It’s the stuff of nightmares – the dream of a mouthful of cracked and crumbling teeth leads to waking up in a sweaty tangle of sheets. But what happens when you actually experience a cracked tooth filling? Relax. It’s no time to panic. Here’s what you need to know.

What happens when fillings wear out?

In a perfect world, the fillings we receive for cavities would last forever, with no complications and no need for any special treatment. Just as in the nightmare scenario, this is not realistic.

It’s an unfortunate reality that fillings aren’t meant to last forever. The pressure of chewing (compounded if you suffer from bruxism) stresses the filling and the filled tooth, eventually causing both to wear out. In general, amalgam and gold fillings last for between ten and 15 years, and composite fillings begin to wear within five. Ceramic fillings last as long as gold, and glass ionomer fillings (used most often in young children) are durable for five years or less.

If fillings begin to wear out, they can crack and fall out of the tooth altogether. There is also a chance that they will begin to allow bacteria underneath the filling itself. This can lead to recurrent caries and even more serious decay that reaches the nerve. When this occurs, the only treatment may be a root canal.

Because a cracked tooth filling can lead to more serious oral health issues, it is important to recognize cracked filling symptoms.

How to tell if filling is cracked

The most obvious of cracked filling symptoms can also be one of the most alarming. You may feel a foreign object in your mouth that is not a bit of food, and you may mistake it for a piece of your tooth (this is usually not the case with silver fillings).

When the tooth filling cracks but does not come out of the tooth itself, look for the following symptoms.

  • Pain when chewing or biting
  • Sensitivity to heat, cold, or sweet foods
  • Pain that fluctuates
  • Swelling of the gum around the affected tooth
  • Bad breath

These are the same symptoms you might experience with a cracked tooth. In many cases, a cracked tooth can lead to deterioration of a tooth filling. When decayed natural tooth material is removed to make way for a tooth filling, the structural integrity of the tooth itself is compromised. This can cause a cracked tooth and a cracked tooth filling to occur, either at the same time or one right after the other.

What should I do if I have a cracked tooth filling?

If you find yourself with a cracked filling, call your dentist. While this is not considered a dental emergency, it is important to get an appointment as soon as you can. Any cracks in the teeth or fillings opens space for bacteria and food particles to get lodged underneath the tooth. It’s important to clean that space and seal out bacteria as soon as possible.

There are a number of ways to fix a cracked cavity filling. Generally, your dentist will take the following steps to treatment when you come in with a cracked tooth filling.

1. Assess the damage

The first step is an assessment of symptoms and an X-ray to see if there is visible decay in or underneath the tooth.

2. Create a treatment plan

There are many possibilities when it comes to a cracked tooth filling (and a cracked tooth). If the cracked tooth filling has deteriorated and fallen out but there is very little (if any) new decay, your dentist can simply replace the filling.

If an X-ray reveals deeper decay that reaches into the tooth’s soft dental pulp and nerves, a root canal may be necessary to save the tooth. This occurs when the tooth filling has been cracked and symptoms of decay have gone untreated. In very rare cases, the decay can be so extensive that extraction is the only option. This is so rare because the cracked tooth filling pain would be extreme long before this point is reached.

If the tooth itself it cracked, the degree of cracking dictates the treatment. A tooth cracked down the center all the way beneath the gum line will need to be extracted, but some other types of cracked teeth may be saved.

3. Receive a dental restoration

If your cracked tooth filling has led to decay that requires a root canal or an extraction, you will need a dental restoration. In the case of a root canal, a dental