Filling trauma, new study finds fillings are rotting teeth

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1.-FilingsThe Journal of Dentistry has recently published a study revealing that fillings could do more harm than good, potentially damaging surrounding teeth.

The researchers discovered that after five years, that six out of ten teeth that sat beside a filling were decaying. Experts have suggested that the secondary decay is due to the trauma of the original filling.

Spokesman for the British Dental Association, Professor Damien Walmsley, told The Express, “This study highlights the fact that dental intervention can cause more harm than good. More research is urgently needed to find out why dentists could be causing these problems.”

Further issues surrounding the provision of fillings arose from this study when it was found that particular dentists had a correlating commonality in patients who developed further decay.

“Once a dentist has gone into a tooth, they may accidentally damage another tooth. Dentists need to keep up to date with the latest techniques to ensure they don’t damage other teeth when they do a filling,” explained Birmingham University’s dental expert Professor Walmsley.

The study’s lead researcher, Simen Kopperud from the Nordic Institute of Dental Materials, Oslo, explained that filings were not a complete answer to the issue of decay. “The most important message is that if restoration takes place in one place the problem of decay is not solved. It is highly possible that the intervention by the dentist causes a problem in adjacent teeth. Fillings are not an ideal solution but at the moment it’s the best solution we have.”

This is the second such study to indicate that dentists need to keep abreast of new developments and protocols in dentistry. The earlier paper, researched at Birmingham University found that fillings done by younger dentists did not fail as quickly as those done by older ones.

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4 COMMENTS

  1. Interesting to read this but I have reservations about the study. The original article can be found here: http://www.sciencedirect.com/science/article/pii/S0300571215300385
    Some key points about this paper that were not mentioned in the summary above and may be misleading to a member of the public who happens to come across this on a simple Google search and become concerned are as follows. 1) Interproximal caries incidence was the dependent variable. There are multiple risk factors for smooth surface caries, the dental practitioner placing a restoration on an adjacent tooth is not likely to be high on the list. For this reason, the title on this news feed is misleading. 2) Inclusion criteria for this study required patients to be <17 years to permit 4-5 year follow-up. Again, caries risk is high in this population and it is clear that incidence of caries reduces with age so the results of this study may not be applicable to adult populations. Again, there was no mention of the sample being children or young adults in the synopsis above. 3) 44.4% of the teeth had enamel-surface caries at baseline and of those, ~40% developed into dentine or were restored during the follow-up period. The only statistically significant risk factor OR [95%CI] 1.06 [1.00, 1.13], P=0.04 following adjustment for confounding in this group was having a high DMFT index to start with. To put it plainly, the people who developed more decay during the follow-up period started off by having a greater caries experience and this risk was 6% higher compared to those who had a low DMFT. Additionally, the lower limit of the 95% confidence interval relating to this odds ratio is 1.00 (meaning that it is absolutely possible that there is no increased risk) compared to having lower DMFT at baseline.
    I could go on much longer about this study but I would like to conclude by stating that as a medium for disseminating information to dental clinicians and the general public, caution must be used when interpreting research findings. We don't need the public avoiding accessing dental services because they fear visiting will do them harm.

  2. I find the title of this article misleading and the conclusions strange.

    I my experience, if tooth decay occurs on one surface between teeth, there is a high risk of tooth decay forming on the adjacent tooth due to the same factors that lead to the decay in the first place. Leaving the tooth decay untreated leads to loss of the tooth or expensive and more invasive treatments such as root canal therapy. Untreated tooth decay will lead to increased risk of tooth decay in the adjacent tooth.

    Fillings do not cause tooth decay. Operator error would predispose further tooth decay, but this is an obvious conclusion. If a dentist accidentally drills a hole into a tooth, of course it will be in risk of decay. The incidence of a skilled dentist having this happen is low.

  3. I agree entirely Kostas.
    I believe this study has been hijacked and the stupid conclusions were drawn purely for sensationalism. The public know nothing about tooth decay but they love to read anything that gives them the excuse to avoid visiting a dentist, or even bothering to brush their teeth for that matter.
    I will throw this article in the bin with the anti-fluoride quackery and other ideas spreading ignorance.

  4. I have come to the same conclusions as Kostas , Tony and John , even before reading their posts. Too many articles using so called evidence based research end up producing inferences contrary to what the research indicates. Clinical advice is still the best.

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