwise violated
    mechanical coupling, which leads to the loss of the restoration;
  • incomplete removal of tissues affected by caries – when during
    preparation by the doctor due to inattention or because of fear of opening
    the pulp chamber leaves a modified dentin at the bottom of the cavity;
    leads to the fact that under the filling begins to develop infectious
    process. Hard tissues are destroyed, therefore the boundary is violated.
    between the tooth and the filling, as a result of which the restoration begins
    loosen and may fall;
  • short time etching enamel and dentin – technique
    total etching does not lose its relevance until today
    of the day, although adhesive systems have been developed that do not require
    prior to this manipulation. Pickling
    implies the application of washed and dried
    hard tissue surface of the prepared cavity
    concentrated gel based on orthophosphoric acid. This
    the procedure allows you to remove the smear layer of dentin, removes
    excessive inorganic from dentinal tubules, and also creates
    roughness on the enamel, which increases the adhesion between the material
    for filling and tooth. According to the rules, enamel is etched for 30 – 60 seconds, and
    dentin – from 15 to 30 seconds. If you change the time down,
    then it may adversely affect the quality of the restoration.
  • violation of the adhesive protocol – the main purpose of making
    adhesive into the cavity is to create a kind of “sticky” layer,
    which allows the seal to firmly bond with solid tissues.
    The main condition that must be met is
    absolute dryness. Even a slight hit of saliva or water.
    breaks the grip, which leads to flaking of the sealing
    material or the development of secondary caries;
  • fluid penetration into the cavity during work – sensitivity
    water has not only an adhesive, but also a photopolymer, from which
    A seal is being performed. Many modern composite materials
    used in the technique of layering, so saliva
    in the process of creating a restoration also adversely affects
    its quality;
  • inadequate curing of the material – on the package to each
    the cement or composite is always indicated the period for which
    there comes its full hardening. And if the JRC (glass ionomer
    cement) is less picky at work, then for curing
    photocomposite required light exposure using an LED lamp
    within 15-20 seconds. Therefore, the doctor must control the degree
    the charge of the device, since the discharged lamp is not able to pass
    the rays to the required depth, because of which the seal “seizes”
    outside, but remains uncharted inside;
  • the use of expired cements and photopolymers – not in vain
    the manufacturer always indicates on the packaging the shelf life, since
    This affects its physical properties. Some
    unscrupulous dentists to save and not to throw out
    expired material, make seals of it, hoping that they
    will stand well. Sometimes this leads to the fact that after rendering
    even a small chewing load, the patient returns with
    complaints that he had a seal out of a tooth.

Sometimes there are situations when the tooth is destroyed so much.
strongly that according to the testimony there it is necessary to make a tab or
install the crown however the patient is financially or whatever
for other reasons, the dentist insists that the tooth be restored
filling material. Naturally, the doctor is trying to help
to the patient cures it, and therefore agrees to the formulation of the seal,
however, warns him that treatment will be without guarantee, so
according to the testimony in this case requires a different type
treatment. Unfortunately, such fillings do not last for a long time, since there is no
conditions for their strong fixation in the cavity.

After reading the above points, you might get the impression
that dentists are always to blame for the fact that restoration happens
short-lived. Of course, unscrupulous doctors meet, however
most dentists value their reputation so they will not
make obviously bad fillings.

Patient errors

At the end of the treatment, the dentist always makes recommendations.
regarding what can and cannot be done to
the filling material was kept in the cavity as long as possible. TO
Unfortunately, patients are sometimes in such a hurry to leave the office,
that attentively listen to the advice of a specialist, which leads to
that after some time you have to come back for
re-restoration of the tooth.

When filling a defect in solid tissue dental
cements or composites of chemical curing is necessary in
Do not eat or drink for 1-2 hours. The thing is
that these materials finally freeze only later
a few hours, so if you start to eat earlier, the integrity
the seals are broken and it falls out.

It is also necessary to brush your teeth regularly, because accumulations of plaque
lead to the fact that new carious cavities are formed. Also
bacteria that accumulate on the teeth can penetrate
micro spaces formed between the material and enamel and
cause relapses, i.e. re-infection of hard tissue,
leading to their demineralization and, as a consequence, caries.

People who like to gnaw seeds, nuts, bite off threads
teeth, are at risk because they are more likely to fly out
fillings. Uneven load distribution leads to
the occurrence of microcracks on the enamel surface, which violates
contact density at the “fill-tooth” boundary.

Full care for the oral cavity, the rejection of bad habits
and proper nutrition will help keep the restoration intact
as long as possible, and also to avoid the emergence of new
carious cavities.

TOаждый стоматологический материал обладает перечнем
physico-chemical characteristics, the knowledge of which allows
use it in a given situation, guided
indications for installation.

It is important in the restoration of the tooth to remember the shrinkage rate
which gives the material during solidification. It means that
directly after entering the cavity, the cement takes up all of it
area, and after 24 hours the seal begins to “sag”, because of what
there is a distinct groove along the boundary between the material and solid
tissues. In the instructions, the manufacturer always indicates this.
indicator, so the doctor must take it into account when starting work
with the material.

Specialсти применяемого материала

Many materials used for fillings are universal, but there are
a large group that is used primarily for the front
or lateral group of teeth. Their main difference in particle size is: what
larger molecules, the higher the strength characteristics
however, low aesthetic qualities.

Macrofilled composites are suitable for the restoration of chewing
teeth, as the main requirement for fillings on molars is
resistance to high loads, and aesthetic qualities are moving away
into the background. If you perform the restoration on the side group
teeth material consisting of very small particles, then
the likelihood that a seal will quickly fall out is increasing.

Loss of temporary fillings

For the manufacture of temporary fillings there is a separate group
materials for curing which requires quite
for a long time, while freezing does not prevent
saliva ingestion.

Temporary fillings are commonly used in the following
cases:временная пломба

  • for applying devitalizing paste for inflammation of dental
    a nerve;
  • after sealing the channels, if necessary, send
    patient for x-ray examination;
  • when applying a medical paste to relieve acute
    inflammation and pain syndrome in the apical
    periodontitis.

The task of temporary sealing is to safely isolate the cavity from
infection of the root canals, so if such a filling
drops out, you need to contact your dentist as soon as possible. AT
at best, the medicine simply will not work, and at worst –
infection of the pulp chamber will occur.

ATыпадать они могут по двум основным причинам:

  • the doctor has not tamped down the material tightly enough or has imposed it
    without observing the anatomical features of the tooth;
  • the patient did not follow the recommendations of the dentist.

ATременные пломбы не предназначены для долгого использования,
therefore, it is necessary to come to the dentist’s appointment strictly in
the appointed day, otherwise the medicine under it may
to leak and lead to necrosis of the interdental papilla or apical
periodontitis. Also нельзя выковыривать пломбу, чрезмерно нагружать
a tooth, otherwise the integrity is temporary restoration will be broken.

ATыпадение пломб в молочном прикусе

For the treatment of teeth in young children, there are special
cements that do not violate their qualities, if in the process
liquid enters the cavity. The child is quite difficult long
time to sit with your mouth open, so the materials used
plastic, easy to form and quickly freeze in
oral cavity.

The answer to the question of why the filling out of the baby tooth falls out
is obvious. Not every baby will sit quietly in a chair
dentist and do what the doctor says. Usually the treatment is
stress for both children and their parents. Therefore, the doctor must
work quickly, otherwise the child simply closes his mouth. Not
surprisingly, it is sometimes difficult for the dentist to prepare the cavity
by all the rules, as well as securely fix the seal.

Another feature of the treatment of young children is the use of
materials that contain as little as possible
�”Chemistry”. Therefore, the adhesion between the filling and the tooth occurs only
mechanical, which also does not contribute to its reliable retention in
cavities.

What to do if a seal has fallen

ATыпавшую реставрацию невозможно поставить на место. therefore
when the seal has fallen, the first thing to do is to record
on reception to the dentist. If in the next few days there is no
possible to get to the doctor, you must adhere to simple
rules that will help preserve the integrity of the tooth.

  1. Limit the chewing load on the causative tooth so as not to
    provoke breaking of the dental wall.
  2. Not кушайте твердую и липкую пищу, способную застревать в
    microspaces of enamel and dentin.
  3. After eating, rinse your mouth. For this you can
    use plain water, rinse aid or medicinal decoction
    herbs
  4. Try to chew the other half of the jaw.

In no case do not need to try to close by yourself.
the resulting defect is chewing gum, wax, propolis or
other non-dedicated material. Also не следует
file sharp edges of hard tissue. ATсе эти действия не
will bring the desired result, but they can even hurt.

Common Questions

ATопрос: Сколько можно ходить без пломбы?

It is not possible to answer unequivocally, since it depends on the clinical
situations. If a temporary filling was installed in the tooth, then
make an appointment on the same day so that the infection does not penetrate
root canal system. If a permanent seal falls out and if
no hypersensitivity to temperature and chemical
irritants, it is allowed for some time to walk around without it. but
It is advisable, of course, to contact a dentist as soon as possible.
restore a tooth.

ATопрос: Нужно ли платить за повторное
tooth filling?

It depends on what conditions are specified in the warranty.
coupon. If the warranty has expired, the patient will need to
pay for tooth treatment. AT течение гарантийного срока стоматологу
will have to restore the restoration in the event that violations
not caused by the patient.

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