Although periodontal disease and cavities continue to threaten oral health, two other problems may assume prominence for people of middle age: replacing worn-out restorations, or fillings, and replacing missing teeth. No filling will last forever. The whitish restorations in front teeth eventually wear away. Silver restorations tend to crack up and chip with age because they contract and expand slightly when hot or cold food and drinks come in contact with them. Even gold restorations, the most permanent kind, are subject to decay around the edges, and the decay may spread underneath.
If a needed restoration is not made or a worn-out restoration is not replaced, a deep cavity may result, leading to gum infections.
When the decay reaches the inner layer of the tooth, temporary warning twinges of pain may occur. If the tooth still is not restored, the decay will spread in the pulp that fills the inner chamber of the tooth. A toothache can result from inflammation of the pulp, and although pain may eventually subside, the pulp tissue dies and an abscess can form at the root of the tooth.
When periodontal disease becomes severe and irreversible, periodontal surgery is required to restore periodontal health.