Tooth filling - All about dental restoration

The tooth filling is used to repair dental pieces damaged by cavities or fractures. We talk about the different types that exist, the materials with which they are made, the problems they may have, and we answer other common questions about the filling.

1) What is a tooth filling?

Dental reconstruction or restoration consists of filling a defect in the tooth caused by decay or fracture with a material, usually resin, which hardens when a special light is applied to it.

1A) What is a dental filling used for?

Fillings make it possible to replace damaged or lost tissues with suitable artificial materials, restoring the function and anatomical shape of a dental piece. The goal of a filling is to prevent further decay from spreading through the tooth, which could end up damaging the nerve and even leading to its loss.

1A.a) Caries, the most widespread dental disease in the world

Dental caries is an infectious disease caused by bacteria that exist in the mouth and that produce acids capable of destroying dental enamel during its metabolism. Caries may end up requiring the extraction of the tooth if it is not stopped in time, so it is recommended to go to the dentist as soon as possible.

1A.aa) Can I have cavities again in a filled tooth?

New cavities can appear even in the filled piece if there is not good dental hygiene. In the same way, the material can wear down and give space to new cavities over time.

1A.b) Other situations that may require a dental filling

We have already seen that caries is the most common situation for which a filling may be required, but not the only one. Here are other reasons: Pulpitis

Pulpitis is an inflammation of the pulp (nerve of the tooth), which can be reversible or irreversible depending on the degree of involvement. If it is reversible, the treatment will be to remove the decayed part and place a filling or restoration with composite. If it is not, a root canal will have to be performed to later rebuild the tooth. Restoration after endodontics

After performing a root canal, the piece is covered with a provisional filling, but this will be replaced by a definitive one if the degree of destruction allows it.

1A.bc) Filling after teeth whitening

Bleaching agents DO NOT change the color of the fillings, so it will be necessary to put new fillings of the same color that has been achieved in the rest of the pieces.

1B) How do I know if I need a filling?

The dentist will determine whether or not a dental filling is required. The professional uses different instruments and x-rays to detect problems both on the visible surface and inside the tooth. In case of seeing any problem, he will determine the appropriate solution.

1C) How is a dental filling done?

To perform a filling or dental reconstruction, these are the steps that are followed:

  1. If the depth of the filling requires it, local anesthesia is applied.

  2. All decay and infected material is removed.

  3. An acid is applied to demineralize the surface.

  4. The area is washed and dried.

  5. An adhesive is applied.

  6. The resin material is placed and light-cured with a special light to harden.

  7. Finally, the filling is polished and the contacts with the neighboring and adjacent teeth are adjusted.

1C.a) Does it hurt to have a restoration done?

No, although in some cases it is advisable to perform them under local anesthesia to avoid discomfort. Yes, it is common to notice slight discomfort for a few days after the placement of a filling, especially if it is close to the dental nerve. If they lengthen over time, they can trigger pulpitis, which could require endodontics.

1C.b) How much does a filling cost?

As always, the price varies according to the work done, the material available and the technique. It is not the same to make a simple one than to restore an entire tooth.

2) What types of fillings are there?

We can distinguish between dental filling, restoration or reconstruction depending on the professional, the amount of damaged tooth and the number of surfaces to be treated.

2A) Depending on the number of affected teeth

Here we distinguish these types of fillings:

  1. Obturation or simple restoration

  2. Obturation or complex restoration.

  3. Dental inlay

  4. Veneers and dental crowns

2B) Depending on the number of surfaces to be treated

They are also classified according to the number of affected surfaces on the tooth:

  1. Simple, when they only affect one surface.

  2. Composite, if they affect two surfaces.

  3. Complex, if the caries has spread over three surfaces.

  4. Large restorations, if they are applied to four or more surfaces of the tooth.

3) What materials are fillings made of?

We can also find different types of filling depending on the material used for its preparation. We found metal or composite resin amalgams or some type of cement.

3A) Composite resins

Composite fillings must be adhered to the tooth, which requires a refined clinical technique and usually takes longer. One of its main advantages is that they are very similar in color to the tooth, so their use is essential on anterior teeth and highly recommended in any visible area. They can last between 5 and 7 years, although they tend to stain with the consumption of coffee, tea or tobacco.

3B) Dental amalgams with mercury

This type of metallic-colored fillings is only used when the dentist considers it strictly necessary. These amalgams are composed of mercury, which is why the European Union approved in 2017 the reduction in the use of this type of filling, vetoing them in people under 15 years of age and pregnant or lactating women.

3C) Glass ionomer

Glass ionomer has worse aesthetics than composites, although better than amalgam. It is only usually used in some milk teeth or as an intermediate layer in definitive pieces. It is also placed under fillings due to its ability to adhere to dentin.

3D) Porcelain fillings

Porcelain restorations, called inlays or onlays, are typically used to cover the majority of the affected tooth due to their ability to simulate the original color and shape of the tooth. They have to be ordered from the laboratory or manufactured with a milling machine and then cemented to the tooth.

3E) Gold restorations

Many specialists consider gold inlays as the best material for restoration because they are well tolerated by gingival tissues and can last more than 20 years. You have to order them in a laboratory and they are the most expensive, in addition to requiring several visits to the dentist to carry out the complete treatment.

3F) What is the best material to make a filling?

Given the different materials, the question now is which of all is a better option. As we have said, porcelain or gold are the most durable materials, although they are also the most expensive, while composites or derivatives of plastic resins are the most common. The dentist's judgment should always prevail.

4) Possible problems with tooth fillings

The dental filling is a very common and optimized treatment, but it can also lead to some problems. That is why it is convenient to take them into account to prevent them and optimize their operation and durability.

4A) Leakage of the filling

The filling material wears out over time, especially if they are made of resin or composite. This could cause leaks in which food debris and bacteria would accumulate and cavities would end up appearing. It is important to repair these leaks in time to avoid major problems.

4B) Overflowing filling

The filling can overflow if it is poorly made, which can be a source of food and plaque buildup. To avoid this, the filling must be repeated and left in the correct point, previously eliminating any cavities that may have arisen from this overflowing filling.

4C) Fillings also change color

Both metallic fillings and those that have been adapted to the color of our teeth can be tinted. On the one hand, the metallic ones can alter the color of the tooth or even the gum areas adjacent to the restoration. On the other hand, resin fillings change color over time and can be stained as a result of coffee, tea, tobacco... etc. Only porcelain fillings remain unchanged.

4C) Can a filling fall out?

A well-made filling should not cause this type of problem, but if the filling material does not have enough structure to hold it, it can fracture or come off. This same problem is common in people who suffer from bruxism.

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