How does the type of restoration (filling) affect treatment?
The type of restoration present is based on prior decay or injury as well as the function and position of the tooth in the mouth. Since most dental abcesses are the result of bacterial contamination, the first step to relieving the problem is to eradicate any decay, which is simply bacterial infection of the tooth structure. The more restorations present in a tooth, the more cumulative damage to the pulp. Any tooth with a crown may be considered to have a “battered pulp” as this is a large, strong restoration usually placed when not enough tooth structure remains to support a filling. Any tooth that has decay adjacent to the margin of the restoration is providing a freeway for bacterial penetration. These restorations must be replaced to avoid a recurrent abcess. Older restorations are more likely to have defective margins. Crowns and bridges complicate treatment in two ways. Radiographically we cannot see through the metalwork, thereby not being able to accurately diagnose decay under
