Fillings and Restorations
If you have minor surface damage or a cavity, then a filling can restore your tooth’s appearance and function.
Fillings are able to restore teeth by repairing damage, rebuilding the tooth to its original size and by preventing further tooth decay.
Cavities or holes in your teeth can cause pain or sensitivity depending on their size. The smaller cavities are generally silent, and you can be completely unaware they even exist. This is why we like you to visit us on a regular basis, we too don’t like nasty surprises as much as you do!
Small cavities are easy to fix, sometimes they don’t even require local anaesthetic and are quiet cost effective. As cavities get bigger, they become more complicated and more costly. The bigger the cavity, the closer it’s gets to the nerve (pulp) of your tooth, which is located right in the middle of your tooth. That’s when the pain kicks in!
Left untreated any cavity, big or small will cause long term damage to your dentition and pain. The longer it’s left, more destruction of your natural tooth occurs and that can lead to extensive treatment being required (or worse, it needs removal).
Types of fillings
There are four main filling materials available – They are:
- Composite (The Great Performer - Realistic and Cost Effective)
- Amalgum (The Old School Classic - The Unpopular Choice)
- Gold (The Glitzy Glamour - Durable and long lasting) and
- Porcelain (The Elegant Solution - Delicate, Realistic, Sophisticated).
Each filling material type has it’s own unique properties, advantages and disadvantages. The location of and extent of the decay, cost of material, and our dental recommendation all take a role in determining which filling will suit you best.
Generally speaking, we are typically place Composite fillings, though let’s take a closer quick look at each material available!
Composite Fillings
We like to use tooth-coloured (composite) fillings, they look natural and are safer than amalgam fillings. We’ve even gone as far as not stocking amalgam at our practice, so you will never leave with a silver filling ever again!
Some people like to change their old amalgams to newer looking tooth colour fillings. This is certainly possible and is sometimes advised by the dentist if your amalgam filling is breaking down or the tooth around the filling is cracking. It’s not however a rule, you don’t have to replace your old amalgams if they are healthy and you don’t mind their appearance.
Facts about Composite Fillings
- Most popular and our style of choice.
- Made up of composite resin, which is a combination of small particles of glass and plastic to give a durable, natural look.
- Comes in many different toothy colours. We will match to the shade of your surrounding teeth to give the most natural look. This way it won’t be noticeable or visible when you smile.
- It is light activated, composite comes out of the dispenser soft and mouldable, it has an activator which is sensitive to blue light, when we have the composite where we want it, the dental nurse will hit it with the blue light to set the composite and make it hard.
- Composite is applied and cured with the light in layers. We cure for every 2mm increments. The reason for this is larger increments will cause the composite to shrink. If this happens your new filling won’t last very long.
- Majority of our fillings are composite resin.
Amalgam Fillings
Amalgam or ‘Silver’ fillings are an amalgamation of different metal alloys such as silver, copper and tin. The process of making an amalgam filling begins by mixing the alloys in a machine in surgery. When the material is freshly mixed it is soft and malleable, so it is easy to be contoured and pressed in a prepared tooth. Over the following 24 hours, it will harden to a strong enough consistency to allow you to successfully chew on it.
Amalgam is strong and seems to last a really long time (sometimes 30 years!) But, don’t get too excited, the most common thing we see is your natural tooth cracking around an amalgam filling. Because they last so long and they are so strong, your tooth cannot hold together very well, leading to cracks.
These type of fillings were the norm many years ago, but given their unnatural appearance, they have fallen out of favour in recent times.
Amalgam fillings contain minute traces of mercury which is toxic to humans, though it is argued that the very small amount contained within a filling does not support a case for it to cause damage and as such, it is approved as safe to use by the Australian Dental Association.
With the ready use of composite, the colouration, the material make-up and potential for cracking a tooth, NONE of the fillings we place at Hello Smiles are amalgam.
Gold Fillings
The longest lasting and most durable option, it is used to make fillings called inlays and onlays. The gold mimics your tooths flexibility so your tooth wont crack like it does with amalgam.
If you ask a dentist what they prefer to have in their mouths, they would all say gold! Not just because it’s fancy, but because it truly is the gold standard.
Sadly they aren’t popular due to cost. Obviously, gold isn’t cheap, but we think you certainly get value for money. We have seen gold fillings last 50 years! Though the average life span of a gold filling is 15-20 years.
You might be wondering how the gold gets into your tooth? Don’t worry we won’t be pouring hot molten gold into your tooth! We actually take a 3D scan of your prepared tooth, send it to our dental laboratory to fabricate your gold filling and finally ask you to return to us for cementation (that is, to glue it in). It’s a 2 appointment process with a 2-3 week gap between appointments to allow for fabrication.
Porcelain Fillings
Porcelain (like gold) is also used to make fillings called onlays and inlays. This type of dental restoration is used when a large amount of the underlying tooth structure has been destroyed. And is preferred over a massive resin filling. Why? Because a huge resin filling has a much shorter life span and doesn’t protect your remaining tooth structure from cracking, unlike an onlay which would!
This technique, if possible for your situation is better than a crown. Why? Because we are able to keep more of your tooth’s natural structure and it can strengthen a weakened tooth.
We will need to take a 3D scan of your prepared tooth and send it to our dental laboratory for fabrication. It’s a 2 appointment process with a 2-3 week gap between appointments to allow for custom fabrication.
These restorations provide a very natural looking appearance.
Advantages
- Natural Looking
- Do not stain like composite resin
- Do not wear down like composite resin
- Very durable and long lasting – Expected 15 year life span
- Free of metal
- Have the ability to support weak structure and prevent your tooth from cracking
- We know the idea of filling isn’t wonderful. But it’s better than losing a tooth
- We strive to give you a nice pain free experience
- We are all trained in 4 handed dentistry which makes things much faster, that way your mouth isn’t wide open for a long period.
- Our equipment is fast, our tools and materials are top notch and our nurses are the best in the business!
Reasons for needing fillings
There are many reasons why we may need a filling. These include
- Chipped teeth
- Closing space between two teeth
- Cracked
- Broken teeth
- Decayed teeth
- Worn teeth
The most common reason for a filling is a tooth that is compromised and broken down by decay.
Tooth Decay (caries/cavity)
The most common reason for decay is poor oral hygiene and diet.
- It’s really important to both brush (for 2 minutes) twice a day and floss at least once per day. This routine will make ensure that any plaque that has developed on your teeth is removed and therefore the bacteria is also removed.
- What is plaque I hear you ask? Plaque is a stick film that is full of bacteria that coats your teeth, it forms everyday. Why does it form? Your mouth is full of bacteria (good ones and bad ones), after we eat or drink (carbohydrate loaded or sugary foods), the remaining particles feed this bacteria. The by product of bacteria eating your food particles is plaque and acid formation.
- If plaque is allowed to stay, it will slowly start to eat away at your tooth’s enamel.
Dry mouth
- A well known reason for causing tooth decay is having a dry mouth. Saliva is our shield, it protects our teeth and lubricates our mouths. Without saliva, everything sticks to our teeth, we cannot clear food from our mouths quickly and anything we eat or drink has a direct impact on our teeth.
- Your teeth a vulnerable when they don’t have the protection of saliva, this can even be the case during exercise. With exercise we suffer from dehydration and therefore saliva flow is reduced. During this period many people try to rehydrate incorrectly and inadvertently cause damage to their teeth.
- If you attempt to rehydrate with anything other than water, you are putting your teeth at risk of tooth decay.
- Drink plenty of water during exercise. Avoid sweet or acidic substances that claim to help you hydrate.
- If you must have a sports drink or supplement (even if its sugar free) you must drink water first, take your supplement and rinse your mouth thoroughly with water immediately
- Avoid eating without first hydrating with water.
- This is the reason we often find athletes have a lot of dental issues.
- There are many other reasons why someone might have a dry mouth
- If you are on a list of medications, you might find your mouth getting quite dry. All medications have side effects and one of the most common side effects is dry mouth.
- If you find your lips are sticking to your teeth, your saliva is frothy or you have a cotton wool sensation in your mouth, you could be suffering from dry mouth.
- Other symptoms might include
- Burning/tingling tongue or mouth
- Plaque building up quickly
- Teeth sensitivity
- Yellowing of teeth
- Dry red raw tongue
- Frequent thrust
- Frothy saliva
- Cracked lips
- Sores in the corners of your mouth
o Other causes of dry mouth are:
- Dehydration
- Sjogrens syndrome
- Health conditions such as diabetes, stroke,
- Oral yeast (thrush) infections
- Mouth breathing (snoring or blocked nose)
- Tobacco or alchohol use
- Increased age, elderly people have reduced saliva flow
o Saliva flow also reduces at night when we go to sleep, so it’s very important to brush your teeth and remove any plaque that might be sitting around. This will help prevent your teeth from decaying whilst you sleep.
Tooth Damage/ Dental trauma
In the event of physical trauma or unfortunate accidents such as falling off your bike.
- Tooth damage can vary from a simple chip to entire loss of a tooth.
- If the damage isn’t too extensive, a filling may be used to restore its function and appearance. Keep in mind, once you’ve damaged your tooth its life-long issue. You will at some point need further treatment, the full extent of damage may not be evident for years to come, eg cracks
- It’s always a good idea to wear a custom fitted mouthguard when exercising, especially when participating in physical / contact sports.
Fillings can be used to rebuild your worn away teeth, you might have caused your tooth to wear away for a few reasons:
- Grinding or clinching your teeth
- Biting your nails or cuticles
- Biting your lips, cheeks or corners of your mouth
- Acid reflux or bulimia
- Taking recreational drugs
- Drinking acidic soft drink and/or wine
- Using your teeth as tools to do things such as
- Opening bits of Lego
- Stripping wires if you’re an electrician
- Holding nails if you’re a carpenter
- Opening packets with your teeth
Replacement of a previous filling
- As much as we would love them to last forever. A filling is not a permanent and it will eventually need to be replaced.
- Given the filling needs to live in an environment like your mouth, its amazing it even lasts as long as it does!
How will you know if your filling needs replacing?
- You may notice the area around your filling will beginning to discolour
- The filling might become loose
- You might suffer sensitivity to cold or sweet foods
- Your dentist might see shadows around the edge of your fillings on an x-ray
Having a regular dental check-up every 6 months is a really good way to make sure that your fillings are okay. Your dentist will only take x-rays if they absolutely need to, early signs of your filling failing can be see clinically.
Is it right for me?
When considering a filling some of the things we look at are:
- The location of the tooth requiring to be restored
- The extent and size of the filing required
- The amount of tooth structure remaining
- Your bite (occlusion) and the chewing / pressure your tooth will need to withstand
- Your habits such as nail biting and teeth grinding
Symptoms that you might need a filling
Remember, when you have symptoms, it means the issue in your tooth is already quite large. You must be swift in your actions and get to a dentist STAT!
Symptoms can include:
- Sensitivity to hot, cold or sweet foods/drinks
- Pain or tenderness when biting down
- Food getting caught between your teeth which seems new
- Ache in your tooth
- Roughness of a tooth felt by your tongue
TREATMENT
What is the process of getting a filling?
If you are thinking about whether you need a filling, we’ll explain everything to you, so you know what’s involved in the procedure.
1. Inspection and Diagnosis.
The first step is being able to identify and diagnose the issue. If you present with no issue, we will do a regular examination as described earlier.
If there is a cavity that is immediately evident from a visual inspection, it will of course be easy to identify. If the cavity is between teeth, a simple visual inspection might not suffice. The use of an x-ray will give us an in depth look at what is really happening inside your mouth.
Sometimes we might want to check how deep the cavity acutally is before we dive into filling it, at this point we will take an x-ray to measure up and formulate a plan of action.
2. Consultation.
It’s really important for us, that you feel on board and in control with your oral health. So before we start any work, we will show you any concerns we find (whether that be on the x-ray) or via our intraoral camera.
We are able to take close-up photos inside your mouth to easily communicate with your what really is going.
We will sit down and explain the options available to you. At this stage it’s great opportunity to ask any questions you may have to ensure you are comfortable and relaxed.
- We take a conservative approach and do not overtreat.
- If we find something of concern but also don’t believe it’s an immediate threat, we will of course make you aware of the issue and keep a close eye on it.
3. Local anaesthetic.
In most cases we use local anaesthetic to ensure you have a painless procedure and you are pain free immediately post treatment.
If you find yourself anxious or nervous at this point, it’s great to talk to us about it. We successfully treat a lot of patients who suffer with needle phobia’s and we have techniques that help.
We are also fully stocked with happy gas/nitros oxide to help if you need.
Before the anaesthetic is administered, we always spend some time rubbing topical anaesthetic to ensure you don’t feel the needle. These topicals come in delicious flavours such as chocolate and mint!
4. Removing the decay.
Before we place a filling, we need to access the tooth where the cavity is via a dental drill. It’s at this stage we remove any decayed tissue and clean the area to ensure it’s free of bacteria. If the noise of the drill bothers you, we have noise cancelling headphones and Netflix to help.
5. Placing the filling. We then create your filling using layers of composite resin. With the aid of UV light we carefully ‘cure’ each layer before applying the next one. This allows the filling to have a natural look and contour to your tooth.
6. Polishing and finishing. Once the filling is complete, we carefully refine, polish and shape the tooth to align to your normal bite.
7. Completion. You should not feel know that you have a filling in place (aside from numbness from the anaesthetic), and once the numbness has worn off, it should be not noticeable in your bite at all. You might feel the texture of your tooth now feels slightly different to before or in comparison with your other teeth. You will be given care instructions by your dentist at the conclusion of your appointment.
What are the alternatives to fillings?
If a tooth experienced significant decay or damage, a filling may not adequately fix this situation. In these instances, we would recommend a dental onlay, veneer or crown. A dental crown encapsulates the tooth, is made of durable and long-lasting porcelain.
If a tooth is cracked vertically, or your filling is very deep, the bacteria may have lead to the pulp of your tooth. In such cases you may need to have a root canal.
If a tooth has a significant crack and is unable to be successfully restored via a crown or a filling, then unfortunately, it may need to be extracted. It’s our goal to save teeth in every instance and will only visit this option as a last resort.
POST TREATMENT CARE
Immediate after care
- Immediately after a filling is placed, it is advisable to not eat or drink until the anaesthetic has worn off. This can take 1-3 hours.
- Sensitivity to pressure, cold and hot temperatures may be apparent in the first few days post placement.
- Once the anaesthetic has gone away, you should be able to eat, drink and drink as you normally would.
- If you experience any further or new pain, or if the filling does not ‘feel right’, be sure to contact us straight away.
How do I look after my filling?
A white filling will last around 5-7 years, they can last longer if you take good care of your oral health.
While your filling is as strong as your natural tooth, it still can be damaged over time by wear, poor cleaning or biting into something hard like an olive pip.
Like teeth, fillings also can be stained by foods and drinks such as tea, cola and red wine.
Please clean your filing like it’s a normal tooth, brushing twice a day and flossing at least once per day will ensure its longevity. You cannot remove a filling with floss, if you have ever “flossed a filling out”, be sure that it was ready to be replaced and you did your dentist a favour!
Pain Management
If your filling was quite large and it took your dentist a lengthy amount of time to restore your tooth you might suffer with some minor pain after your appointment.
Things to expect
- Pain from the injection site.
– Especially if your tooth required a few extra injections - Pain coming from your jaw
– Especially if you had to keep open for longer than normal - Pain around the gum line
– If your filling was very deep - Tenderness when chewing
- Sensitivity to foods
Its best to give us a call if you are finding yourself in the above category, we might ask you to take some mild analgesics or anti-inflammatories for a few days.
RISKS AND COMPLICATIONS
Having a filling is very low risk procedure. It is the most common procedure on both children and adults alike and it does not normally come with many side-effects. You may however feel slight sensitivity after a filling is placed for things like pressure, hot or cold food and drink for a short period afterwards.
If experience discomfort longer than 2 weeks or any other unusual symptoms, it is strongly advised to arrange an appointment with us. It could be something as simple as your bite needing adjusting.
Frequently Asked Questions Quick fire Q&As on Fillings and Restorations.
Will my teeth fix themselves?
Unfortunately the answer to this is not the one you want to hear. No, your teeth cannot fix themselves. You can try to remineralise your enamel if have a small area of demineralisation (not cavitation/broken) but once the problem is a physical cavity or involves the dentine layer (2nd layer after enamel) then you will need help from a dentist.
How long will it take to have a dental filling?
We generally book your filling appointments in for 30-45minutes. Don’t worry, we won’t spend all that time drilling! The drilling generally takes 3-5 minutes. The rest of the time is made up of chatting, laughing and more chatting.
What is a temporary filling?
We might suggest placement of a temporary filling in your tooth for a few different reasons. You might have an unstable tooth that we aren’t sure will survive or you have started a root canal. The temporary filling isn’t a bad quality filling, its just different. Temporary fillings are called Glass Ionomer Cements. They often have extra ingredients that can help medicate the tooth and nerve back to good health. It is cheaper than resin so we might use it sometimes as a test run if we aren’t sure a tooth will survive. We don’t want you to spend money unnecessarily.
Also, during root canal therapy, we will drill out the filling multiple times, it doesn’t make sense to put a fancy more expensive filling to cover your tooth during these appointments.
What does it mean if my filling is turning black?
Fillings turning black can be a sign the filling is failing, usually fillings will only change colour if there is decay under them or they are very old and breaking down. Its best you have these looked at by a dentist as soon as possible.
How long before you can eat after a white filling?
You can technically eat straight away after a composite filling. All the setting is complete before the tooth is even polished! You will however need to be careful of your numb mouth if you have been given anaesthetic. We recommend you refrain from eating until you have some sensation back. If you must eat, please try your best not chew your tongue or cheek.
Are white fillings the best match for me?
White fillings or composite fillings are what we mainly use for restorations these days. They do vary in quality, we always like use the latest supra-nano spherical particle composite resins which are just beautiful to work with and give a very high aesthetic outcome.
Is it important to have silver or amalgam filling removed and replaced?
This is a good question. It does come up from time to time in our practice. If you have a silver or amalgam filling, we can replace them for you if you would like.
It is important to note the fillings of this nature are considered safe. A lot choose to have them removed and replaced to composite, white fillings as an aesthetic choice to help improve their smiles.
Should I have my old amalgam fillings replaced even if they aren’t broken or causing any trouble?
A lot of people like to change their old amalgams to shiny tooth colour fillings. This is of course possible and sometimes required say if your amalgam filling is leaking, breaking down or the tooth is cracking that the amalgam is place in. But, you don’t have to replace your old amalgams if the colour doesn’t bother you and they are healthy.
When dentists talk about tooth surfaces, what does that mean?
It’s a way for us to describe how big or small the filling is, it easier than us describing your filling as small, big, huge, ginormous.
A tooth has 5 surfaces, the front, back, middle, inner and outer. So you can imagine a 5 surface filling usually = ginormous. Whilst a one surface filling = small.
Does oil pulling actually work?
Oil pulling is a process by which you take a teaspoon of coconut oil and swish it in your mouth for 20minutes before spitting it out. The theory is, the oil is anti-bacterial and it will help heal your mouth. We agree the oil is antibacterial however, oil pulling cannot heal your teeth, it cannot whitening your teeth and it cannot rebuild your teeth.
Are fillings safe?
Tooth coloured fillings in particular are non-toxic and proven to be perfectly safe for your body. As an accredited practice we adhere to a very strict code of practice and only use TGA approved materials.
Is it safe to have a filling when pregnant?
You mustn’t stop looking after your teeth just because you are pregnant, in fact it’s one of the most important times to ensure your teeth are healthy, for the health of your baby.
Our main concern while you are pregnant is reducing your chance of infection. That might mean placing a filling to stop a cavity from getting too big and turning into an abscess. Keep in mind the most ideal to have dental work done when pregnant is the 2nd trimester and ask your dentist about pregnancy-safe dental anaesthetics for pain relief.
How do you know if you need a filling?
You may not know, that’s why its really important to do to the dentist regularly to make you don’t have a cavity growing that you were unaware of.
If you have symptoms, your cavity could already be quite large. You must get to a dentist quickly
Symptoms can include:
- Sensitivity to hot, cold or sweet foods/drinks
- Pain or tenderness when biting down
- Food getting caught between your teeth which seems new
- Ache in your tooth
- Roughness of a tooth felt by your tongue
How long to fillings last?
Fillings are placed in warm, wet, bacteria filled environment, and are until continual pressure. After all we are chewing with them. Despite this the average span is 5-7 years and 10-12 years if looked after. Sometimes things go wrong such as a crack, break or even fall out. A lot of this also depends on your underlying support structure. With a good hygiene routine, they should last for a substantial period of time.
Does a filling hurt?
No, we do everything we can to ensure the process of receiving a filling is enjoyable and pain free. We start with using a delicious flavoured topical anaesthetic gel, usually chocolate flavour. That stays on for at least 5 minutes whilst we are chatting, once this has taken effect, we will give you a local anaesthetic which is a small, teeny, tiny injection, most patients don’t even feel this! We spend a lot of time chatting after this too, we need to wait until you are numb enough for us to start. Once you give us the go ahead, or we see you are starting to talk funny, we will start drilling, filling and finish with a polish.
Before you know it, your filling is done and ready to eat on!
Do fillings cause sensitivity or numbness?
Immediately after a filling you can experience some sensitivity, this generally only lasts a couple of weeks and isn’t a constant pain. We know this happens because when we use our drills and curing lights, we create heat and we bother the nerve just a little, some might say we tickle it. The nerve will react to the filling by awakening the tooth a little. This can happen with really big fillings close to the nerve (pulp) or even small surface fillings. Teeth sure are strange but could you imagine how much pain you would have if we drilled a hole in your hand? When you think of it this way, teeth seem pretty darn cool!
In truth, most of the time, patients don’t feel any pain, we will warn just in case after every filling.
How much does a filling cost?
Not all fillings are alike. It depends on the location in the mouth (front or back tooth) and it’s size (how many surfaces of your teeth is involves). We can always help you claim white fillings with your health insurance and we are able to offer payment plans to help spread out the cost. A single surface filling costs $160 to a five surface filling being $405.
Do children need fillings, even if it’s their baby teeth?
Yes, children until the age of 6 only have baby teeth. Around the age of 6 they start to lose some baby teeth but also gain adult molars. 12 out of the 20 baby teeth children have won’t be turned over to adult teeth until they are 10-12 years old. If your child has a hole in of their baby molars tooth at the age of 7, it’s advised to repair it with a filling to prevent the formation of an abscess. You can imagine, leaving it for 3-5 years will not lead to a good outcome.
We will always try to do the right thing, of course we never plan to fill a tooth that is close to getting wriggly and close to falling out. We will help plan and workout the likely timeframe we have and if there is a strong likelihood the tooth needs to keep its position for more than 12 months, we will consider restoring the tooth.
Badly broken down baby teeth will require extraction. Early loss of a baby tooth will change the spacing in the mouth and can sometimes leave no space for the adult tooth to come through. All of this can be avoided with a simple filling.