Fillings

Dental fillings replace parts of a tooth that has been damaged due to injury or decay. Also known as dental restoration, a filling preserves the integrity of the tooth and prevents further damage from cavities. Fillings can also restore the chewing surfaces of teeth that have become worn. Avoiding damage from decay or injury is preferable, but fillings are a good way to prevent the eventual loss of a tooth. Most cavities and fractures that are caught early are good candidates for restoration with fillings. 



Who Needs Dental Fillings?


If your teeth are chipped, cracked or damaged by tooth decay, they need fillings. Large cavities are obvious and often painful, but small pinhole cavities and hard-to-see areas between teeth may also need attention. Your dentist can find cavities and sites of tooth decay that you may not see in the mirror. X-rays, dental probes and dyes can reveal areas that need dental restoration. Your dentist can also see areas that you may not be able to spot, which is one reason why regular dental check-ups are vital for your oral health. Regular visits allow the dentist to see small problems before they become large ones. 



Although cavities are the most common reason for fillings, they are not the only reason your dentist may recommend reconstructive work. If you grind your teeth, bite your nails or use your teeth as tools, you may erode the chewing surfaces enough to require a filling to restore a healthy bite. Signs that you may need a filling include:



  • Visible holes or dark spots on teeth
  • Visible chips or cracks
  • Sensitivity to heat and cold
  • Sharp pain when biting down on the affected tooth
  • A constant dull pain or ache

Materials for Fillings


Fillings used to be made of precious metals because they could withstand years of use. Today, gold and silver amalgam fillings are still available, but new options include tooth-colored resin composites, porcelain and glass ionomer cement. Your dentist will recommend a filling type for you based on the amount of restoration that must be done, the location of the filling, your personal preferences and your budget. 



Gold and silver amalgam fillings have the greatest longevity, often lasting 10 years or longer with normal maintenance. Although gold is the more expensive option for precious metal fillings, it offers extraordinarily long wear; gold fillings can last decades or even a life time. Silver amalgam fillings contain silver, tin, copper and mercury. They are an inexpensive option and are most often used to fill small cavities. 



Composite resin fillings resemble a specialized epoxy and contain particles of silica or ceramics in a polymer matrix. They can be blended to match the color of the surrounding tooth material, making restoration less noticeable than it is with metal fillings. They also spare more of the original tooth during the filling process. However, resin fillings do not have the longevity of metals and may need to be replaced in under 10 years. 



Porcelain fillings may be made entirely of the ceramic material or bonded to metal. They look natural and have greater longevity than composite fillings, but they are costly. Also called inlays, porcelain fillings are a good solution for worn teeth. 



What to Expect During Your Dental Appointment


Your appointment for dental restoration starts with numbing the area with a local anesthetic. After the anesthetic takes effect, you may be fitted with a dental dam to isolate the tooth that needs work. To fill a cavity or rebuild a chipped tooth, the dentist must first remove damaged dental tissue. The high-speed dental drill files away damaged portions of the tooth and prepares the area for the filling. Although you may feel some pressure during this process, it is typically painless. 



Depending on the purpose of the filling, your dentist may paint the prepared region of the tooth with a fluoride solution to prevent future decay or place a liner over the area. Composite resin fillings may also require a coating of adhesive to prepare the tooth's surface to bond with the compound. Dentists have various techniques for applying the filling to the tooth; some dispense resin directly into the prepared space while others transfer it to the tooth on a specialized instrument. The dentist then shapes the material, curing it with ultraviolet light if it is a composite resin. 



Some porcelain fillings follow a different application technique that resembles how bridges are installed. The filling is cast and shaped after the first appointment and cemented into place during a subsequent visit. These innovative fillings may also use computer-aided design to visualize and create the inlay.

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