Steps to a Filling

When you visit your dentist to get a filling, you may be given local anaesthetic to numb the area if necessary. Next, your dentist will remove decay from the tooth, using a drill. Lasers also can be used to remove decay.

A drill, which dentists call a hand piece, uses metal cones called burs to cut through the enamel and remove the decay. Burs come in many shapes and sizes. Your dentist will choose the ones that are right for the size and location of your decay.

At first, your dentist will use a high speed drill (the one with the familiar whining sound) to remove the decay and unsupported enamel of the tooth. Once the drill reaches the dentin, or second layer of the tooth, the dentist may use a lower speed drill. That’s because dentin is softer than enamel.

Once all the decay is removed, your dentist will shape the space to prepare it for the filling. Different types of fillings require different shaping procedures to make sure they will stay in place. Your dentist may put in a base or a liner to protect the tooth’s  pulp (where the nerves are). The base or liner can be made of composite resin, glass ionomer, zinc oxide and eugenol, or another material.

Some of these materials release fluoride  to protect the tooth from further decay.

If your dentist is placing a bonded filling, he or she will etch (prepare) the tooth with an acid gel before placing the filling. Etching makes tiny holes in the tooth’s enamel surface. The composite material fills in the holes as the dentist places the filling. A bonding material also is used, so the filling bonds to the tooth in two ways. Bonded fillings can reduce the risk of leakage or decay under the filling. Bonding is generally done with composite fillings.

Certain types of fillings get hardened by a special light. With these fillings, your dentist will layer the material, stopping several times to shine a bright light on the resin. This cures (hardens) the material and makes it strong.

Finally, after the filling is placed, your dentist will use burs to finish and polish the tooth.

After a Filling

Some people feel sensitivity after they receive a filling. The tooth may be sensitive to pressure, air, sweet foods or cold. Composite fillings often cause sensitivity, but other types of filling materials can, too.

The most common reason for pain right after the anaesthetic wears off is that the filling is too high. Call your dentist so you can be seen as soon as possible to reduce the height of the filling.

The second type of discomfort is a very sharp shock that appears only when your teeth touch. This is called galvanic shock. It 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.

In most other cases, the sensitivity will decrease 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 after two weeks, contact your dentist’s office.

It’s important to let your dentist know about any sensitivity you are feeling. The next time you need a filling, he or she may be able to use a different material and make changes to reduce sensitivity. People vary in their response to different materials. Your dentist has no way of predicting if your tooth will react to a particular material.

When you talk to your dentist about the sensitivity, try to describe it as precisely as possible. This information will help decide what should be done next. Your dentist may take out the filling and put in a new one. He or she may add a base, liner or desensitizing agent on the tooth as well. If the filling was very deep, you could need a root canal treatment to solve the problem.

Your dentist polishes the filling after it is placed, but occasionally sharp edges may remain. You can’t detect this at first because of the anesthesia. If you find one, contact your dentist and arrange to have it smoothed as soon as possible to avoid injury to your tongue or mouth.

Temporary Fillings

You may receive a temporary filling  (usually white, off-white or gray) if:

• Your treatment requires more than one appointment.
• Your dentist wants to wait a short period of time for the tooth to heal.
• You have a deep cavity and the pulp (containing the  nerve and blood vessels) becomes exposed during treatment.
• You need emergency dental treatment.

A temporary filling may make your tooth feel better. This is because the filling seals the tooth, protecting the pulp from bacteria and reducing sensitivity.

Temporary fillings often contain eugenol, an ingredient in over-the-counter toothache remedies. Eugenol is also a component of oil of cloves, which people use for toothache pain.

Temporary fillings are not meant to last. Usually, they fall out, fracture or wear out within a month or two. If you get a temporary filling, make sure you visit your dentist to get a permanent one. If you don’t, your tooth could become infected or you could have other problems.

Why Replace a Filling?

Fillings don’t last forever. They can become discolored. Composite, tooth-colored fillings pick up stains, and yellow or darken over time. When you chew, your teeth and any fillings in them are subjected to tremendous pressures. Even if no other problems develop, some fillings will wear out over time and will need to be replaced. A filling will need to be replaced earlier if it falls out, leaks or cracks.

Bacteria and bits of food can seep down under a filling that is cracked or leaking. Since you can’t clean there, the bacteria feed on the bits of food and form the acid that causes tooth decay. Decay under a filling can become extensive before you notice it or it causes you pain. This is why you should have your fillings checked regularly and get them replaced when problems are found.

 Replacing a Filling 

Before removing your old filling, your dentist will discuss treatment options with you. It is often possible to repair an old filling instead of removing it and replacing it completely. However, if the entire filling has to be replaced, the dentist may re evaluate what filling material to use. Talk with your dentist about how you would like the filling to look. Then he or she can select the material that is best for you.