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Surprising Reasons Fillings Could Fail

For many people, there are few things more frustrating than hearing they need an old filling replaced. After all, you already went through the pain to have it put in the first time - who wants to go through that again for the same tooth? Unfortunately, despite what we may have been led to believe, fillings aren’t meant to last forever. But for some people, filling failure happens more often and in some cases sooner than anticipated. So, what causes this premature failure, and what can be done to prevent it? 


Recently, research teams from the University of Pittsburgh School of Dental Medicine in Pittsburgh, Pennsylvania, and the University of Pernambuco School of Dentistry in Recife, Pernambuco, Brazil, sought to answer this question, and their findings may come as a surprise.

"As it turns out, patients who smoke and regularly drink alcohol experienced filling failure at a much higher rate," says Dr. Michele Simpson, a Wilmington, North Carolina, dentist. "Patients in this category experienced filling failure within about two years, whereas the average shelf-life of most fillings is 10 to 15 years."

Another interesting finding? Filling failure may be at least partly genetic. An anomaly in the gene for an enzyme called matrix metalloproteinase (MMP2) in teeth was also found to increase filling failure in patients who have it, because it may destroy the bond between the tooth and filling composite.

So, what can be done to help ensure fillings get the longest life possible?

"It’s a multi-fold problem with a multi-fold solution," says Simpson. "First, you need to be honest with your dentist if you smoke or drink. Based on that, your dentist can help choose a filling material that will work best with your lifestyle. But you should also try to cut back on smoking and drinking if that applies to you."

As for the genetic differences, researchers are still examining the connection.

"Once we know if MMP2 really does ruin the bond between teeth and fillings, we can further address how to help patients who are carriers," Simpson says. "Whether that will mean a special kind of filling that is MMP2 resistant or simply notifying the patient that there’s a good chance they’ll need to replace their filling sooner than average, that remains to be seen."

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