Dental Fillings: Complete Guide

Dental fillings are one of, if not the most common, procedures a dentist performs in a dental office. They are used to restore teeth that have received damage to their outermost layers (enamel and dentin), such as from cavities or chipping. This article will provide a comprehensive overview of dental fillings, including what they are, how they are done, risks, complications and alternatives.

Table of Contents

What are Dental Fillings?

Dental fillings are a type of restorative dentistry that is used to repair teeth that have been damaged by decay, chipping or even cracking. Once any decay has been removed from your tooth, a filling is a material that is inserted into the affected area, filling in any gaps created by the damage and restoring the tooth to its original shape, size and strength. Fillings can be made from a variety of materials, such as metal amalgam (silver filling), composite resin (white filling), porcelain and even gold! Some common reasons that a dentist may recommend a filling include:

Cavities: Cavities are the most common reason for a dental filling. They are caused by bacteria creating acids that erode away the enamel, leaving small holes or pits in the tooth.
Chipped Teeth: Chipping of the enamel may occur due to trauma, grinding, chewing hard objects, or other causes.
Cracked Teeth: Cracks can occur in the enamel for various reasons, such as trauma or grinding.
Broken/Missing fillings: If an existing filling becomes loose, broken or infected, it may need to be replaced.
To Change Appearances: Fillings can also be used to improve the appearance of your teeth by altering their shape or colour.

Please note that dental fillings cannot be used to repair teeth that have been severely damaged. A crown, root canal, or other more extensive dental work may be required for larger chips and breaks, severe amounts of pain, or infections.

What are Dental Fillings Made Of?

There are several types of filling materials available that can be used to repair decayed, chipped, or cracked teeth. Each has its own advantages and disadvantages. These filling materials can be broken down into two types of fillings, direct and indirect. In general, direct fillings are done in one visit, while indirect fillings require two appointments. The advantage of indirect fillings is that they can be stronger and more durable for larger amounts of decay. Recently, this has become an even more attractive option since recent advances in dental technology, such as CAD/CAM, now allow some indirect fillings to be completed in a single visit.

Amalgam (Silver) Direct Filling

Amalgam fillings are the oldest and most commonly used found material. This is because they are very affordable and have excellent wear resistance, making them last longer than most fillings. However, they are silver in color and contain small amounts of mercury, which has resulted in some concerns about their safety (However, these concerns are unfounded and not proven).

Composite Resin (Tooth-Colored) Direct Filling

A composite resin filling is a tooth-colored mixture of plastic and glass that is bonded directly to the tooth. This filling material is ideal for teeth that are visible when you smile because they blend in with your natural teeth. However, composite fillings cost more than amalgam fillings, and the bonding process can sometimes cause sensitivity in the tooth.

Glass Ionomer (GI) Direct Filling

Glass ionomer fillings are made from a mixture of acrylic and glass. GI fillings bond chemically to the tooth and have a fluoride release, which makes them cavity-resistant. However, these fillings don’t last as long as other filling materials.

Intermediate Restorative Material (IRM) Direct Filling

IRM is often called either a temporary filling or a medicated filling, and these two names best describe it. IRM contains eugenol, which helps promote healing; however, it is quite weak and must be replaced with a more permanent solution listed above.

Ceramic (Porcelain) Indirect Filling

Ceramic fillings are made from a type of dental porcelain and are created in a dental lab or with CAD/CAM technology.

Gold Indirect Filling

Gold is a durable material for filling teeth and can last for decades. It is also biocompatible and gentle on the tooth structure. However, gold fillings are expensive and don’t match the color of natural teeth.

What to Expect During a Cavity Filling Procedure

The average time for one filling can range between 30-45 minutes, but additional teeth or cavities in between can take longer depending on size and clinician experience. The steps in the filling procedure for the most common filling type (composite resin) as well as pictures of each step in a filling are included below:

During the Procedure

Local Anesthesia Administration

During a filling procedure, a patient will first receive local anesthesia in the form of a numbing gel, followed by an injection. This will make sure that they do not feel anything during the procedure.

Removal of Decay

Following this, the decay will be removed with a high-speed handpiece which may make noise and involve water and air. A slow-speed handpiece can also be used to remove cavities that are harder to reach more accurately.

Rubber Dam Placement:

A rubber dam will be placed around the affected tooth to keep it dry and free from saliva during the procedure. Alternatively, if a patient doesn’t like the feel of the rubber dam, a dentist can use cotton rolls to keep the tooth dry.

Acid Etching

Next is a step known as etching. This is when a gel is applied to your tooth to create a more suitable surface area for the filling to connect to the tooth. It does so by removing what is known as the smear layer of the tooth, which has low binding strength.

Priming

Afterwards, a primer is applied to the tooth, which penetrates into dentinal tubules to create a surface for the filling material to connect to the tooth.

Bonding

The bonding agent is then applied, and the filling material is placed into the cavity in layers before being light-cured with an LED curing light to let it harden. This will be repeated as often as needed until your entire tooth is reconstructed.

Checking the Bite

After most dental procedures, the bite should also be checked with a special type of paper to confirm the filling isn’t too big. If the filling is too big, this creates unneeded pressure, which increases the chance of the cavity breaking in the future.

Polishing and Final Checks

Finally, any rough surfaces need to be polished with a smoothing instrument so the new filling doesn’t irritate your tongue. During this step, the dentist will communicate with the patient to make sure that the filling is to their liking and that nothing needs to be changed.

Recovery and Aftercare

If the filling is taken care of properly, it can last many years. The average time a filling lasts depends on the material used – composites or amalgams can last up to 10 years, while gold restorative treatments are known for their longevity, lasting decades if properly cared for. After receiving a filling, make sure to:

Brush and floss twice daily
Schedule regular professional cleanings and exams
Cut back on sugary snacks and drinks
Use a fluoride mouthwash
Wear a nightguard if you have bruxism (teeth grinding)
Avoid hard, crunchy and sticky foods
Quit smoking if you are a smoker

Alternatives to Dental Fillings

The cost of dental fillings makes them one of the most cost-effective ways to fix a tooth that has received minor damages. However, there are alternative treatments available:

Do Nothing: If the decay has not breached past the outer layer of your tooth (the enamel), then you may choose to simply leave it as is. With proper oral healthcare, it may be possible for you to reverse the cavity.
Flouride Rinse: If the cavity is caught early enough (if decay is caught before reaching the enamel), a fluoride rinse may help to reverse the decay.
Root Canal: In cases of extensive decay, root canal therapy may be necessary to remove the infected pulp before filling the tooth with an appropriate material.
Crowns: Crowns are an option for more advanced cases of decay which have damaged a larger portion of the tooth.
Dental Extraction/Implants: If a tooth is too far gone, then an extraction and implant may be necessary to replace it. However, this is a last resort.

Risks and Complications

The risks associated with dental fillings are quite low and generally limited to mild discomfort during the filling procedure. However, complications can occur, including:

Pain or Sensitivity: Generally, it is normal to have some amount of sensitivity in a treated tooth for a few days after it has been treated. If the pain persists longer than a few days, contact your dentist.
Incorrect biting: If the filling is too big, it can cause you to bite incorrectly. This can lead to jaw pain, tooth pain, or cause you to accidentally bight your lip or cheek. In cases like this, go see your dentist, and they will be able to fix that easily.
Pulpitis: If the filling isn’t done correctly, it can lead to inflammation of the pulp (the center of your tooth). This may heal on its own, or it may not. If it doesn’t heal, this usually requires root canal treatment or extraction of the tooth.
Allergy to Materials: In rare cases, patients have been known to have allergies or sensitivities to certain materials used in fillings. Make sure to let dentists know of any allergies you have before beginning the procedure.
Broken Filling: Fillings can sometimes break over time if they are too big. If this happens, make sure to go see your dentist as soon as possible and get the filling replaced.
Filling Falls Out: A well-placed filling should last many years. However, it is possible for them to fall out if the cavity is too large or if the patient bites down too hard on that specific tooth. If it falls out, make sure to contact your dentist and have it replaced as soon as possible.

Conclusion

Dental fillings are an effective and cost-efficient way to repair minor cavities. With proper care, they can last many years. Before having a filling done, talk to your dentist about the best option for your situation. Be sure to follow all instructions after the procedure has been completed in order to maintain your healthy smile.

Disclaimer

The contents of this website, such as text, graphics, images, and other material are for informational purposes only and are not intended to be substituted for professional medical advice, diagnosis, or treatment. Nothing on this website constitutes the practice of medicine, law or any other regulated profession.

No two mouths are the same, and each oral situation is unique. As such, it isn’t possible to give comprehensive advice or diagnose oral conditions based on articles alone. The best way to ensure you’re getting the best dental care possible is to visit a dentist in person for an examination and consultation.