Restoration failure


A dental restoration is a replacement for parts of a tooth or for missing teeth. Ideally, a good dental restoration should stop decay and allow for chewing, restoring the function, esthetics and comfort. Metal, ceramics and resin composites are the most used materials for dental restorations in adults.

Restorations can be direct, when the material is placed directly into the prepared tooth, or indirect, when the tooth is prepared, an impression is taken, and the restoration is prepared out of the mouth and bonded or cemented in place.

The most common types of dental restorations include:

  • Fillings: direct restorations, replaces small to medium loss of tooth structure, usually made with tooth-colored composite resin.
  • Onlays and inlays: indirect restorations for medium to large tooth destruction.
  • Veneers: indirect restorations, very thin partial crowns that usually cover the outer part of a front tooth.
  • Crowns: indirect restorations, also known as caps, replace large loss of tooth structure to reinforce the remaining parts and recreate the shape of the tooth. It can be made of different materials and it can serve as anchor for a bridge. Crowns are also used with dental implants.
  • Bridges: indirect restorations, used to replace missing teeth using crowns as anchorage.



Dental restorations can fail in many ways and this is a big clinical problem. The most common causes for restoration failure include:

  • Tooth decay. The development of gaps between the material and the tooth can cause retention of food debris and bacteria, which can result in decay underneath the restoration.
  • Problems with the material. Most dental materials can chip and crack.
  • Problems with the bonding or cementing of the material to the tooth and leakage. Bonded restorations can get debonded; cemented restorations can get loose and lost.
  • Trauma, excessive forces, bite problems.



The way the teeth come together when you bite or chew affects the structure of each tooth, as well as the gums, jaw muscles, jaw joint, head and neck. These forces can cause teeth and restorations to break down when they are out of balance.

Thus, a bad bite puts more pressure on certain teeth, and if they have fillings, crowns or any kind of restoration, those are at increased risk for fracturing.

Teeth grinding and clenching, often linked to a bad bite, add further pressure to teeth and restorations. Cracked fillings and teeth are not a rare finding in people who grind their teeth.



Diagnosing a failing restoration before disaster strikes can be very challenging. It is very important to attend regular follow-ups at the dentist, so early problems can be detected before it is too late.

Visual inspection and x-rays are good tools that allow the dentist to judge the integrity of your restorations. Ideally, a suspicious restorations should be replaced. If a dental restoration is associated with signs of tooth decay, gum inflammation or pain, it should be addressed as quickly as possible. Waiting too long can have serious consequences, such as inflammation, death of the nerve, fracture of the remaining tooth structure and tooth loss.



If you have symptoms such as chronic headaches, problems in the jaw joint, pain in the muscles from the jaw and the face, tooth wear and sensitivity, chances are that your bite is not balanced. As mentioned previously, a bad bite can lead to fracture of teeth and restorations; it can also worsen oral and general health.

The best way to modify the position of the teeth to improve the bite and prevent breakdown of teeth and restorations is through orthodontic treatment. Reshaping and adjusting old restorations may also be needed.

Adults can benefit from orthodontic treatment with clear aligner therapy, such as Invisalign. With this treatment option, teeth are gently corrected through clear plastic devices. They are removable, making eating and cleaning easy. Regarding appearance, clear aligners are discrete, making it a convenient solution.

Talk to your dentist and get all your restorations and your bite checked.