Large filling fell out -- saw dentist, adamant they can save tooth but 1 month time?

[Whyohwhy12]

Hi,

You might have seen my thread on the general board area of the site (i forget the exact name now) and how I eventually dragged myself to the dentist for the first time in 14 years. Lots of fillings and one extraction. However the one that is bothering me most is a large old lower right molar filling that came out recently (3 weeks ago), and it's what prompted to think of dental health and to join the board.

I saw the dentist as a new patient as I've paid to go private (on NHS waiting lists locally for up to 4 years in some places...) so had a thorough examination, x-rays and even 1 extra on that side, and the dentist didn't make a big deal about it at all. When she said 'unfortunately that one will have to come out' I even said 'oh, this one here on the bottom?' and she's like no, it's not that one, it's another that I have a low chance of saving even with some heroics and extra cost but on balance I don't recommend trying. Okay fine.

Thing is it's large, like on my sheet it's down as composite normal large MODL, and it looks like half of the entire tooth is exposed. It looks like if you chopped a log for a fire but it just held on at the bottom, but half the log still fell away anyway. How am I supposed to manage this for an further month (and that's assuming it's the first one they tackle as I have 4 appointments)? It's so difficult to not chew on that side, and prior to the dentist when I chewed on that side not thinking I got a funny feeling of ''stop that right now'', not a pain, just an awareness of it being there and being vulnerable.

I'm not sure if sending me on my way with it and not discussing how to minimize damaging it further is just their confidence in saving it, or if it slipped her mind in our general discussion about how to tackle everything, same as my appointment not being for a month. How durable is this area really? I had stupidly sporadically chewed on it prior to the dentist and it was still salvageable, but how can I ensure it holds up and doesn't turn into a RCT and crown (which I can't really cover, so in that case it'll be extraction). I'm obviously now extra vigilant with brushing/flossing, but can I brush directly on this area?

 

[letsconnect]

Any chance of a photo and/or X-rays @Whyohwhy12 ? Might make it easier for dentists to comment. And belated congratulations on making that first visit

 

[Whyohwhy12]

@letsconnect hi, I don’t have any X-rays to hand but I can try take a picture later.

The dentist was 100% sure it’s salvageable to the point she didn’t even really sweat it when I bought it up, and they took another x-ray of that side anyway which is where my extraction will be just on the upper side (she said my right side has more work than the left) and I’m down for a MODL large composite on it (& it’s costing me 285£). Maybe the large MODL will indicate the damage I’m talking about.

I guess to simplify my question it would be “how do I keep a tooth like that safe from any further damage for an entire month so I don’t end up with a RCT/crown?” and “how durable is a tooth like that? If I chew on it will it damage the now exposed inside portion?”

 

[Gordon]

I guess to simplify my question it would be “how do I keep a tooth like that safe from any further damage for an entire month so I don’t end up with a RCT/crown?” and “how durable is a tooth like that? If I chew on it will it damage the now exposed inside portion?”

You can't. A month really won't make any difference whatever to the outcome. Just be a bit careful when chewing very hard stuff and don't do anything daft like open bottles with it!

 

[Whyohwhy12]

@Gordon thank you, no bottle opening here! So how durable is the inside if a large filling falls out? Feels kind of morbid talking about it and gives me the chills but I’m curious. In my head it would all be extremely soft and delicate, so I’m paranoid it’s going to turn into an extraction somehow.

But my dentist happily sending me away without even discussing it much makes me think it’s more durable than I suspect? Especially considering my appointment isn’t for a month.

 

[Gordon]

Obviously without looking at it it's not possible to give 100% guarantees, but it's probably pretty strong, assuming that it's a clean break without too much decay present.
I broke an upper molar just at the beginning of lock down, took about 8 months to finally get it sorted, it was fine. It was a bit sharp at the edges but my wife's best nail file sorted that out (don't tell her!). Worst part was paying for the new crown

 

[Whyohwhy12]

I assume it's salvageable after a thorough new patient investigation, two x-rays on that side and the dentist not even being phased when i asked if that's the tooth for extraction and she said it wasn't. It wasn't even a 50/50 kinda thing, or a 5/95 situation like the other tooth that she suggested to extract because even with some heroics it's likely not to work and just cost me. She just brushed it off this one as just another large filling like it's nothing.

So I'm just worried as it's so exposed that the condition is going to deteriorate seeing as I'm not there till June 18th, so a month from now. It's already been two weeks since I lost the filling. Can the inside structure of a tooth hold up like that with such a large filling lost? It's practically the entire back half that's gone. How strong is the dentin? I'm hoping that as you said it was a pretty clean break, and all that needs to be done is almost a like for like replacement and there wasn't much further decay around it to write off the tooth entirely. I guess I won't know their thought process behind their confidence that it's just a large filling, but to a layman it seems bad because of how it looks, so I just worry.

It just feels like a ticking time bomb and one accidental chew too many is going to somehow damage the nerve or its supporting structure or something so I have no choice but to get a RCT/Crown or extraction. If you had drilled in prep for a large filling on someone, but didn't actually do the filling, could that tooth hold up for a couple of months still?

8 months makes me feel a bit better about things however.

 

[Gordon]

So I'm just worried as it's so exposed that the condition is going to deteriorate seeing as I'm not there till June 18th, so a month from now. It's already been two weeks since I lost the filling. Can the inside structure of a tooth hold up like that with such a large filling lost?

I can't say for sure without seeing it but your dentist has and seems happy to leave it, so I'd say it'll be fine.
Just be careful not to chew anything stupidly hard with it and it'll be OK.