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When tooth decay has destroyed a part of the tooth a hole remains. The dentist needs to fill this hole produced by the tooth decay; a dental filling is thus placed. Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse.

Dentists have more ways to create nice, natural-feeling and looking smiles. Dental researchers developing materials, such as ceramics and polymer compounds that look more like natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials to repair missing, worn, damaged or decayed teeth.

Material for Dental Filling

The most common material for filling molar teeth is dental amalgam. This metal alloy has low mercury content and is considered to be effective and safe.

NHMRC (The National Health and Medical Research Council) considers that dental amalgam is a useful and necessary restorative material and states that there have been no proven cases of a direct link between dental amalgam and specific illnesses. There is also no clinical evidence to support any connection between amalgam fillings and cancer.

Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as Composite Resin Dental Fillings,are made of a plastic dental resin. Composite Resin Dental Fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.

Determining if You Need a Filling

Your dentist may use several methods to determine if you have tooth decay, including:

• Dental observation - Some discolored spots on teeth may indicate decay, but not all of them. Your dentist will use other methods in addition to observation like an explorer, a metal instrument with a sharp tip. Healthy tooth enamel is hard and will resist pressure by the explorer. Decayed enamel is softer and the instrument will stick in it slightly.
• Dental cavity-detecting dye - This can be rinsed over your tooth. It will stick to decayed areas and rinse cleanly from healthy ones.
• Dental x-rays - X-rays can help your dentist see decay that doesn’t show on the surface. However, X-rays often are not accurate in detecting smaller cavities, and existing fillings or other restorations can block the view of decay.

Decay is not the only reason you may need a filling. Cracked or broken teeth, or teeth that are worn from unusual use - Such as nail-biting, tooth grinding or using your teeth to open things - may also need fillings.

Process of Filling a Tooth

First, the dentist will numb the area around the tooth to be worked on with a local anesthetic. Next, a drill, air abrasion instrument or laser will be used to remove the decayed area. The choice of instrument depends on the individual dentist’s comfort level, training, and investment in the particular piece of equipment as well as location and extent of the decay.

Next, your dentist will probe or test the area during the decay removal process to determine if all the decay has been removed. Once the decay has been removed, your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Several additional steps are required for tooth-colored fillings and are as follows. After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that “cures” or hardens each layer is applied. When the multilayering process is completed, your dentist will shape the composite material to the desired result, trim off any excess material and polish the final restoration.

After a Dental Filling

Many people experience some sensitivity after they receive a filling. The tooth may be sensitive to pressure, air, sweet foods or temperature. Composite fillings often cause sensitivity, but other types of filling material can, too.

In most cases, the sensitivity will subside over one to two weeks. Until then, try to avoid anything that causes it. If your tooth is extremely sensitive or your sensitivity does not decrease over about a two-week period, you should contact your dentist’s office.

It’s important to let your dentist know about the sensitivity you are experiencing. The next time you need a filling, he or she may be able to use a different material and make modifications to minimize sensitivity. People vary in their response to different materials, and your dentist has no way of predicting if your tooth will react to a particular material.
Besides sensitivity, some people experience pain when they bite down.

There are several types of pain, each with a different cause:

• First type of pain - when you bite, worsening over time. This is caused by a filling that interferes with your bite. Once your anesthetic wears off, you would notice this right away and should contact your dentist. You will need to return to the office to have the filling reshaped.
• Second type of pain - very sharp pain that appears only when your teeth touch. This is called galvanic pain and is caused by two metals (one in the newly filled tooth and one in the tooth it’s touching) producing an electric current in your mouth. This would happen, for example, if you had a new amalgam filling in a bottom tooth and had a gold crown in the tooth above it.

It is possible that you might feel another pain that’s similar to a toothache. In other words, your tooth could feel like it still needs a filling. This might occur if your filling is leaking, allowing saliva and other contaminants inside the tooth. Again, you should contact your dentist.

Keeping Your Tooth Filling

To maintain your fillings, you should follow good oral hygiene practices - visiting your dentist regularly for cleanings, brushing with a fluoride-containing toothpaste, and flossing at least once daily. If your dentist suspects that a filling might be cracked or is “leaking” (when the sides of the filling don’t fit tightly against the tooth, this allows debris and saliva to seep down between the filling and the tooth, which can lead to decay), he or she will take X-rays to assess the situation. If your tooth is extremely sensitive, if you feel a sharp edge, if you notice a crack in the filling, or if a piece of the filling is missing, call your dentist for an appointment.

Although some fillings can last for many years, the average life of an amalgam filling is five to seven years. Composite fillings may not last this long.

Many people believe that chewing ice will make your fillings fall out, but this is not true. Chewing ice should not affect your fillings, but you should avoid this habit if you have any sensitivity to cold.

Alternatives to Restoring Damaged or Decayed Teeth

• Porcelain veneers - a ceramic material is bonded to the front of teeth to change the tooth’s color, size, and/or shape.
• Crown - a “cap” that covers a cracked or broken tooth, unfixed by a filling, to approximate its normal size and shape.
• Cast gold restorations - this type of restoration is often more costly and may require more than one dental fitting.