Intra-Oral Cameras – What Can You See? A Case Study – The Filling, The Crack and The Decay

The photo above shows a dark line crack leading away from the centre of the tooth to the lower right corner of the photo. The decay is the dark tan colour. The white material was used under the filling to protect the tooth, called a base.

The amalgam filling looked suspicious as it looked like it was sinking into the tooth, as shown below.

The colour around the filling that was within the filling was unusual. There was no decay on the x-ray below, but the base was large and deep (the less than white material under the bright white of the metal filling).

Now after removing the metal filling the white base is exposed with the darker decay surrounding it.

In the past bases were used extensively to protect the nerve of a deep decay. We now know that over time with successive chewing and grinding of teeth, the tooth flexes and the base (which is softer than amalgam) compresses. Eventually the filling leaks. The amalgam starts to sink into the tooth. Bacteria travel into gap around the filling. The amalgam corrodes and stains the decay a dark colour.

The weakened tooth, under pressure, develops a crack allowing more bacteria to join the party. This process does not always occur with every amalgam with a base, however over time, usage and changes to the bite, can have an effect on a tooth which has less of the original stuff!

The camera shows under magnification and its own light source, a better view of what is happening to the tooth.

The filling, the crack and the decay.