Application
Amalgam is still frequently used in German dental practices and is also quite easy to insert into the tooth. After a local anaesthetic is applied, the caries is completely removed and the tooth is prepared in a box-shaped manner. This preparation ensures the highest possible adhesion between the tooth substance and the filling material.
In case of very deep caries, a so-called underfilling made of a calcium hydroxide containing medication must be placed under the seal first. This medication has a calming effect on the nerve fibers of the tooth and is also supposed to stimulate the formation of new dentin. In dentistry, this procedure is known as capping.
Before the filling material is inserted, a shaping matrix is placed around the tooth to be treated and fixed with small wedges. The dentist then inserts freshly mixed amalgam into the tooth. Before the seal can be polished, the material has to harden over a period of at least 24 hours, so in the case of an amalgam filling at least two sessions are required.
The polishing of the seal not only serves to embellish the surface of the filling, but above all to reduce the mercury emission. More and more often patients decide to have a plastic filling instead of a seal, which is mainly due to the fact that plastic fillings are almost invisible in the tooth. The statutory health insurance companies only cover the costs of a tooth filling if amalgam is used as the filling material, plastic fillings are only covered in the anterior region. During pregnancy and people with proven kidney dysfunction (renal insufficiency) are the exception, because the health insurance companies also cover plastic fillings in the posterior region.
Seal fell out
Even with a carefully made seal, it is possible that the seal will come loose from the tooth after a certain period of time. In most cases, a seal that has fallen out causes no pain at all, but is perceived as unpleasant and very annoying by the affected patients. Nevertheless, a prompt presentation to a dentist is urgently necessary, because otherwise there is the threat of toothache after a period of a few days to weeks.
In addition, there can be permanent damage to the tooth and/or the nerve fibres within the tooth pulp.In many cases, caries that forms under the filling material (so-called secondary caries) causes the seal to fall out. In fact, this is already by far the most common reason for loosening of the filling material placed in the tooth. If treatment is not carried out quickly, there is often a risk of root inflammation and in the worst case the tooth may be removed (extraction).
See Tooth extraction. Also the breaking through of an outer wall of the treated tooth can lead to the loss of the seal. Damage to the outer wall of the tooth can occur as a result of excessive or overloading the natural tooth substance.
In the case of the affected patients, the reapplication of a seal may not be sufficient to ensure long-term care of the tooth – a so-called inlay is necessary. Other reasons are so-called filling fractures, i.e. broken seals, and the loss of the bond between the tooth substance and the actual filling material. Also the breaking through of the actual filling is usually caused by an overload of individual tooth surfaces, which makes the filling material porous in the long run.
Especially very old fillings show signs of wear and tear and a resulting loss of the layer thickness of the filling material, which finally leads to breaking through. In the area of the incisors and canines, fallen out fillings are caused by a loss of the adhesive forces between the tooth substance and the actual filling material. Patients who have lost a filling should make an appointment with their dentist as soon as possible.
If a seal has fallen out and you have swallowed it, there is no need to worry. In most cases, the seal is eliminated from the body naturally. However, you should visit a dentist as soon as possible to have the now exposed tooth surfaces repaired.
Often there is a reason why the seal has fallen out. This could be a carious lesion underneath the seal or a broken tooth surface. If the seal is broken, this does not necessarily affect the entire seal.
Only a piece of the filling may have broken off. This can usually be felt with the tongue. In this case the filling only needs to be rebuilt.
In many cases, however, the tooth with the broken seal causes toothache. Mostly it is also sensitive to hot or cold food. This is an indication that the filling must be renewed. In any case, a dentist must be consulted to have the defect repaired.
