Fillings (restorations)

Treatment Overview

A filling is a material that your dentist uses to fill a cavity after he or she removes any tooth decay.

To fill a tooth, your dentist will:

• Numb your teeth, gums, tongue, and surrounding skin. Your dentist will first put a substance that feels like jelly directly on the area to start the numbing process, and then inject an anesthetic to complete it. Many dentists will give you nitrous oxide gas (laughing gas) to reduce your pain and help you relax.
• Sometimes use a small sheet of rubber on a metal frame (rubber dam) to target the decayed tooth and to stop liquid and tooth chips from entering your mouth and throat.
• Drill out all the decay and replace it with a filling.

Fillings can be made from many types of material. Talk to your dentist about which type would be best for you.

• Amalgam is the easiest material for a dentist to use. It is the fastest and least costly choice. Amalgam is a mixture of mercury, silver, tin, or other metals.
• Composite resins are tooth-colored fillings. Your dentist may use them on your front teeth, where appearance is important. Composite resin is easier than gold for a dentist to work with and generally is less expensive than gold.
• Ionomers are tooth-colored materials that dentists often use for small cavities or cavities between teeth. Some ionomers release small amounts of fluoride, which may help you if you often have cavities.
• Gold is costly and is harder for your dentist to work with. This makes the procedure take longer and cost more.
• Ceramics are costly tooth-colored fillings. They require special equipment and may require dental lab support. You may need several appointments.

What To Expect After Treatment

After your dentist has filled the cavity, your lips and gums may remain numb for a few hours until the numbing medicine wears off. To avoid injuring your mouth, be careful not to chew on your numb lip or cheek.

Why It Is Done

You need a filling when tooth decay has caused a hole (cavity) to form on a tooth surface. If you don't get a filling, the cavity will get worse and lead to more severe problems, such as bone loss.

How Well It Works

A filling repairs the tooth and stops tooth decay. Over a long period of time, you may need to replace a worn-out filling.

Your filled tooth may be sensitive to heat and cold for days to weeks after you get the filling. Talk to your dentist about toothpastes that may help you with this discomfort. Tell your dentist if your teeth are too sensitive after you get a filling, because you can usually treat this problem.

Risks

There is almost no risk involved in having a cavity filled.

Some dental work can cause bacteria in the mouth to enter the bloodstream. These bacteria can cause infections in other parts of the body. People who have a difficult time fighting infections may need to take antibiotics before and after dental surgery. Such people include those who have artificial heart valves or were born with heart defects.

What To Think About

It is important to start treatment before tooth decay becomes worse. More severe decay may cause pain and tooth loss and may require a costly crown, a root canal, or tooth removal (extraction).

Some dentists now use a laser system to remove tooth decay and prepare the tooth for filling. The laser is quiet, does not vibrate like a drill, and is usually painless, so medicines to deaden pain often are not needed. Laser treatment is a relatively new choice for dental treatment. Two dental laser systems have been cleared by the U.S. Food and Drug Administration (FDA). These systems are under review by the American Dental Association.¹

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Author:	Jeannette Curtis	Last Updated: July 30, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Arden Christen, DDS, MSD, MA, FACD - Dentistry
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