Tooth Fillings: A Complete Patient Guide

What is tooth filling?

Tooth filling, also called dental filling, is a type of restorative dentistry treatment used to restore a tooth that has been affected by cavities or decay. If your tooth is damaged due to decay or wear, your dentist removes the damaged portion and fills the cavity with a filling material.

This helps restore the tooth's shape, function, and strength while saving the natural tooth structure as much as possible.

Types of tooth fillings

Depending on how the filling is applied and fabricated, there are two types of toooth filling.

Direct filling

It involves placing the filling material directly within the prepared cavity of your tooth by the dentist. It typically requires a single appointment.

Following materials are commonly used for direct fillings.

1. Amalgam fillings (silver fillings)

   • Material: A mixture of metals including silver, mercury, tin, and copper.

   • Appearance: Silver-grey in colour.

   • Durability: Very durable and long-lasting, often used for back teeth where the pressure from chewing is greatest.

   • Cost: Generally, less expensive than other types of fillings.

   • Pros: Strong, durable, and affordable; very effective for larger fillings in the back teeth.

   • Cons: Not aesthetically pleasing due to their colour; exposure to mercury vapours, although the amount is considered safe by dental authorities.

2. Composite fillings (tooth-coloured fillings)

   • Material: A mixture of metals including silver, mercury, tin, and copper.

   • Appearance: Silver-grey in colour.

   • Durability: Very durable and long-lasting, often used for back teeth where the pressure from chewing is greatest.

   • Cost: Generally, less expensive than other types of fillings.

   • Pros: Strong, durable, and affordable; very effective for larger fillings in the back teeth.

   • Cons: Not aesthetically pleasing due to their colour; exposure to mercury vapours, although the amount is considered safe by dental authorities.

3. Glass ionomer fillings

   • Material: A blend of glass and acrylic acids.

   • Appearance: Tooth-coloured but slightly more opaque than composite fillings.

   • Durability: Not as durable as composite or amalgam, but it releases fluoride over time to help prevent further decay.

   • Cost: More affordable than composite and ceramic fillings.

   • Pros: Releases fluoride, which helps protect against decay; good for fillings in areas that are not subject to heavy chewing pressure.

   • Cons: Not as durable or aesthetic as other types of fillings.

Indirect filling

Indirect filling involves fabrication in a lab by a dental technician, followed by bonding the prepared filling within the cavity on your tooth. This usually requires two visits to the dental office.

For indirect restorations, these are the commonly used dental filling materials:

1. Gold fillings

   • Material: A mixture of gold and other metals.

   • Appearance: Yellow-gold colour, which makes it visible in the mouth.

   • Durability: Highly durable and resistant to wear and corrosion. It can last 15 years or longer.

   • Cost: The most expensive option for fillings.

   • Pros: Extremely durable and long-lasting; resists tarnish and corrosion.

   • Cons: Highly visible, particularly for fillings in the front teeth; expensive.

2. Ceramic fillings

   • Material: Porcelain or ceramic-based material.

   • Appearance: Tooth-coloured, providing a natural look.

   • Durability: Durable, but more brittle than gold. Suitable for medium to large fillings.

   • Cost: Expensive, though typically less than gold fillings.

   • Pros: Aesthetic, durable, and more stain-resistant than composite fillings.

   • Cons: Can be more fragile, may require more than one visit to complete, may not be available in all dental offices.

3. Porcelain fillings

   • Material: A combination of a metal base with a porcelain layer on top.

   • Appearance: Natural colour on the visible side but with a metallic base.

   • Durability: Durable but might chipping over time or crack under extreme stress.

   • Cost: Moderate to high, depending on the size and complexity.

   • Pros: Combines strength of metal with aesthetics of porcelain; ideal material for large restorations.

   • Cons: Porcelain can wear down opposing teeth; aesthetics compromised if metal base is exposed.

The type of filling and filling material options depends on factors like location of the cavity, durability needs, cost, and cosmetic preferences.To learn which type of dental filling is most suitable for you, consult our experienced dentists at Thomson Medical.

Process of getting a filling

Here's a step-by-step breakdown of a dental filling procedure and what you can expect during your visit.

1. Examination and diagnosis:

   • The dentist will examine your teeth and take dental x-rays if necessary to determine the extent of decay or damage. 

2. Anesthesia: 

   • If the tooth cavity is deep, the dentist may administer a local anaesthetic to numb the area around the decayed tooth.

3. Removing decay:

   • The dentist will remove the affected portion from the tooth surface using a dental drill or laser.

4. Cleaning the cavity:

   • After removing the tooth decay, the cavity will be cleaned of any bacteria or debris.

5. Cavity filling and curing:

   • Direct filling: The chosen tooth filling material will be placed into the cavity. The dentist will mould and shape it to fit the contours of your tooth. The filling will be hardened using a special light (for composite material) or allowed to set naturally (for amalgam).

   • Indirect filling: The dentist places the prepared filling onto the cavity surface and bonds it with a resin or dental cement. The resin is cured (light-cured) after placement to bond securely.

6. Finishing:

   • The dentist then polishes the filled tooth to smooth out any rough edges. Final adjustments for the dental filling procedure are made to ensure a proper bite for chewing function and the filling is polished.

What are the benefits of dental fillings?

Filling restorations have several benefits. These include:

• Restore function:

  • Fillings restore the tooth's shape, function, and strength, allowing it to perform normal chewing and biting activities.

• Prevent decay progression:

  • By filling the cavity, the material seals the area and prevents additional decay from affecting the tooth.

• Relieve pain:

  • If the cavity was causing tooth pain or sensitivity, the filling can help alleviate that discomfort by sealing the area.

• Cosmetic improvement:

  • Tooth-coloured fillings, such as composite or ceramic, provide a more aesthetic solution and a natural appearance,particularly for visible teeth.

When you might need a filling?

Getting a dental filling is one of the most commonly used treatment options in restorative dentistry. You might require a filling in these circumstances:

• Cavity: 

  • Most commonly, you will need a filling when you have a cavity caused by tooth decay.

• Cracked or chipped teeth:

  • Fillings can be used to restore teeth that have been cracked or chipped.

• Tooth wear:

  • Fillings can repair teeth that have worn down due to grinding or other factors.

• Preventive dental treatment:

  • In some cases, fillings can be used to treat small areas of demineralisation before they develop into full cavities.

If your damage is too extensive to be repaired by a filling, you would need alternate treatments such as dental crowns or complete tooth extraction. 

What are the possible complications of tooth fillings?

The complications of dental fillings include:

• Tooth sensitivity:

  • Temporary discomfort to hot, cold or sweet foods are common after fillings, typically subsiding within a few days. If it persists, it may indicate an issue with the filling.

• Tooth pain:

  • Mild pain can occur from irritation during the procedure, but persistent and severe pain may signal a poor fit or infection. It usually resolves within a few days.

• Nerve damage:

  • If the decay was too deep or if the filling places pressure on the nerves inside the dental pulp, it can cause nerve damage. In that case, a root canal treatment may be necessary.

• Infection or allergies:

  • Infection can occur if decay isn’t completely removed before filling placement or if decay-causing bacteria enter, while some may experience allergic reactions to materials like amalgam or composite resins.

• Filling falling out:

  • Improper placement, high pressure or defective filling material can cause the filling to loosen or fall out, requiring a replacement to prevent further tooth damage.

If you're experiencing persistent sensitivity or discomfort with your tooth filling, get a thorough assessment with our oral health team at Thomson Medical's Dental Centre.

How long does dental filling last?

Based on your type of dental restoration, the optimal duration of how long your filling will last varies.

• Amalgam fillings: 10-15 years or longer

• Composite fillings: 5-10 years

• Glass ionomer fillings: 5 years or less, depending on wear

• Gold fillings: 15-30 years

• Ceramic fillings: 10-15 years.

• Porcelain fillings: 10-15 years

Dental fillings are an essential solution for restoring decayed or damaged teeth. Regular dental visits, good oral hygiene, and timely treatment can help maintain your fillings and keep your teeth healthy.

FAQ

Are tooth fillings painful to get?

No, fillings are generally not painful. Your dentist will numb the area around the tooth using a local anesthetic, so you won’t feel any pain during the procedure. While you may feel some pressure or vibrations, these sensations are usually not painful.

What happens if you do not get a dental filling?

If you don't get a dental filling to an already decaying tooth, it will only worsen with time. Eventually your decay would reach the nerves of your tooth, which would lead to extreme sensitivity and pain.

Are tooth fillings permanent?

Although a filling can last for several years, they are not a permanent solution. They will eventually need to be replaced due to wear and tear, changes in your oral health, or damage to the filling.

Can fillings get stained?

Some fillings, such as those of composite may stain over time, especially with food and drinks like coffee, tea, or red wine. If you want stain-resistant options, porcelain and gold fillings are choices of fillings.

What is the aftercare for dental fillings?

• Avoid eating immediately: After getting a filling, especially if it’s a composite or gold filling, avoid chewing on that side of your mouth for at least an hour.

• Good oral hygiene: To extend the life of your filling, maintain good oral hygiene by brushing with fluoride toothpaste and flossing regularly. You need good dental care and regular dental check-ups to ensure longevity.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist by requesting an appointment with Thomson Medical today.