Fillings

Tooth fillings are one of the most common dental procedures, used to repair teeth damaged by decay. Modern filling materials restore tooth structure, function, and appearance while preventing further decay.

When Do You Need a Filling?

• Cavities (tooth decay) detected during examination
• Toothache or sensitivity indicating decay
• Visible holes or dark spots on teeth
• Broken or cracked fillings needing replacement
• Worn teeth requiring restoration

Types of Filling Materials

Composite (White) Fillings

Tooth-colored resin material that bonds directly to tooth structure.

Advantages:

• Natural appearance, matches tooth color
• Bonds to tooth, providing support
• Requires less tooth removal than amalgam
• Versatile for front and back teeth
• Sets immediately

Disadvantages:

• More expensive than amalgam
• May wear faster in heavy-use areas
• Longer placement time
• May stain over time

Lifespan: 5-10 years

Cost: £80-£250 (NHS Band 2: £73.50)

Amalgam (Silver) Fillings

Durable mixture of mercury, silver, tin, and copper.

Advantages:

• Extremely durable, lasts 10-15+ years
• Less expensive
• Quick placement
• Withstands heavy chewing forces
• Less technique-sensitive

Disadvantages:

• Metallic appearance
• Requires more tooth removal
• May expand/contract with temperature changes
• Contains mercury (though safe according to dental associations)

Lifespan: 10-15 years

Cost: £50-£150 (NHS Band 2: £73.50)

Gold Fillings

Cast gold alloy fillings made in a dental laboratory.

Advantages:

• Extremely durable (15-20+ years)
• Doesn't corrode
• Gentle on opposing teeth
• Some people prefer gold aesthetics

Disadvantages:

• Most expensive option
• Requires multiple visits
• Metallic appearance

Cost: £250-£500+

Glass Ionomer

Tooth-colored material that releases fluoride.

Best for: Children's teeth, non-biting surfaces, root surfaces

Advantages:

• Releases fluoride continuously
• Bonds to tooth structure
• Less expensive than composite

Disadvantages:

• Less durable than other options
• More opaque appearance
• Not suitable for heavy-use areas

Lifespan: 5 years

The Filling Procedure

1. Anesthesia

Local anesthetic numbs the area (unless decay is very minor). Topical anesthetic applied first to minimize injection discomfort.

2. Decay Removal

Decayed tooth material is removed using a drill, laser, or air abrasion. The cavity is cleaned and prepared for the filling.

3. Filling Placement

The chosen material is placed in layers (for composite), packed firmly (for amalgam), or cast (for gold). Composite is hardened with a special light. The filling is shaped and polished to match your bite.

4. Bite Adjustment

Your dentist checks your bite and makes necessary adjustments to ensure comfort and proper function.

Duration: 30-60 minutes per filling

Aftercare and Recovery

After the procedure:

• Numbness typically lasts 2-4 hours
• Avoid eating until numbness wears off
• Mild sensitivity to temperature is normal for a few days
• Take over-the-counter pain relief if needed
• Sensitivity persisting beyond 2 weeks should be reported to your dentist

Preventing Future Cavities

• Brush twice daily with fluoride toothpaste
• Floss daily
• Limit sugary and acidic foods/drinks
• Drink tap water (contains fluoride)
• Attend regular dental check-ups
• Consider dental sealants for back teeth
• Use fluoride mouthwash if recommended

When to Replace Fillings

Fillings may need replacement when:

• Filling cracks, chips, or falls out
• Decay develops around the filling
• Tooth sensitivity develops
• Visible wear or damage occurs
• Gaps form between filling and tooth

Cost and NHS Availability

NHS fillings are available as Band 2 treatment (£73.50) covering unlimited fillings in one course of treatment. White fillings on front teeth are covered; white fillings on back teeth are available on NHS if clinically necessary, otherwise private fees apply.

Private costs vary based on material and size, ranging from £50-£500. Many dentists offer both NHS and private options.

Modern Alternatives

For larger cavities or more extensive damage, alternatives include:

• Inlays/Onlays: Custom-made restorations for larger cavities
• Crowns: For extensively damaged teeth
• Root canal treatment: If decay reaches the pulp

Early detection and treatment of cavities through regular dental check-ups prevents more extensive and expensive treatment later. Don't ignore tooth sensitivity or pain – see your dentist promptly.