Short answer: A dental filling is a restorative treatment in which tooth tissue lost to decay, fracture or wear is cleaned out and replaced with a suitable material. Today, tooth-colored composite fillings are the most commonly used; there are also options such as glass ionomer, and porcelain or composite inlays and onlays. The procedure is usually done in a single session under local anesthesia. If tissue loss is too extensive, a crown may be needed instead of a filling.
As one of the most frequently performed treatments in dentistry, the dental filling is a procedure most people have at least once in their lives. Even so, people often wonder why a particular material is chosen, when a filling is enough and when a crown is needed, or what to watch out for after a filling. In this article we explain in detailed but plain language what a dental filling is, when it is needed, the difference between a filling and a crown, the types of fillings, the steps of the procedure and aftercare.
What is a dental filling and when is it needed?
A dental filling is the removal of tooth tissue lost to decay, fracture or wear and the filling of the resulting cavity with a suitable material to restore the tooth's shape, function and appearance. In dentistry these treatments are also called "restorative" or "conservative" treatments; the aim is to repair the tooth while preserving as much of it as possible.
The main situations that require a filling are:
- Tooth decay: Decay that has progressed into the enamel and dentin and will not reverse on its own
- Tooth fractures: Small and medium-sized fractures of edges or corners
- Wear: Notches at the gum line caused by brushing or clenching (cervical lesions)
- Replacing old fillings: Fillings with decay at their edges, that have broken or that leak
- Esthetic corrections: Small gaps, color differences or irregularities in shape
Early decay that appears only as a white spot on the enamel does not always need a filling; these lesions can be stopped with fluoride applications and good oral care. Which lesions need a filling is determined by examination and, if necessary, an X-ray.
Restorative treatment: filling or crown?
If the amount of tissue lost from the tooth is limited, a filling is preferred; if it is very extensive, a crown or indirect restorations such as inlays and onlays are preferred. Broadly speaking, if the outer walls of the tooth are intact and thick enough, a filling can protect the tooth for a long time. However, if the cusps of the tooth (the raised points on the chewing surface) have broken, if the filling covers more than half of the tooth, or if the tooth has had root canal treatment and become weakened, a filling alone may not withstand chewing forces. In this case, a restoration that covers or strengthens the tooth from the outside is recommended to reduce the risk of the tooth fracturing.
When making this decision, the position of the tooth, the person's clenching habits, their bite and their esthetic expectations are also assessed. The aim is always to make the tooth last as long as possible with the least intervention needed.
What types of fillings are there?
Types of fillings are grouped by the material used and by whether the filling is made in the mouth or in a laboratory.
Composite (white) fillings
This is the most commonly used type of filling today. It is a tooth-colored material made of resin and glass-like particles. It is bonded to the tooth with a special adhesive system and hardened with blue light. Because it can be matched to the shade of the tooth, it gives an esthetic result on both front and back teeth. Because it bonds to the tooth, it allows less healthy tissue to be removed. It requires meticulous technique; keeping the tooth dry during placement is important for the filling's lifespan.
Glass ionomer fillings
This is a material that bonds chemically to the tooth and releases fluoride over time. Because of this property, it may be preferred for baby teeth, decay at the gum line and people with a high risk of decay. Because its wear resistance is lower than composite, it is generally not the first choice for large back-tooth fillings where chewing forces are heavy. There are also types mixed with composite (resin-modified glass ionomer).
Amalgam (silver) fillings
Amalgam was widely used for many years because of its durability. Because it is not esthetic, does not bond to the tooth and for environmental reasons, its use has declined markedly today and has been restricted in many countries. Replacing old amalgam fillings that are sitting in the mouth without problems is generally not considered necessary for this reason alone; the decision to replace is made based on the condition of the filling.
Inlays and onlays (indirect fillings)
These are fillings made from porcelain or composite in a laboratory, or in the clinic with computer-aided systems, from an impression or a digital scan, and then bonded to the tooth. An inlay covers the part of the tooth between the cusps; an onlay is a restoration that also covers one or more cusps. They are a good intermediate solution for teeth with extensive tissue loss where removing a lot of healthy tissue for a crown is not desirable.
How is a dental filling done?
A direct filling (made in the mouth) is usually completed in a single session under local anesthesia in the following steps:
- Examination and diagnosis: The location and depth of the decay are determined by examination and, if necessary, an X-ray.
- Local anesthesia: When needed, the tooth and surrounding area are numbed; it may not always be needed for small, shallow fillings.
- Isolation: Cotton rolls or a rubber dam are used to protect the tooth from saliva.
- Removing the decay: Decayed tissue is removed with rotary and hand instruments, leaving healthy tissue untouched as much as possible.
- Protective base if needed: If the decay is very close to the nerve, a protective material is placed to protect the pulp.
- Bonding and filling: The tooth surface is prepared, the adhesive is applied, and the filling material is placed in layers and hardened with light.
- Shaping and polishing: The filling is shaped to match the tooth's natural anatomy, the bite is checked and the surface is polished.
For indirect fillings such as inlays and onlays, the tooth is prepared, an impression or scan is taken and a temporary filling is placed in the first session; in the second session, the finished restoration is bonded to the tooth. With some in-clinic systems, this can also be completed on the same day.
What new filling technologies are there?
Filling materials and techniques have developed considerably in recent years. Composites made with nanotechnology polish better and have high color stability. Bulk-fill composites can be placed in thicker layers, which can shorten the procedure on back teeth. Bioactive materials aim to provide extra protection against decay by releasing minerals into the surrounding tooth tissue. Digital intraoral scanners and computer-aided design and manufacturing systems help make inlay and onlay restorations with a more precise fit. Magnification systems and advanced bonding protocols also improve the marginal fit and lifespan of fillings. Still, which technology is used should be decided according to what the tooth needs.
How should you care for a filling?
After a filling there may be mild sensitivity to heat, cold or pressure for a few days; this usually goes away on its own. Points to keep in mind are:
- Not eating until the anesthesia has worn off and being careful not to bite your lip, cheek or tongue
- Letting your dentist know if the filled tooth feels high when you bite, so the bite can be adjusted
- Brushing your teeth twice a day with fluoride toothpaste and cleaning between your teeth with floss
- Not biting very hard foods and avoiding habits such as chewing pens or ice
- Asking your dentist about a night guard if you clench or grind your teeth
- Going for a check-up if sensitivity does not ease within a few weeks or gets worse
- Continuing regular check-ups every six months to once a year
How long a filling lasts depends on the material, the size of the filling, oral hygiene and chewing habits. Regular check-ups make it possible to spot small problems such as marginal leakage before they grow. For other common topics, you can visit our frequently asked questions page.
When should you see a dentist in Ankara about a filling?
If you notice a twinge in your tooth with cold or sweet foods, food constantly getting stuck between your teeth, a visible hole or a dark spot on a tooth, you should have an examination without waiting for the decay to progress. Decay detected early can be fixed with a small filling, while delayed cases may need root canal treatment or a crown. At our clinic in Oran, Çankaya, your teeth are examined in detail and the restorative options suitable for you are explained.
Frequently asked questions
How long after a filling can I eat?
Because composite fillings harden immediately with light, there is no need to wait as far as the filling is concerned. However, if anesthesia was used, it is recommended not to eat until the numbness wears off, to avoid biting your cheek or tongue. If your dentist used a different material, they will give you separate instructions.
Is tooth sensitivity normal after a filling?
Mild sensitivity to heat and cold may occur for a few days to a few weeks after a filling and usually eases on its own. If you feel pain or a high spot when you bite, the filling may need adjusting. If the pain is severe, wakes you at night or keeps getting worse, you should see your dentist.
Should I replace my old amalgam fillings?
Replacing amalgam fillings that are sound and problem-free solely because of the material is generally not considered necessary. If there is decay, a fracture or leakage at the edges, or if replacement is wanted for esthetic reasons, they can be replaced after an assessment by your dentist. The decision is made based on the condition of the filling.
How is it decided whether to do a filling or a crown?
The decision is based on the amount of healthy tissue left in the tooth, the position of the tooth and chewing forces. If tissue loss is limited, a filling is recommended; if most of the tooth has been lost, a crown or onlay is recommended. Your dentist explains the options after an examination and X-ray.
