Home » Conventional » Dental fillings » How drilling and filling can damage teeth

1. Drilling and filling teeth: general considerations and objections

Nothing a dentist does will ever heal your tooth. Much more likely, it will in fact increase the damage to your tooth since the tooth is  weakened by drilling and subsequent filling with artificial materials (see below for the numerous reasons). A filling typically doesn't stop the tooth's decay, and once filled,  more fillings and treatments will appear to be required (unless you decide to ditch all dentists and fare by yourself).  Amalgam and  composite resins only "repair" the tooth for a certain time since there is no restorative material capable of protecting a tooth from further decay for its entire life. In sum: in great likelihood, having a tooth filled is the first step towards eventually losing the tooth.

2. Drilling damages and possibly kills teeth.

See Pulp (inner nerve) damage, pulp irritation, pulp inflammation/infection and pulp death.

3. Preparing a tooth for a filling removes healthy tooth structure.

To place a filling so it is securely fixated, the dentist drills out some of the sound tooth structure to allow proper anchoring. When a filling is renewed, more sound tooth structure is sacrificed.

4. Fillings typically have a finite lifespan.

When the filling is replaced some time later, more healthy tooth substance will be sacrificed, until after several such "merry rounds", the tooth is gone.

In fact, a 1993 study by author Monika Sinha analyzing  the treatment records of some 18.000 patients and several hundred dentists determined that one in three fillings was being re-treated three years after the original placement at the latest, either by placing a new restoration, crowning or even extracting the tooth.

No filling reportedly lasts indefinitely.* Gold cast fillings when carefully prepared are said to be able to potentially last 30 years/a lifetime (in contrast for instance with Class II gold inlays, 50% of which according to one study will fail within seven years).

* though there will be exceptions - although reputedly among the least stable fillings, I know a person who has carried the same composite fillings for 30 years (and counting) - and in her wisdom teeth at that.

5  Bacterial contamination adjacent to and underneath fillings causes new tooth decay ("secondary caries").

At the junction between the filling (incl. the "best" of them) and the remaining natural tooth/existing dentin, a residual micro-gap is unavoidable. This gap or missing seal can be colonized by streptococcus mutans bacteria which are impossible to be removed by brushing*.  These cariogenic bacteria will increase caries risk and possibly decay the tooth underneath.  The infiltratation process is further aided by the normal expansion or contraction of the filling (see number 6 below).

Tooth decay at the margin of an existing restoration or crown is so commonly diagnosed that it has been given its own name: "secondary caries" (or recurrent decay). Secondary caries is the most commonly encountered cause of restauration failure and subsequent replacement and can be considered the biggest problem of the filling paradigm.

Similarly, many a filling has to be replaced due to bacterial contamination left under the filling. In fact, the primary reason for root canals (which deal the death blow to the tooth by removing the pulp) is recurrence of bacteria underneath the filling. This is a known fact but many/most dentists will fill the tooth anyway. When food for these caries bacteria manages to reach them (see the first paragraph of this section for how this is possible), this will kill the tooth.

* but possibly by antibacterial chlorhexidine as well as anti-cariogenic xylitol rinses

6 Fillings expand or contract.

Amalgam

"Silver" fillings expand with age. In fact, amalgams are able to crack the tooth. Drs. Graeme and Lilian Munro-Hall write that "all amalgam-filled teeth are cracked; no exception". For other possible consequences, see below under Badly adjusted fillings/crowns.

Composite resins

Composite fillings shrink. Gaps created by shrinkage invite bacterial contamination (see number 5 above). Composites can provoke hairline cracks in the tooth as early as during the initial hardening process. (A reader told me that one of her teeth  with a resin filling cracked in half after some time, front to back to the base.)

7 Fillings corrode, abrade, dissolve and outgas, leading to the release of extraneous products & substances with sometimes toxic effects

It's not just food but all materials undergo changes in the harsh conditions of the oral cavity, releasing some of their components to be absorbed into the body.

Metal fillings

There are more than one thousand different dental alloys* in use (none of which have been safety-tested). Faraday's Law states that "dissimilar metals in a moist environment will release the least precious metal". In other words, these dental alloys will corrode and release metal ions into your mouth and body. This is considered particularly dangerous in the case of amalgam fillings (mercury release). Others such as nickel (from non-precious metals such as stainless steel) can be antigenic (i.e. stimulate the production of an antibody). Additionally, saliva constitutes a "salt bath" so that an array of metallic fillings may generate electricity (like in a battery) or form an artificial electromagnetic structure affecting the body's meridian (energy) system.

*  An alloy is a substance composed of two or more metals intimately mixed (Webster's).

Composite fillings

Composite resin fillings are particularly non-resistant to wear and by outgassing, dissolving and/or abrading acrylic resins, will/may release many potential allergens/possibly toxic substances/possible carcinogens, incl.  estrogenic compounds (BPA or bisphenol A) into patients' saliva (the same can apply to denture bases). 

Abrasion will be exacerbated by teeth clenching and grinding (compare Dental glossary: bruxism and Healing brusixm).

8. Dental cements can be toxic and damage the tooth (acidity, leakage and tooth decay and death)   

Cements which come in a variety of types (zinc cements, polycarbonate cements, composite cements and many others) are used for a number of dental applications (such as cavity-lining, insulation under metal or ceramic fillings) and help in  fixing fillings to enamel and/or dentin.

All dental permanent cements release (toxic) fluoride². For instance Viviglass Cement states that their product "continuously releases fluoride." Fugi Triage Cement boasts that their cement "releases 6 times the amount of fluoride than any other glass ionomer cement. " Additionally, most temporary cements are flavoured and scented with added ester odorants. These flavours are genetically modified and made to last, as are the fluoride-releasing cements. (A site visitor wrote that the least toxic permanent cement material which also has the least fluoride release seemed to be RelyX Unicem. "If there may be others that are low in fluoride, I couldn't find them.")

Dental cements also release either bisphenol A glycidyl methacrylate (BIS-GMA) or other chemical substances, or they are acidic.

According to dentists Drs. Munro-Hall, older types of cement generally "cause less problems of a systemic nature than newer types, but the older types of cements are more acidic and can cause teeth to become sensitive or even die."

Additionally, cements can gradually dissolve (a property which is less pronounced with composite cements, however), with subsequent leakage of the restoration and new tooth decay beginning to form underneath. This secondary caries process which can happen very fast under composite fillings often seems  to be slowed, however, in the case of metal fillings and is most likely due to the toxic nature of the metal alloys used in the fillings which at least temporarily inhibit bacterial growth. Since teeth are also nourished from the inside and via the saliva, a person's diet will influence how quickly tooth decay will set in underneath as well.

9. The pulp (inner nerve) can be damaged and irritated: pulp inflammation/infection (incl. bone infection) and pulp death can result.

During drilling and filling, the tooth is subjected to multiple mechanical and chemical traumata which may first inflame and eventually spell the death of the pulp and thus the tooth. Damage to the pulp of the tooth and its eventual death can occur by a number of pathways.

a) High-speed drilling

High-speed drilling creates microscopic fractures and damages the tubules.  When  enamel is removed and microcracks are created in the dentine, the inner nerve frequently is damaged, often killing the tooth in the longer term via  nerve death.  (If you look at this high-resolution picture of dentin, you will better see how drilling at high speed can indeed damage these filigrane structures.)

b) Drilling too fast

"Going over the speed limit" (eg during the preparatory work for a bridge or crown) will create too much heat. (Author Rosemarie Mieg writes that for placing a crown, teeth need to be filed for 20 minutes to avoid overheating and resultant pulp death.)

c) Removing too much enamel

Dentist Dr. Graeme Munro-Hall writes, "Removing the enamel and making the micro-cracks in the dentine quite often, but not always, damages the inner nerve. The damage can cause the nerve to die slowly over years allowing infection to take hold. This infection can spread from the tooth to the bone and cause acute conditions, pain and abscesses as well as chronic pain-free infections in the tooth and bone. Overheating the tooth during drilling can create the same conditions as well for the nerve or pulp. All infections create toxic load... the greater the amount of enamel left behind after a tooth is prepared for a crown or bridge, the greater the chance of survival for that tooth ... Crowning should be the last choice ... not the first choice."

Veneers not infrequently trigger pulp death (veneering removes more than half of the tooth enamel).

d) Placing inlays or crowns

may cause nerve inflammation leading to the dentist devitalizing the nerve. In fact, crowning  not infrequently triggers pulp death. Death of the pulp after crowning is the main reason for later extractions. Compare b) and c) above and badly adjusted fillings or crowns further down.

e) Etching teeth with acids

Teeth are etched with acids to allow the filling to bond with the sound tooth structure. This also allows bacteria to penetrate into the tooth's interior where they can trigger serious inflammation.

f) Adhesives

Bonding systems used to attach the filling to the teeth can damage the pulp and lead to pulp death.

g) Restorative materials

such as dental composites can irritate/damage  the nerve (pulp). When the work isn't done carefully,  the acid plus restorative material used can have a toxic effect leading to the death of the tooth.

h) Vibrations of the drill

The pulp of the tooth can be killed by the vibrations of the drill.

10 Drilling helps cariogenic bacteria to quickly penetrate deeply into the tooth

...much quicker than they could penetrate on their own to destroy the tooth (assuming that no proactive action is taking by you and your body to stop them in the first place).

11 Metal fillings absorb and re-emit microwaves.

According to specialist Barrie Trower all metal fillings, be it amalgam, gold or titanium implants in the mouth (in fact any metal inside the body) will absorb microwaves and re-emit them into the body, typically at a slightly different wavelength, which can result in quite a serious internal heating effect. Suffering from pins-and-needles sensations is most likely caused by this.

12 Dental composites and bonding systems can damage the gums.

13 Dental composites ingredients encourage bacteria.

Composite resins contain ingredients that facilitate bacterial attachment to the tooth and  gingival margin. The above-cited secondary caries developing at the margin of the tooth is particularly prevalent in composite restorations. Some earlier resin-based composites made from TEGMA apparently  encourage microbial growth, i.e. further tooth decay underneath the filling.

14 Restorative materials and cements can emit low-intensity radioactivity.

Certain types of fillings (eg dental ceramics [aka porcelain] used in crowns, bridges and veneers) as well as cements emit low-intensity radioactivity. As an example, the International Organization for Standardization (ISO) permits a maximum value of 1.0 Bq/g for ceramic materials used in dental restorations (see ISO 6872).

15 Miscellaneous observed risks and dangers of drilling and/or filling treatment (incl. death in the dentist's chair)

Dental anaesthesia risks (routine dental injections)

Injecting a local anaesthetic has caused permanent nerve injury/irreparable nerve damage (such as to the lingual nerve and the inferior alveolar nerve incl. numbness and loss of taste), trigeminal neuralgias, and even permanent facial paralysis.

Side effects of anaesthetics include allergic reactions (even allergic shock), hoarseness, chronic difficulties in swallowing,  nausea and emesis (vomiting), and death in the dentist chair (yes, do an internet search, as an example, the number of people dying yearly in a dentist's chair within Germany is estimated at 1000).

Dental x-rays and cancer

Dental x-rays have a contributory role in thyroid cancer (more at Ionising radiation from dental X-rays and increased thyroid cancer risk).

Badly adjusted fillings/ill-fitting crowns

Possibly more common than assumed, badly adjusted fillings or ill-fitting crowns will lead to problems with the bite (malocclusion), make the teeth sensitive to pain, can trigger neck and back pain, tinnitus (one tinnitus case I've read about involving a French man was healed after years of intense suffering when his teeth's malocclusion due to wrongly placed metal fillings was finally resolved), as well as migraine and inability to sleep (waking up from pain again and again as the mouth involuntarily closes). Another case reported on the French-language internet involved a man who was driven to suicidal feelings due to constant pain and sleeplessness from a crown that was too high, with his dentist instead of admitting and remedying his mistake, accusing him of somatizing psychological issues. Generally speaking, a crown that is too high and which is not corrected will first lead to much pain, then the tooth it is placed on will loosen, bacterial infection sets in, and eventually the tooth will fall out. (Re crowns, also compare b), c) and d) above.)

Effects on adjacent tissues

Neighbouring teeth/gums can be damaged, drilling can injure mucous membranes, tongue and  bone tissue.

Sepsis

An  inflammatory state of the whole body an be triggered.

Periodontal diseases

Gum problems incl. loss of teeth can be triggered.

Death in the dentist's chair

The fact that some people incl. children die in the  dentist's chair (such as upon receiving anesthesia, see above) is also "helped" by the fact that many/most offices appear to lack  the required equipment, medications and  emergency guides to deal with medical emergencies (such as automated external defibrillators, vital sign monitors, emergency drug kits and portable oxygen) and/or the skills and training to handle emergencies and machinery  and are thus unable to provide basic life support, cardiopulmonary resuscitation and whatever else may be required to save a life.³

Footnotes

1 Compare Advice on what to do when you can't or don't want to see a dentist.

2 See The harmful effects of fluoridation: fluoridated water and toothpaste damage teeth and body.

3 More dental procedures which have led to the death of patients are discussed at Tooth extractions: potential health risks and dangers (incl. death) and Root canal treatment: potential (short-term) complications incl. irreversible brain damage and death.

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