The seal from a tooth has dropped out: the reasons, treatment

Since filling is one of the final stages of treatment, one must take into account not only the quality of the sealing itself, but also the rationality of carrying out previous manipulations. This is necessary because many of the procedures performed directly affect the consistency and durability of the seal. 

Why did the seal fall out?

There are many reasons why a tooth seal can fall out. This is sometimes due to the fault of the doctor, due to carelessness of the patient, after the end of the life of the seal, etc. This is often associated with the nuances of dental care. The reasons why a seal can fall out are divided into 2 groups: iatrogenic and non-carotenous. Iatrogenic causes are associated with dentist's mistakes in the provision of medical care. Very often doctors use budgetary versions of filling materials, which have a high shrinkage and low adhesion (adhesion). With a large shrinkage, the filling material decreases in volume after curing, which causes it to "detach" from the walls of the cavity. At low adhesive properties, the material is not adhered, but fixed in the cavity by mechanical force. Those. Filling, repeating the shape of the cavity of the tooth, as the puzzle enters it and thus strengthens. And, although this kind of fixation at first glance inspires confidence, in fact it is not reliable. This is due to the fact that between the filling and the tooth are micro-spaces, which are an ideal environment for the accumulation of food residues and microorganisms. As a result, a secondary carious process occurs and the tooth tissues with which the seal contacts, are gradually subjected to demineralization (caries). Also it is worth noting that the filling material after the expiration date loses its adhesive properties. This contributes to the violation of fixing the seal and its rapid loss. Not everyone knows that a seal and a tooth are not all elements of sealing. Between them is an adhesive system that serves as a link between the hard tissues of the tooth and the filling material. The importance of the adhesive system can not be exaggerated, since it provides a tight contact between the tooth and the seal. Requirements for this material - high quality and acceptable shelf life.

Now we need to talk about the manipulations that the doctor is carrying out during the restoration of the tooth. The first stage is the preparation of the carious cavity. With the help of metal and diamond burs, the dentist removes all tooth tissues that are affected by caries. Carry out this procedure very carefully, since the remains of carious dentin provoke the development of secondary caries. If such a cavity is sealed even by the most expensive and high-quality composite, the seal can fall out after a few months. At the same time the carious process will continue to progress. The second stage is the creation of a regular cavity shape. This point is very important in connection with the mechanical fixation of the seal. And for each filling material, there are requirements to the formation of the cavity and the creation of strong points. To focus on the properties of individual materials in this article is not necessary, but you must be sure that your doctor has this knowledge. One of the reasons that a seal may fall out is failure to adhere to an adhesive protocol, or, in other words, to prepare a tooth for sealing. Due to the fact that many doctors save their time and supplies, some important stages of restoration training can be missed or poorly met. However, if you see that the doctor is working slowly, comments on each of his manipulations, deploys answering all your questions and is morally open to you, you can be sure that he performs his work in good faith.

Often there are situations when the doctor performs composite restoration of the tooth in those cases where it is inadmissible. Most often these are situations where the chewing surface of the tooth is completely destroyed, but the patient refuses to replace the crown. Then the doctor, as an alternative, offers the patient a composite seal. It is important to understand that such a seal is doomed to rapid fallout, since it can not take and transmit the chewing load for a long time.

One of the reasons for the loss of a seal can be the ingress of liquid onto the filling material before it solidifies. It so happened that water and other liquids are very detrimental to most of the filling materials that exist today. However, if the doctor used a cofferdam (rubber shawl for a tooth) when stamping the seal, the likelihood of the seal falling out precisely because of contact with the damp environment is extremely small.

Many dentists in modeling the chewing surface of the tooth spend a lot of time and energy trying to create the most natural appearance of the tooth. Concentrating on the artistic application of the filling material, some specialists do not notice that they overestimate the level of the seal in relation to other teeth. If, at the conclusion of the treatment, the doctor did not thoroughly check the contact of the teeth, and the patient did not attach importance to the unusual position of the new seal, then the tooth with the seal will be directed to an increased load. When chewing, the seal will experience vertical overload and, after reaching the ultimate strength, will fall out of the tooth.

Often patients complain that the seal falls in a dream. This is not an abnormal phenomenon and is not uncommon in dentistry. The reason for this problem is explained by the fact that most people have different parafunctions of the chewing musculature. That is, a man's teeth in a dream can close and open with great strength and frequency. This leads to an overload of periodontal and hard tissues of the teeth. Many people suffer from bruxism, which is also a representative of parafunctional activity. In this case, the human teeth not only close together with great force, but also yield to friction. Teeth of the lower jaw with great force pressed against the upper teeth, after which the lower jaw is pushed forward and sideways. Thus, the teeth are exposed to a load that is stronger than the pressure when eating. And if there are seals in the teeth, then due to the frictional force they quickly lose their stability. Some patients claim that they dreamed of how they get a seal. This is very likely, since our body always reports a possible danger to its existence. Therefore, if the seal falls in a dream, then it is likely that it can be figuratively reflected in dreams.

There are many risk factors that can provoke the loss of a seal. The main sign is unsatisfactory hygiene of the oral cavity. The causal algorithm is quite simple here: if there is a plaque, then there is a congestion of microorganisms. If there is cariogenic flora - then there will be caries. If there is tooth decay - then the seal will very soon fall out. Plaque, perhaps, is the main risk factor, which often leads to the loss of a seal. Often, patients themselves use their teeth inappropriately: they keep clusters, needles and other objects, open glass bottles. It is worth mentioning about the careless use of solid food. In these cases, not only can a seal fall out, but the integrity of the tooth may be compromised. Therefore, always follow the recommendations of your doctor after the treatment.

Symptoms

Far from always dropping a seal is accompanied by some kind of symptomatology. But, to understand that the seal fell out is quite simple. Compare a defective tooth with a symmetrical tooth: if the tooth on the other hand is visually different and looks more complete, then the suspect tooth most likely has a seal.

If it is difficult for you to visually distinguish a healthy tooth from a defective one, then most likely there was not a loss of a seal, but its break-off. If there is a fallout, the patients themselves discover a "hole" in the tooth when performing hygiene procedures or carrying out the tongue on the tooth. In addition to the cavity itself, you can feel the sharp edges of the filling or tooth. Often they lead to trauma to the oral mucosa. When eating, the food remains in the tooth cavity, they remain in it until the patient finds a cavity and does not conduct a thorough hygiene in this place. Otherwise, the food will begin to be saturated with microorganisms, which can cause inflammation in the mouth, secondary caries, bad smell from the mouth, etc. Also, one of the unpleasant symptoms is a symptom, in which a cold, hot, sweet or sour cold comes into the tooth. This suggests that the tooth tissues that were under the seal are not protected at this time and foreign substances penetrate them.

Very often leakage of the jointing of the filling material with the tooth is the first sign that soon fallout will occur. Before falling out, the seal can become mobile. This occurs in cases when the doctor formed a globular cavity in the tooth for the photopolymer composite. The mobility of the seal can be felt by the tongue or by eating, when food particles (for example, chewing gum, iris, caramel, etc.) adhere to the seal and cause it to move into the cavity.

Consequences and complications

Complications caused by loss of a seal - this is not uncommon, so walking without it for a long time is impossible. As a rule, all the complications are due to the fact that people do not make timely use of dental care. Most often they adapt to life with a cavity in the tooth and can even tolerate toothache. Argumented by lack of free time and lack of financial resources. However, in the presence of complications, time and money resources will need much more, and this needs to be understood. But, the recklessness of people leads to the fact that after the appearance of the filling the carious process progresses, reaches the pulp chamber and causes pulpitis. Thus the person can feel, that the seal has dropped out and the tooth began to hurt. Pain more often spontaneous, amplifies from cold, hot, from hit in a cavity of the rests of nutrition.

If the form of the pulpitis is purulent, then the patient on the same day will seek help from the dentist. But if the pulpitis is focal or common, then a person can endure pain attacks and even not ask the question "why does the tooth hurt?" As a result, pulpitis can go on into a chronic form and subsequently cause periodontitis. Thus, not paying attention to the symptoms of dental diseases can lose a tooth. Often loss of a seal leads to gingivitis or localized periodontitis. In this case, the gum swells near the causative tooth. When revealing the swelling, it is important to immediately take action to eliminate the inflammatory process. To do this, you can rinse the mouth with a solution of chamomile, sage and other medicinal herbs. To prevent infection, you can locally use the "Metrogil Denta" ointment.

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Diagnostics

Diagnosis at home is reduced to determining the pain of the tooth from ingestion of food and water into the cavity of the tooth. Also, you need to inspect the causal tooth: if it shows sharp edges of the tooth or a seal, then there is a chance of damage to the oral mucosa.

When you look at the tooth cavity, you most likely will see one of three situations: the first - in the cavity there will be a layer of filling material, the second - in the cavity you will see undamaged enamel and dentin (grayish-white color), the third - in place of the fallen fillings there will be a carious lesion of hard tissues. This will visually look like a black tooth. Any of these options involves an early visit to the dentist, although it is worth noting that the third version of the current is most undesirable. In any case, the dentist will re-conduct the examination and use some other diagnostic methods: collection of complaints and anamnesis, general and local examination, radiography, electrodontodiagnostics (to determine the viability of the pulp).   

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What should I do if I have a seal?

If the front filling is dropped, then the causal tooth should be examined immediately. Pay attention to possible remains of the seal, sharp or thin parts of the tooth. This is necessary in order to prevent further damage to the oral mucosa and fracture of the remaining part of the tooth. Immediately inform the attending physician of the situation and before the treatment, perform antiseptic treatment of the oral cavity as often as possible.

If the seal with arsenic fell out, then do not worry, it's just a temporary restoration. However, there are certain nuances that need to be clarified. First, do you feel pain in the tooth? If the tooth does not spontaneously hurts, try to collect water at room temperature in the mouth and determine if there is any pain in this case. If there is pain, then the pulp (nerve) is still alive and you need to visit the dentist to determine the further treatment tactics (repeated application of the devitalizing paste, or the choice of another method of devitalization). If there is no pain, then most likely the pulp has already succumbed to the action of arsenic paste and the remnants of the material must be removed. Thoroughly examine the cavity and assess its condition. If there are particles of arsenious paste there, try to rinse out with an antiseptic solution (chlorhexidine bigluconate, hydrogen peroxide 3%, Givalex, solutions of herbaceous cathedrals). If there are no foreign elements in the tooth, then close the cavity with a cotton ball and make an appointment with a doctor.

It is also worth paying attention to the time after which you had a seal with arsenic. The fact is that arsenous paste is superimposed on the pulp for no more than 12 hours for one-root teeth and no more than 24 hours for multi-rooted ones (not to be confused with paraformaldehyde paste, which is put on for 7-10 days). A qualitative arsenic paste during this time will necrotic the pulp. If you do not come to the dentist 24 hours later, then visit him urgently, because arsenic in the tooth can develop arsenic periodontitis - a toxic damage to the ligamentous apparatus of the tooth with arsenic anhydride. Therefore, do not neglect the instructions of the doctor, because not for nothing they say: everything that is moderately - a medicine, and that beyond measure - that's poison.

A permanent seal can fall out for various reasons, they have been described above. Principles of pre-medical care are that you need to maximally isolate the opened cavity and as often as possible perform antiseptic treatment of the mouth with solutions of chlorhexidine, hydrogen peroxide 3%, Givalex, chamomile, sage. Than to rinse, if the seal has dropped out, there is not much difference. All these solutions have a mild antiseptic and anti-inflammatory effect. Perhaps even a combination of these drugs. 

When you go to see a doctor, you should know in advance whether a replacement replacement is waiting for you. If the filling falls in a week or a month, then, as a rule, dentists make a repeated sealing according to the guarantee. But, this will happen only if you fulfilled the warranty obligations (did not allow traumatic damage to the tooth, conducted regular oral hygiene). If the warranty period has expired (in each clinic it can be different), then you will have to pay for the restoration of the tooth yourself. 

If you are undertaking complex endodontic treatment, it can be performed in several visits. After you have sealed the channels, the doctor could put a temporary seal before your next visit. If it fell out before you came to the dental office, you should rinse the mouth with chlorhexidine 0,06% or hydrogen peroxide 3%, dry with a cotton swab dry the cavity and place a dry cotton ball in the tooth. In this case, do not rinse your mouth too often. The fluid that enters the root canal zone can adversely affect the material that they are sealed. Therefore, it is important not to allow contamination of the tooth cavity and its moistening. Change the cotton ball to a clean dry as often as possible.

After the seal has dropped out, many people wonder what would replace it. The answer to this question is very simple and obvious - nothing! Among household items you will not find such items that could replace the seal in the tooth. This is due to the fact that the filling materials have very specific properties that allow them to be fixed firmly in the tooth, do not irritate the pulp tissue and not dissolve in the oral fluid. Therefore, do not try to seal the fallen out seal with plasticine, gum, gypsum and other similar things. The most correct action is to thoroughly rinse your mouth with an antiseptic and place a dry cotton ball in the tooth cavity. Change the ball and rinse your mouth as often as possible, especially after eating.

If the seal staggers, but does not fall out, then the principles of pre-medical actions will be approximately the same as with the fallen seal. First of all - make an appointment with a doctor. The second principle is rinsing the mouth with antiseptics. Third - try not to chew on the side of the dentition, where there is a mobile seal. The last point is related to the fact that it is almost impossible to extract food residues from home from the gap between the filling and the tooth. Therefore, the ingress of foreign particles into the problem zone should be minimized.

In women, during pregnancy, the metabolism is very often disturbed, there is a shortage of mineral components and vitamins. As a consequence, teeth become more vulnerable to tooth decay. If you are pregnant and you have a seal, then register with the dentist in the near future. Most conscientious doctors, hearing that you are in position, will agree to accept you as soon as possible. At home, you should only rinse the mouth with solutions from herbal dues (chamomile, sage) and insulate the tooth cavity with a cotton ball. Do the dentist always say again that you are pregnant. To receive such patients, there are individual methods of providing dental care, which are more sparing.

Treatment with a dentist

If the filling in the tooth staggers, but does not drop out, the dentist will have to remove it anyway. And this is completely correct action. The mobile seal can not be strengthened or fixed in any way. Even if you try to do this, then with a very high probability under this seal a carious process will begin. Or the seal will simply drop out in a short time due to poor fixation.

When a temporary seal with arsenic falls out, the doctor must determine the viability of the pulp. If the pulp is alive, then it will be necessary to repeat the stage of devitalization, or to remove the nerve under anesthesia. In the case when arsenic has managed to kill the pulp, the doctor will remove it and begin to carry out instrumental processing of the root canals. When the treatment of the canals is completed, the dentist will perform the restoration and simulate a permanent seal.

If a permanent seal from a milk tooth has dropped out, the treatment will be based on when the given tooth should fall out. If there is about 2-4 weeks left before the tooth change or the filling was small, there is no point in replacing it. However, if the tooth is in the mouth for several months or years, the restoration of the tooth is extremely necessary. After all, the defect of the tooth will constantly accumulate food, the carious process will continue to progress, which will lead to further destruction of the tooth. Destruction of temporary tooth tissues will cause inflammation of its periodontal, which can lead to damage to the permanent rudiment. As a result - the delay or complete stop of the development of the rudiment and, in the long term, the loss of the permanent tooth. Even if the rudiment is not damaged, an equally unpleasant process will occur-the displacement or incline of neighboring teeth. This is due to the fact that all teeth exert pressure on each other to create strong and stable dentition. If, on one side, there is a gap, the tooth will move to the side where there is free space. Therefore, every milk tooth should, throughout its existence, maintain a place for permanent teeth. And to perform this function the milk tooth should be anatomically complete, have clear and undamaged borders. For this reason, the baby's teeth need not only to be sealed, but also to do it qualitatively, taking into account their anatomical shape.      

In some cases, the filling falls only partially. As a rule, these are parts of the tooth that are susceptible to chewing load, for example, the bumps of lateral teeth. In such a situation, the integrity and stability of the remaining part of the seal should be assessed. If these parameters are satisfactory, you should not remove the remaining restorative material entirely. The doctor will partially complete the preparation, prepare for restoration and simulate the missing part of the seal.

When a composite, cement or amalgam filling falls out of a permanent tooth, the treatment will depend on the clinical situation. If the fallout occurred recently, the seal will simply be changed. If more than six months have passed, then you can be sent for an X-ray examination of the tooth. A snapshot is necessary in this case in order to assess the condition of the periodontal and root of the tooth. After all, neither to the doctor, nor to you it would not be desirable, that after the qualitative spent aesthetic restoration the seal had to be removed for the treatment of chronic periodontitis. If no pathological changes are detected on the roentgenogram, then you will be offered a method of restoration according to your aesthetic needs and financial preferences. With sealed canals, the treatment regimen will be approximately the same as in the presence of live pulp: radiography, analysis of the dental image, restoration of the tooth. One has only to note that if a splint or a carious lesion of a part of the tooth has occurred with the deposition of the seal, then you can be offered more reliable methods of restoration: an in-channel pin design, a crown prosthesis or a combination of these methods. The same way out of the situation is suggested if a seal with a pin fell out. The channels are prepared for the re-installation of the pin and further the choice of restoration is determined depending on the clinical picture (filling or crown).   

Prevention

Prophylactic measures of prolapse of a seal are reduced to not admit the reasons on which they arise. Take good care of food that contains solid parts (fish, meat on bones, nuts, fruits and berries with bones).

If you have the habit of opening the glass bottles with your teeth, holding nails between your teeth, snacking the wire, it is important to get rid of them. Also, do not use toothpicks as a hygiene item. They not only injure the tooth and gum, but also spread harmful microorganisms throughout the oral cavity. Strengthen the body's immunity, observe the mode of eating and sleeping. After all, every tooth is part of a large organism, which is closely connected with all its organs. If all the systems of the body will work correctly, the probability of caries and loss of a seal will be low. Try to examine your teeth more often and, at least once every six months, visit a dentist for a preventive examination. This will allow you not only to avoid the loss of a seal, but also to prevent the appearance of new ones. Be healthy!

Forecast

It is rather difficult to forecast the consequences of the fallen seal, since it depends on different parameters of the body. If you regularly hold oral hygiene, have few sealed and removed teeth, then most likely you have quite strong immunity, proper metabolism and good genetic data. Consequently, the risk of developing any dental diseases (pulpitis, periodontitis, secondary caries) is low. However, this does not mean that you do not need to go to the dentist after the filling has dropped out. This means only that your body is able to withstand the pathogenic flora longer before irreversible structural changes occur in the tooth. Also, it is always worth paying attention to the dental diagnosis, about which you were treated. After the fallen out seal after the treatment of periodontitis requires an early appeal to the dentist, and the loss of a seal after the treatment of chronic middle caries allows you to apply for several weeks (provided that during this period, the rules of hygiene, diet and antiseptic treatment). In any case, with a sealed seal, try to contact a specialist as soon as possible.

Thus, you will help your health to save resources, and to the dentist - to restore the tooth defect as qualitatively as possible.