Tooth fillings

About dental fillings

A dental filling is used to fill a cavity (a hole in your teeth caused by tooth decay) or other damage such as a chipped tooth. Cavities get bigger over time, so the sooner they’re spotted and filled, the less likely you are to have problems later. That’s why regular check-ups are important.

Without treatment, a cavity or chipped tooth can lead to toothache, bad breath, infection, and even the fracturing or loss of your tooth.

How do you know if you need a dental filling?

People of all ages, even young children, may need a tooth filling. Perhaps you have a nagging toothache, sudden pain when you bite down, or sensitivity to hot and cold. You may even have noticed a cavity, or food getting caught in a damaged tooth.

Reasons for needing a tooth filling

Tooth decay:

Tooth decay is the most common reason for needing a filling. Bacteria can feed on the sugars and starches left on your teeth by food or drink, causing plaque to form. The acids in plaque soften and then dissolve your enamel (the hard-protective coating on your teeth). This causes tiny holes which then grow bigger.

Acid erosion:

Your protective enamel coating can get worn away by acids in certain foods and drinks, or by some medical conditions like reflux or hiatus hernia.

Chipping:

You might have a sharp, broken or chipped tooth as part of an injury, or after eating something very hard. This can expose the inner parts of the tooth and lead to erosion over time.

Abrasion and attrition:

This is when teeth get worn, and can be caused by brushing too aggressively or grinding your teeth.

Dental filling procedure - what’s involved?

Before placing a filling, your dentist may need to remove any decayed or weakened parts of the tooth. They’ll offer you the option to numb the area first, usually with injections of local anaesthetic.

Next, they’ll shape, clean and dry the remaining tooth so it can take the filling.

They’ll fill the cavity with an amalgam or composite filling.

Finally, they’ll check your bite still feels right when you put your teeth together.

What kind of tooth fillings are available?

The type of treatment you need will depend on how much damage there is, and which tooth is affected. Your dentist will go through any options with you:

Amalgam fillings:

These traditional silver-coloured fillings are made from a combination of metals including silver, tin and copper. Amalgam is very hard-wearing, so it’s ideal for fillings in your back teeth. Amalgam fillings can last up to 20 years, as long you take good care of your teeth. If you’re pregnant, your dentist will probably advise against an amalgam filling, but they can talk to you about this. Amalgam fillings are available on the NHS, and we have NHS practices across the UK.

Composite fillings:

These are what people often call ‘white fillings’, but actually they can be matched closely to the colour of your teeth. They look natural, so they’re great if your filling will be visible when you smile, laugh or talk.

Inlays and overlays:

If a standard filling isn’t suitable, your dentist may recommend an inlay or overlay (sometimes called onlays, too). They’re more suitable for larger chewing surfaces, such as your back teeth. Inlays fit into the hole in your tooth, while overlays build up the shape of the tooth. They can be made from metal, composite or porcelain. Porcelain may be ideal if you're looking for something that's practically invisible.

Temporary fillings:

As the name suggests, a temporary filling isn’t a long-term solution. It’s used to protect or restore your tooth until it can be replaced with a permanent filling. They’re most commonly used in urgent cases, for example, after an accident or tooth trauma. Temporary fillings aren’t as hard wearing as permanent ones, meaning they can’t withstand normal eating and drinking habits over a long period. If you have one fitted, your dentist will replace it with a permanent one as soon as possible.

If the tooth cavity is very deep, or the centre of your tooth is damaged, you may need root canal treatment to avoid needing the tooth extracted. Although often called ‘root canal fillings’, these aren’t the same as a standard filling.

How long does a filling last?

If you take good care of your teeth, your fillings can last for a very long time. Amalgam fillings can last up to 20 years, while composite fillings can last for around 12-15 years.

Depending on the choice of material, inlays and overlays have a lifespan of up to 20 years, but this depends on teeth specific factors which will be discussed by your dentist.

As a temporary filling is never intended to be permanent, it can last for up to three months, although your dentist will likely replace it well before then.

When can I eat and drink after a filling?

The local anaesthetic will make your gums, tongue, cheeks and even your lips feel numb for a while. Until this wears off, you may have difficulty talking, chewing and drinking. As sensation returns, you may feel some tingling.

Avoid chewing on that side for a while, partly to protect your filling but also to prevent accidentally biting yourself.

For up to a week after your tooth is filled, it may be more sensitive to cold and heat. If it gets much worse or goes on for longer, tell your dentist – this could indicate changes to the nerve, which may need treatment.

How can you avoid fillings in future?

Dental fillings are a very good way to repair tooth cavities, and they can stop toothache while preventing further tooth decay. But it’s much better to avoid tooth fillings in the first place. You can help to do this, with advice from your dental hygienist or dentist, by:

• Avoiding/cutting down and managing your intake of sugary or acidic foods and drinks. If you sip on a sugary drink throughout the day, for example, your teeth are exposed to the sugar for longer, and your mouth doesn’t have chance to recover
• Seeing your dentist and dental hygienist regularly
• Cleaning between your teeth before brushing
• Brushing your teeth twice a day for two minutes
• Using the right toothpaste; your dentist or dental hygienist can advise you on what’s best for you
• Changing your toothbrush (or electric toothbrush head) at least once every three months

Your dentist is the best person to give you advice on how to look after your teeth.