How long will my restoration last?

You may have paid a lot of money for your restoration and it is  a perfectly valid question to ask, how long is it going to last?

However, this is an extremely tricky question to answer as there are many factors that determine treatment success.

Imagine going into a car dealership, buying a new car and asking the dealer, when is this car going to breakdown? There are so many variables outside of the car dealer's control,  it is impossible to answer that question with a large degree of confidence.

Your dentist should be able to give you an average estimated life expectancy for your restoration,  based on their personal experience and evidence from professional dental literature. The actual time your restoration is going to last, is influenced by the factors outlined below:

Environmental Factors

These are conditions inside the mouth, not under the direct control of the dentist or the patient. 

1. Which tooth. Back teeth generally have more force exerted on them than front teeth. Front teeth are more susceptible to damage from trauma. 

2. Tooth support. Does your tooth have adequate support from the bone and gums?

3. Tooth structure and quality. How much healthy intact tooth structure is left to support your restoration? Has the tooth already been badly damaged?

4. Existing restorations.  How much work has already been done on your tooth? Are their any existing restorations inside your tooth? Has your tooth previously undergone Root Canal Treatment?

5. Existing teeth. Do you have most of your teeth left, or will the restoration receive increased forces as it is not supported by adjacent teeth?

6. Access. Can you open your mouth wide enough to allow the dentist a good field of view and do you readily accept dental treatment?

7. Occlusion. When you bite, how do your teeth meet together? Some occlusions are more favourable than others.

8. Tooth grinding. Do you grind or clench your teeth? If so is this being actively managed?

9. Trauma. There is always chance of unpredictable trauma to the mouth. For example, slipping on ice, being involved in an accident...etc

Dentist Factors

These are factors largely based around the skill and training of your dentist.

1. Restoration Advice. Has your dentist advised the best type of restoration for your situation?

2. Ability. Does your dentist have the technical ability and knowledge to place the restoration?

3. Dental Technician. If a dental technician has been used to manufacture your restoration, what is their skill level?

4. Conditions. What are the conditions under which the restoration is placed - for example, if moisture control is paramount, is dental dam used?

5. Aftercare. Are you given the support and aftercare needed to help maximise the chance of your restoration being a success?

Materials

The dental material(s) chosen for your restoration will be based mainly on functionality, aesthetics and price.

1. Variety. There are many different types of restoration that can  be placed in your mouth  -  a filling, veneer, crown, bridge...etc all made from different materials by different manufacturers. 

2. A dental restoration is not an 'off the shelf' product. Every dental restoration is a bespoke item, made specifically to fit your tooth. It may be fabricated by your dentist whilst you are in the chair or in a dental lab by a dental technician.

3. Physical properties. Is the material strong, durable and have good wear resistance?

4. Quality. Has the dentist been able to choose the best material for your tooth, not hampered by restrictions on price or aesthetics?

5. Adhesive. If an adhesive is to be used to cement your restoration, is it the best for your tooth and type of restoration chosen?

Patient Factors

These are factors that are largely under your control, as the patient

1. Restoration Choice. Have you chosen the best restoration for your situation, after being given all the options and as advised by your dentist?

2. Affordability. Can you afford to pay for the skills of a proficient dentist who uses the best materials?

3. Diet. Do you have a  diet that increases your chance of tooth decay or erosion? Certain foods and drinks may also increase the chance of tooth staining. Are you being careful when eating hard foods which could chip your restoration?

4. Oral hygiene. Are you cleaning your teeth adequately? This includes brushing twice per day and cleaning between your teeth.

5. Tobacco. Smoking increases your risk of periodontal disease and causes tooth staining.

6. Contact Sports. Do you play contact sports? If so, do you wear a custom mouth guard?

The Evidence

The reported lifespans of various treatments and materials in the dental literature is derived from research.

1. Quality of Research. High quality research is needed to enable dentist's to have confidence when estimating restoration lifespans.

2. Volume of Research. Dental materials are constantly evolving and newer materials may not have much of an evidence base compared to materials that have been around longer.

3. Difference of Opinion. Research papers may differ in their findings, so the more high quality data we have, the more confident we can be in any conclusions we draw.

4. Normal Distribution. Restoration lifespans tend to follow a normal distribution, which can be represented as a bell-shaped curve.

Do restorations have a guarantee?

If you've read this far, then you will realise that the exact same restoration can behave very differently in two different mouths.

Two people can take care of their mouths completely differently, chew on different types of foods, and have all kinds of different habits. One person can have the same restoration last in their mouth for 30 years.  Another totally different person can have the same restoration chip and break in 1 year. For this reason, any guarantee will normally only cover any defects in materials or workmanship.

If you have a restoration that keeps failing, it may be an indication that it is not the correct restoration for your mouth, and an alternative solution will need to be found.

Every good dentist will do their utmost to avoid patients from needing to come back with the same problem; it is bad for the patient, and bad for the dental practice.

The vast majority of restorations that placed correctly and well cared for will far exceed their expected lifespan.