For some people, going to the dentist for a filling is an experience they want to avoid. With proper oral hygiene and regular check-ups, cavities and subsequent dental fillings can be prevented. Even after a filling is placed it still needs to be maintained otherwise, it could fail and lead to further dental work. There are many causes for dental fillings to fail such the recurring tooth decay or the filling dislodging. How can filling failure be prevented? Is failure caused by the filling material?

Filling Failure

A recent study has found that the periodontitis-causing bacteria can also lead to dental filling failure, rather than the filling material itself. Those people who drink alcohol or more specifically men who smoke are at a higher risk of suffering from a failed dental filling. Additionally, there is also a genetic difference between some of those patients who experience failure.

Contrary to prior belief, these failure rates show no major difference between the traditional amalgam fillings and the modern composite resin. These results also suggest that personalized dental treatments could help the overall outcomes since they would take into consideration different habits of the patient.

Types of Dental Fillings

There are two types of filling material commonly used by dentists. Amalgam fillings were once the most common type and had been used for over 150 years. They are composed of a mixture of metals such as mercury, which is toxic and banned in several countries.

The more modern alternative is the composite resin filling. While these fillings do look better and aren’t toxic, they are more costly and challenging for dentists to fit. It’s also still up in the air whether composite fillings are as durable as those made from amalgam.

Researchers from both America and Brazil analyzed patient records from the University of Pittsburgh School of Dental Medicine Dental Registry for their DNA Repository project to determine if the filling materials had any effect on their rates of failure. They looked at the failure rate up to five years after the initial procedure and then looked at information about the patient’s lifestyle, including their drinking and smoking habits along with a DNA sample.

Amalgam vs. Composite Filling Failure

From this data, the researchers found no notable differences in filling failure rates between those patients who received amalgam or composite fillings. These results suggest that composite fillings are as durable as amalgam fillings, and remain a viable alternative without any toxic ingredients.

They found that the patient lifestyles, including smoking, drinking, and genetics could affect the failure rate of their composite fillings. For those patients who drank alcohol within the two-year period after surgery, their fillings failed more often. Overall, men who smoked experienced the highest filling failure rate.

The researchers used patient DNA samples to look at the genetic differences between those patients with failed fillings and those without. They found that an increase in filling failure was linked to the gene for matrix metalloproteinase (MMP2), an enzyme found in teeth. Researchers hypothesize that this MMP2 enzyme could be capable of degrading the bond between the tooth and filling, leading to potential failure.

While this hypothesis is interesting to consider, researchers must continue to investigate the connection between the MMP2 gene and how they could be responsible for failed fillings. These results do, however, suggest that these personal habits of patient’s do influence their likelihood of filling failure as opposed to the filling material used.