A tooth filling is a dental procedure that involves the removal of decayed or damaged tooth structure and its replacement with a filling material. The goal of a tooth filling is to restore the function and structure of a damaged tooth, prevent further decay or damage, and improve oral health. Tooth fillings can be made from various materials, most commonly composite, a tooth-colored, resin-based material; amalgam, which is a silver-colored alloy of metals; gold, or ceramic. The choice of filling material depends on factors such as the tooth location and extent of the decay, aesthetic preferences, and budget. Dental filling materials must be approved by the U.S. Food and Drug Administration.  Tooth fillings are a safe and effective solution for restoring damaged teeth and maintaining good oral health.

Why would I need a tooth filling?

A tooth filling may be needed if a tooth has decay or damage caused by cavities, trauma, or wear and tear. When decay is left untreated, it can spread deeper into the tooth and cause pain, sensitivity, or infection. A tooth filling can restore the function and structure of the tooth and prevent further decay or damage, although decay can reoccur around old fillings without proper care and maintenance. Without one, tooth decay can progress to the point where more extensive dental work such as a crown, root canal, or even extraction may be necessary. In addition to restoring function, a tooth filling can also improve the tooth's appearance by restoring chips, cracks, or gaps. Regular dental check-ups can help detect decay or damage early on, allowing for timely treatment with a filling.

Fillings are generally used for minor tooth decay or damage, although in some circumstances, they can be used even if the damage is more extensive. If there is not enough solid tooth structure remaining to successfully place a filling, then your dentist will likely recommend a crown. A crown covers the entire visible portion of your tooth above the gum line. This is a stronger and usually longer-lasting alternative to a large tooth filling, but it is more expensive and typically requires multiple appointments

Crown versus filling – which one do I need?

In general, tooth fillings are used for more minor tooth decay or damage while crowns are utilized when there is not enough remaining healthy tooth structure to support a filling.  

Types of tooth fillings

Several types of tooth fillings are available, each with advantages and disadvantages. Direct fillings are placed on the same day as the tooth is prepared. Indirect fillings are made in a dental laboratory from an impression taken of the prepared tooth. The filling is then cemented or bonded into place at a later appointment.  

Common direct fillings are:

• Composite fillings are made of a tooth-colored resin material that can be matched to the natural color of the tooth, making them a popular choice for front teeth, but they are also the most commonly used filling in back teeth.
• Amalgam fillings, sometimes known as “silver fillings,” are made of a mixture of mercury and other metals and are strong, durable, and long-lasting. They are a less costly alternative and are particularly effective for larger fillings on back teeth, but they are not as aesthetically pleasing as composite options.

 Common indirect fillings include:

• Ceramic fillings are also tooth-colored and are a good option for patients who have metal allergies. The choice of filling material can depend on several factors, including the location and extent of the decay, aesthetic preferences, and budget, and should be discussed with your dentist.
• Gold fillings are highly durable and long-lasting, but they can be expensive and require multiple visits to the dentist. They lack the aesthetics of composite and ceramic fillings.

What are the steps for a composite or amalgam tooth filling?

The tooth filling process typically involves the following steps:

• Initial dental examination and diagnosis – Your dentist will examine your teeth and take X-rays to determine the extent of the decay or damage and decide if a tooth filling is needed.
• Preparing the tooth for filling – Your dentist will numb the area with local anesthesia and remove the decayed or damaged part of the tooth using a dental drill or laser.
  
• Placing the filling material – The placement technique varies, depending on the filling material and size of the tooth preparation. In the case of composite or amalgam, it is a one-appointment procedure with the filling material placed right after tooth preparation.  
  
• Shaping and polishing the filling – The filling is then shaped and polished to make sure it fits the natural contour of the tooth and does not interfere with the bite. 
  

Ceramic and gold fillings follow the same basic procedure, but instead of placing the filling material that day, an impression is taken of the prepared tooth and sent to a dental laboratory where the final restoration is made. At the next appointment, the filling is cemented or bonded in place. 

Getting a tooth filling is typically a simple procedure with most completed in one visit to the dentist. The process can vary slightly depending on the type of filling material used and the extent of the decay or damage. Your dentist will discuss the procedure with you and answer any questions you may have before beginning the treatment.

How do I care for a tooth filling?

Proper care and maintenance of teeth with fillings are crucial to ensure their longevity and prevent further decay. Some tips for caring for teeth with fillings include:

• Brush and floss regularly: Brushing and flossing regularly helps remove plaque and food particles from the teeth and prevents decay from forming around the filling.
• Use fluoride toothpaste: Fluoride toothpaste helps strengthen the tooth enamel and prevent decay.
  
• Depending on the type of material used, your dentist will guide you as to when to resume normal eating after receiving a filling.
  
• Be aware that hard and sticky foods may damage or dislodge fillings, particularly large fillings on back chewing surfaces.
  
• Don't grind or clench your teeth: Grinding or clenching your teeth can put excessive pressure on the filling and cause it to crack or come loose.
  
• After the numbness from the local anesthesia has worn off, and you have had the opportunity to chew, let your dentist know if your bite does not feel normal. Make an appointment to have the filling adjusted. 
  
• Schedule regular dental check-ups: Dental fillings, crowns, and other restorations do not last forever, and may require maintenance or replacement over time. Regular dental check-ups allow your dentist to monitor the filling's condition, detect any problems early on, and recommend any necessary maintenance or replacement. 
  
• By following these tips and maintaining good oral hygiene practices, you can help ensure the longevity of your tooth filling and promote overall dental health.
  

Conclusion

Tooth fillings restore the function and structure of teeth damaged by decay, trauma, or wear and tear. They help prevent further decay or damage and improve oral health. Overall, tooth fillings are a safe and effective solution for restoring damaged teeth and maintaining good oral health.

Sources:

^{1. Dental Fillings. (2023, February) from https://www.nidcr.nih.gov/health-info/dental-fillings} 

^{2. Dental Fillings. (2023, February 22) from https://my.clevelandclinic.org/health/treatments/17002-dental-fillings}