The Most Frequently Asked Questions about Dental Fillings

In the US, most adults have a dental filling or will need one in the future. It is important to know what types are available and what filling options are best.

FAQs about Dental Fillings

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The dental filling is one of the most common procedures in the world of dentistry. Every year, specialists create thousands of these basic repair jobs. They do it fast and they do it with precision. It is extremely common for people to have filled teeth. You probably know more than a few relatives, friends, or colleagues who have a dental filling.

While they may be present in a lot of mouths, your dentist would still prefer it if you took steps to avoid needing one. A tooth is only ever filled because it has developed a hole, as a result of plaque and subsequent decay. With a good oral health routine, starting from childhood, it is possible to avoid fillings altogether. However, most of us eat foods that are filled with sugar and this makes it hard for the teeth to heal and regenerate.

If you do think that you are developing a cavity (a hole inside or below a tooth), it is imperative that you visit your dentist for advice. For patients who attend regular check-ups and appointments, this is an easy thing to do, because the specialist will likely pick up on any signs of trouble before you do. If your dentist decides that you need a filling, they will inform you and schedule the treatment for a later date.

The good news is that dental fillings on their own do not indicate signs of infection. If a dentist is able to simply and easily fill the cavity, then send you on your way, the problem is a very minor one and unlikely to cause you many problems in the future. It is important to remember, however, that fillings need to be replaced very 7-12 years. They are not permanent and can disintegrate and break down over time.

This comprehensive guide to some of the most frequently asked questions about dental fillings will tell you all that you need to know.

What Happens When a Dentist Fills a Tooth?

There are two main steps involved in creating a dental filling. The first sees the dentist remove all dead and decaying material from the broken tooth itself. This material is made up of all the enamel that cannot be saved. It is taken away so that the replacement filling can be inserted and secured. To do this, the dentist has to administer an anesthetic, so that the patient cannot feel any part of the procedure.

There should be no pain involved in getting a filling, though the sensation of the drill is likely to feel very strange. The drill is used to remove the unwanted portions of the decaying tooth. Following this, the dentist prepares the tooth for filling by cleaning out the cavity. It is imperative that all bacteria and debris is cleaned out of the tooth.

In cases where the tooth has decayed extensively and the root is close to the surface, the dentist may decide to insert a dental linear. This will be made of either glass ionomer or composite resin. It is designed to protect the nerve and make sure that it does not become exposed. The dentist then inserts the filling on top, before cleaning and polishing the entire tooth. For tooth coloured fillings, a special tool is used to harden the different layers.

What Materials Can Dental Fillings Be Made Out of?

As the dental industry continues to evolve and develop, new types of filling are always emerging. Today, there are a number of different options available to patients. Some are very popular, others are a little rarer and more expensive, and some have become very controversial. The most common types of filling are gold, porcelain, silver amalgam, plastic, and composite resin.

Dental fillings can also be made out of special glass particles, but this is a less common option. It is not available at all surgeries and clinics. The type of filling recommended by your dentist will depend on a whole host of factors; how much you are willing to pay, how extensive the damage is, whether you need to avoid certain materials, and which options offer the best long term advantages.  

Gold Cast Fillings

The typical gold cast filling lasts a fairly long time (around 10-15 years). If cared for extremely well, it may even last longer than this. The material does not corrode, so it offers a high level of durability and strength. Gold can stand up to the pressure of years of chewing, though it is not a look that pleases everybody.

If you do not want a very noticeable filling, gold is probably not the best option. It also happens to be much more expensive than silver amalgam products. While it was a very popular choice twenty or thirty years ago, gold fillings are less common now.

Silver Amalgam

If cared for properly, a silver amalgam filling can last just as long as a gold one and probably longer than a tooth colored alternative. It is similarly suited to prolonged chewing and offers the same amount of strength as a gold filling but at a much lower cost. It does not match the natural shade of teeth, but it can be a good choice for patients on a budget.

The downside to silver amalgam fillings is that they require more of the tooth to be removed, in order to make space for the filling material. They are also prone to cracking and fracturing in response to extreme changes in temperature. This is why they generally need to be monitored a little more closely than other dental options.

Tooth Colored Composites

The most obvious advantage of choosing tooth colored composite fillings is that they offer a more natural aesthetic. This is the best option for patients who want to conceal the fact that they have a filling. They are often indistinguishable from natural teeth, unless viewed up close, even if they are placed in the front of the mouth.

Plus, tooth colored composites actually bond to the natural tooth structure itself. This provides an enhanced level of support and strength. Unlike most other options, they can be used to repair chipped, broken, and ground down teeth as well. On the other hand, this option means more time spent in the chair, because they take longer to prepare, fit, and refine. They also wear out a lot faster than silver amalgam and gold (the typical lifespan is five years).

Ceramic and Glass

Ceramic fillings are usually made out of porcelain. This material is very good at resisting stains, so it retains its colour for longer than composite resin alternatives. However, it is also more abrasive. These fillings will generally last around 15-17 years, but they are fairly expensive.

Glass ionomer fillings contain acrylic and a very specific kind of glass compound. They are usually reserved for repairing cavities below the gum line or dental problems in the mouths of children. The material produces fluoride which actively strengthens the teeth. The problem is that glass ionomers are less resistant to wear and tear. They usually need to be replaced after five years or so.

Will My Dental Plan Cover the Cost of Composite Fillings?

It is common for dental membership plans to cover the cost of composite fillings up to the price of the silver components. It is then the responsibility of the patient to make up the rest. Every plan varies though, so it is worth talking to your dentist about the most suitable options. The cost of fillings is different from clinic to clinic. Make sure that you ask for information about the cost of your preferred option.

What Is Different about an Indirect Dental Filling?

An indirect filling does exactly the same as a standard dental filling. The only real difference is that it is specifically designed to be placed in an extensively damaged tooth structure. This option is usually offered to patients with a decayed tooth that cannot handle a regular filling. It is a midway option between this and a full crown.

If the tooth is not damaged enough for a crown, but too decayed for a regular filling, an indirect filling can be created. The patient usually has to attend two repair sessions for this procedure to be completed. The first step (and the initial appointment) is when the dentist removes the decayed segments of the tooth. Then, a mould of the tooth and surrounding enamel is cast.

The mould is taken to a dental laboratory where a repair expert will then put together the indirect filling. In the interim between the first and second repair sessions, the patient is expected to wear a temporary filling. This protects the cavity from bacteria and further damage. Once the indirect product is ready to go, the patient can return to the surgery for a fitting.

If it matches the shape of the mouth well and feels comfortable, it is cemented into place. While this is a longer and more expensive option than a lot of other filling types, it has the added advantage of being that midway choice between a standard filling and a crown. Also, if fitted skilfully, indirect fillings can last up to three decades. They are very strong and promise to stand up to a substantial degree of wear and tear.

Why is My Dentist Recommending a Temporary Filling?

As aforementioned, a temporary filling may be used as a protective barrier while a patient waits for an indirect filling to be designed and cast. In fact, any repair procedure that involves more than one session will likely require a temporary filling. This is because it is not very hygienic or safe for cavities to remain exposed.

They may fill up with bacteria, continue to erode on contact with acid, or they might crack under the pressure of chewing and biting. It is common for temporary fillings to be provided after root canal treatments. Even if a crown is the intended repair option, a temporary filling gives the irritated nerve tissue and pulp time to heal before more work is carried out.

If a patient is in severe pain with a decayed tooth, it may be necessary for a dentist to provide an emergency filling. These are almost always temporary and are designed to be replaced with something more secure and more closely suited to the problem. The risk of infection remains high if a patient is allowed to continue eating and chewing on an exposed cavity.

Are Mercury Amalgams Fillings Still a Safe Choice?

It is worth thinking carefully about mercury amalgam fillings, even if they represent the cheapest option at your clinic or surgery. While they were very popular and quite common a couple of decades ago, they have long fallen out of fashion. This is because there are concerns about the safety of mercury in the body.

A number of European countries have banned the use of mercury fillings outright and the FDA has recommended that they not be given to pregnant women, children, and patients with weak immune systems. Ultimately, there are two sides to the story. Yes, many campaigners and safety organisations believe that mercury fillings are detrimental to health. But, the US government and the majority of dental groups and associations disagree with this.

If your dentist gives you the option of mercury amalgam fillings, it is entirely your decision whether or not to accept or reject them. However, it is worth considering a slightly more modern alternative, even if it is a little more expensive. Over the last thirty years, the dental industry has evolved massively and there are lots of sophisticated filling options available. You do not have to settle for mercury amalgam if you are not happy with this option.

If you are worried about the safety of existing mercury amalgam fillings, have a chat with your dentist about the issue. They will be happy to answer any questions that you might have and check your mouth for signs of damage or danger. If you happen to fall sick and you think that your mercury fillings may have something to do with it, consult your doctor. Unless this happens, there is no reason to believe that your fillings pose a danger.

How Do I Take Care of My Dental Fillings?

The good news is that taking care of fillings is easy. You just have to keep up with your regular dental care routine. This means brushing and flossing twice a day, attending regular dental check-ups, and informing your dentist about any changes as soon as they appear. Over time, fillings do degrade and eventually need to be replaced.

When this happens, a number of signs may appear. Your tooth will likely become very sensitive and you may experience sharp pains. You might be able to feel jagged edges or cracks when you probe the area with your tongue. If this is the case, your dental filling has probably cracked and needs a fast and efficient repair.

The dentist will x-ray your mouth to locate the problem and confirm the most suitable solution. Usually, the only viable course of action is to remove the degraded material and replace it with a brand new filling of the same type. It may be possible for you to upgrade to a better filling material, but this will have to be discussed with the specialist.  

What Will Happen after My Filling Is Finished?

It is very common for there to be an increased level of sensitivity immediately after a filling has been created. This will probably last for around two or three weeks, but it will gradually lessen and become easier to tolerate. If the tooth is so sensitive that it causes pain to chew or talk, an over the counter painkiller is a good way to regulate the sensation.

For most patients, however, this is not needed. The discomfort is usually mild and only temporary. It can be controlled by steering clear of triggers (for example, very cold or very hot substances). You can also switch to a desensitizing toothpaste. You need to keep a close eye on all pain symptoms, so that you can report back to the dentist. It takes a lot of skill to create a custom filling and, sometimes, follow up repairs and alterations are needed.

If pain and sensitivity do not subside as and when expected, the dentist may need to make some changes to the filling. This can be a little frustrating for patients, especially if they have already sat through a number of sessions, but it is all part of creating a filling that will last for a decade or more. The better quality the filling, the more durable and long lasting it will be.

In some very rare cases, patients have an allergic reaction to the filling materials. This is not seen often and can usually be avoided, because patients with this condition normally have a family history of such problems. The main symptoms are a skin rash or chronic itchiness. Once again, this is quite rare and can be solved by removing the filling and replacing it with one made out of a more suitable material.

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