Lost or Broken Filling
A fractured, ditched or dislodged filling that is broken or lost may cause discomfort or sharp pain due to jagged edges. There can be aesthetical concerns if the filling is in a visible area. Patients need to be aware of the sharp edges and ensure their tongue does not constantly apply pressure around that area, as it can cause cuts to the tongue. However, in some cases the result of the loss of a filling can cause irritation to the side of the cheek and potentially lead to an ulcer. Sharp edges can easily be dealt with by levelling the filling or tooth edges from your local dentist during the emergency appointment. Hypersensitivity issues may also arise, short sharp pain caused by exposed underlying dentine, after the deterioration of the filling material.
During the emergency appointment the dentist will need to take a set of radiographs to assess for any underlying caries, bone loss or possible abscess. The clinical examination will detect the reasons behind the failure of the restoration. Upon treatment the dentist will provide options on the tooth’s prognosis, these may include a new restoration, extraction, root canal or placement of a crown. The tooth prognosis includes the tooth’s vitality and restorability.
Crowns can become broken by a fracture, non-retentive preparation, secondary caries, weak cement, excessive occlusal forces, decementation or loosening of the crown. The consequences of a crown becoming loose include the risk of ingestion and less likely, inhalation. The management of the loose crown includes immediate recementation or a replacement crown, depending on the assessment conducted by the dentist.
A fracture can involve any damage to the denture. Any type of repair to the denture is much less ideal then making a new one.
Broken or Loose Implants
Implant success is relatively high, the rate of implant survival is between 85-95%, although it is not uncommon for emergency management of a failing implant or one of its components. The failure is most likely due to infection of the implant. It is highly recommended to visit or refer patient to the specialist who provided the implant.
Late failures that occur with implants are usually due to moderate to severe bone loss, mostly located in the posterior areas of teeth and involve a multi-unit prosthesis.
A fracture or decementation of a post or loosening of the abutment screw of an implant could be the result of dissolved cement, secondary caries, use of a weak post, or excessive occlusal forces.