Will Temp Filling Hold???

[alfatodd]

Hi Everyone!

I'm going diving off Wilmington, NC soon to a maximum depth of 85 feet and have a temporary filling. Do you think it will hold? Has anyone had any diving experiences to share involving temporary or permanent fillings?

Thanks much,

Todd
Annapolis, MD
Sherwood Oasis Reg
Sherwood Avid BCD

 

[Laurence Stein DDS]

Hi Todd,

Perhaps, a definite maybe....it might depend upon what the temporary filling was used for and if the underlying reason could be problematic.

Some reasons for a temporary filling:

1) Something to keep the food out after a permanent filling broke and before it could be fixed permanently. Probably can dive but bring some extra temporary cement in case it comes out.
2) Treatment of a sensitive tooth. A temporary sedative filling can eliminate sensitivity. That tooth however may also be headed toward a root canal. If the vitality of the tooth is in question...wait to dive.
3) Caries control. Used in patients with multiple deep cavities. A quick way to remove decay and allow time to go back and restore as indicated. If these cavities are deep you might want to wait on diving.
4) To plug the opening into a root canal. It may be used between root canal visits or at the end of the treatment but before a final restoration is placed. Make sure the root canal is completed and check with the dentist to make sure there is no cotton ball inside, under the filling. Don't dive if the root canal is incomplete.

I'm sure there are more reasons. What is important here is that in cases of root canal treatment, there may be a piece of cotton placed under the temporary. This has the potential to cause serious problems while diving. Have the cotton removed and a durable temporary material placed.

If a root canal has been started but is not complete, it would be best to avoid diving. There will be an air space guaranteed. Does the word, BOOM!!! mean anything? :11:

Something else to consider...how far away is your dentist and how long will you be away diving. In general, a temporary is not a good idea for diving if you are going half way around the world and plan to be gone for weeks. Murphy's Law is going to work here. On the other hand, if you are diving in town and just over the weekend, a temporary used to plug a hole left by a broken piece of filling may be OK.

A sedative temporary filling may be placed in an effort to see if a tooth MAY need a root canal. If the vitality of the nerve within the tooth is in question, it may be best to resolve the problem before diving.

BTW, you can purchase temporary cement at the pharmacy for emergency use. Mix it as per instructions and squash some into the hole if the previous temporary comes out...sort of a save-a-dive in a tube.

Why don't you let me know why the temporary is there and I can give a better answer.

Regards,

Laurence Stein, DDS
:doctor:

 

[alfatodd]

Thanks for the info Dr. Stein. Here is some more info for you. It is a temporary filling in a molar in preparation for an onlay that will be inserted after my dive trip. I had some decay under an amalgom filling and a new, smaller cavity on the outside of the molar. So, my dentist said I would be a good candidate for an onlay since it will be a wrap-around filling. I will be 7 hours from my dentist, but my trip will be cut 3 days short if my temp filling pops out. My dentist is currently on vacation, so I won't be able to have the permanent onlay inserted until after my dive trip. What do you think will/might happen?

Thanks,

Todd

Hi Todd,

Perhaps, a definite maybe....it might depend upon what the temporary filling was used for and if the underlying reason could be problematic.

Some reasons for a temporary filling:

1) Something to keep the food out after a permanent filling broke and before it could be fixed permanently. Probably can dive but bring some extra temporary cement in case it comes out.
2) Treatment of a sensitive tooth. A temporary sedative filling can eliminate sensitivity. That tooth however may also be headed toward a root canal. If the vitality of the tooth is in question...wait to dive.
3) Caries control. Used in patients with multiple deep cavities. A quick way to remove decay and allow time to go back and restore as indicated. If these cavities are deep you might want to wait on diving.
4) To plug the opening into a root canal. It may be used between root canal visits or at the end of the treatment but before a final restoration is placed. Make sure the root canal is completed and check with the dentist to make sure there is no cotton ball inside, under the filling. Don't dive if the root canal is incomplete.

I'm sure there are more reasons. What is important here is that in cases of root canal treatment, there may be a piece of cotton placed under the temporary. This has the potential to cause serious problems while diving. Have the cotton removed and a durable temporary material placed.

If a root canal has been started but is not complete, it would be best to avoid diving. There will be an air space guaranteed. Does the word, BOOM!!! mean anything? :11:

Something else to consider...how far away is your dentist and how long will you be away diving. In general, a temporary is not a good idea for diving if you are going half way around the world and plan to be gone for weeks. Murphy's Law is going to work here. On the other hand, if you are diving in town and just over the weekend, a temporary used to plug a hole left by a broken piece of filling may be OK.

A sedative temporary filling may be placed in an effort to see if a tooth MAY need a root canal. If the vitality of the nerve within the tooth is in question, it may be best to resolve the problem before diving.

BTW, you can purchase temporary cement at the pharmacy for emergency use. Mix it as per instructions and squash some into the hole if the previous temporary comes out...sort of a save-a-dive in a tube.

Why don't you let me know why the temporary is there and I can give a better answer.

Regards,

Laurence Stein, DDS
:doctor:

 

[Laurence Stein DDS]

Hi again,

As I think I understand what you said...you have a temporary filling in a tooth that is going to receive an onlay...correct? Is that temporary filling being used as the temporary between visits for the onlay or is it a temporary filling placed in your tooth and it still has to be prepared for the onlay?

It seems like a nit picking question but it's not. Most dentists would refer to the temporary in the tooth prepared for the onlay as a temporary ONLAY rather than temporary filling. This type of temporary is fabricated to fit the intricate shape of the onlay preparation. We would refer to a temporary filling if something was plugged into your tooth but you still had to return for the onlay preparation and the insertion of the temporary onlay.


So you're probably wondering, "Why is it so darned important to know whether the tooth is prepared for the onlay?" Here's why...onlays involve partial coverage of the tooth cusps and as such have margins or finish lines that are exposed in the mouth. These margins are fragile until the onlay is completed. The onlay preparation is also shaped so that the final restoration can be inserted into the tooth...the vertical wall of the preparation are very slightly divergent allowing the onlay to be inserted.

A filling, is prepared with convergent vertical walls. Once placed into the tooth, it will not slip out unless it is broken.

A TEMPORARY FILLING will not protect the margins/finish lines very well. A TEMPORARY ONLAY offers more protection. It is usually made of plastic, carved to shape OUTSIDE the mouth and is cemented into the preparation. A temporary filling is made of a fairly soft material that is pushed into a hole, allowed to harden and carved to shape in the mouth.

There are occasions where a filling material can be used in the onlay preparation but it affords little protection against breakage of the margins.

Diving with an uncompleted onlay with a filling material inside risks chipping the margins/finish lines. If that occurs, the preparation has to be repaired or re-prepared, a new impression is needed along with a new temporary. The pressure of the regulator bite tabs on the chewing surface of you molar could predispose ruining the preparation.

If you are indeed wearing a temporary onlay rather than a temporary filling, there is another risk...aspiration of the temporary onlay if it becomes loose during your dive. Since the walls are divergent, it could become loosened and then slip out. If this happens on a dive and your are taking a breath, the onlay will end up in the lungs.

Strangely, if you simply have a temporary FILLING placed into the tooth and are still waiting to prepare it for the onlay, that filling has a better chance of not coming loose. Because it is a soft material though care must be taken not to break it.

Neither a temporary filling nor a temporary onlay is an absolute contraindication to diving but you must be careful and be prepared in case it comes out.

Regards,

Laurence Stein, DDS

 

[alfatodd]

Thanks so much Dr. Stein! I actually have a temporary "filling" in preps for a permanent onlay, so it sounds like my chances of it not popping out and me breathing it in are better. I will be careful not to bite down too hard on my mouthpiece.

Take care and happy diving to you!

Todd

Hi again,

As I think I understand what you said...you have a temporary filling in a tooth that is going to receive an onlay...correct? Is that temporary filling being used as the temporary between visits for the onlay or is it a temporary filling placed in your tooth and it still has to be prepared for the onlay?

It seems like a nit picking question but it's not. Most dentists would refer to the temporary in the tooth prepared for the onlay as a temporary ONLAY rather than temporary filling. This type of temporary is fabricated to fit the intricate shape of the onlay preparation. We would refer to a temporary filling if something was plugged into your tooth but you still had to return for the onlay preparation and the insertion of the temporary onlay.


So you're probably wondering, "Why is it so darned important to know whether the tooth is prepared for the onlay?" Here's why...onlays involve partial coverage of the tooth cusps and as such have margins or finish lines that are exposed in the mouth. These margins are fragile until the onlay is completed. The onlay preparation is also shaped so that the final restoration can be inserted into the tooth...the vertical wall of the preparation are very slightly divergent allowing the onlay to be inserted.

A filling, is prepared with convergent vertical walls. Once placed into the tooth, it will not slip out unless it is broken.

A TEMPORARY FILLING will not protect the margins/finish lines very well. A TEMPORARY ONLAY offers more protection. It is usually made of plastic, carved to shape OUTSIDE the mouth and is cemented into the preparation. A temporary filling is made of a fairly soft material that is pushed into a hole, allowed to harden and carved to shape in the mouth.

There are occasions where a filling material can be used in the onlay preparation but it affords little protection against breakage of the margins.

Diving with an uncompleted onlay with a filling material inside risks chipping the margins/finish lines. If that occurs, the preparation has to be repaired or re-prepared, a new impression is needed along with a new temporary. The pressure of the regulator bite tabs on the chewing surface of you molar could predispose ruining the preparation.

If you are indeed wearing a temporary onlay rather than a temporary filling, there is another risk...aspiration of the temporary onlay if it becomes loose during your dive. Since the walls are divergent, it could become loosened and then slip out. If this happens on a dive and your are taking a breath, the onlay will end up in the lungs.

Strangely, if you simply have a temporary FILLING placed into the tooth and are still waiting to prepare it for the onlay, that filling has a better chance of not coming loose. Because it is a soft material though care must be taken not to break it.

Neither a temporary filling nor a temporary onlay is an absolute contraindication to diving but you must be careful and be prepared in case it comes out.

Regards,

Laurence Stein, DDS