What is a Filling Made Of?
Tooth-colored fillings are made of a special material called composite resin. Thanks to its advanced properties, this material allows the tooth to be restored in terms of function, form, and appearance.
Your dentist can choose from several shades of composite material to match your natural tooth color as closely as possible. This ensures that the filling blends seamlessly with your teeth and remains virtually invisible.
Composite fillings are strong, durable, and resistant to wear and fractures. Once treated, the filled tooth can function almost the same way as a natural tooth. However, if too much of the tooth structure is missing and the filling must cover a large area, the remaining tooth may become weakened. In such cases, a more long-lasting solution like an inlay, onlay, or dental crown is recommended.
Another advantage of composite fillings is that they can be polished to a glossy, smooth surface, making them indistinguishable from the natural tooth. Proper polishing also prevents plaque buildup on the filling.
Why Are Dental Fillings Important?
Dental fillings serve two main purposes:
- Restoring teeth affected by cavities (tooth decay)
- Replacing old or faulty fillings
If a large portion of the tooth structure is missing, other types of dental restorations may be required, such as veneers, inlays, onlays, or crowns.
Untreated tooth decay can spread deeper into the tooth, eventually reaching the pulp (nerve), causing sensitivity, pain, or even pulpitis (inflammation) and pulp necrosis (nerve death).
In these cases, root canal treatment may become necessary, during which the nerve is removed. Severely decayed teeth may also fracture due to weakened structure, and in some cases, the tooth may need to be extracted.
Replacing old or leaking fillings is equally important, as decay (secondary caries) can develop beneath or around them if they no longer seal properly. This type of hidden decay often requires an X-ray for detection, although sometimes it can be spotted visually due to tooth discoloration.
Symptoms of Tooth Damage
Sensitivity and Pain
In the early stages of tooth decay, patients may experience tooth sensitivity to sweet foods or cold drinks. As the decay progresses, sharp pain may occur, which usually subsides immediately or within a few seconds after the stimulus is removed. Persistent or lingering pain often indicates that the dental pulp (tooth nerve) is affected, a condition typically associated with deep or extensive cavities.
Tooth Fracture
Decayed areas of the tooth often first appear as white spots, which later become discolored. As the cavity develops, the tooth structure weakens, leading to cracks or fractures in the affected areas. In advanced cases, parts of the tooth may break off completely.
Gum Bleeding, Sensitivity, and Inflammation
When tooth decay develops near the gum papilla (the area of the gum between two teeth), the rough, sharp edges of the cavity can irritate the gum tissue. This irritation may cause gum sensitivity, inflammation, and even bleeding.
Prevention of Tooth Decay
Regular Dental Check-Ups
Routine dental examinations are essential for the early detection and treatment of cavities (incipient caries). Tooth decay often develops in areas that are difficult to see or clean, such as between the teeth, along the gumline of back teeth, or deep within the grooves of the chewing surfaces. Regular check-ups help ensure that these cavities are identified before they progress and cause more serious problems.
Monitoring and Replacing Old Fillings
Old fillings should be regularly checked and replaced if necessary. This preventive approach helps reduce the risk of toothache, secondary decay, or even tooth fracture, ensuring long-term oral health.
The Dental Filling Procedure – Step by Step
1. Vitality Testing: The dentist first checks the vitality of the tooth by testing its response to cold stimuli. This examination helps determine the condition of the dental pulp (tooth nerve). Root canal treatment is only necessary if the pulp is no longer vital and does not respond to external stimuli.
2. Local Anesthesia: To ensure a completely pain-free treatment, the dentist administers local anesthesia around the affected tooth. For minor cavities, anesthesia may not always be required.
3. Isolation with Rubber Dam: A rubber dam (dental isolation sheet) is placed over the tooth or teeth being treated. This ensures a clean, dry, and saliva-free working area. It also prevents small dental instruments, materials, or rinsing liquids from entering the patient’s throat or airway.
4. Removal of Old Filling (If Present): If the tooth already has a defective or leaking filling, it will be removed and replaced. In some cases, the cavity may need to be extended slightly to ensure full removal of decayed tissue.
5. Removal of Decay and Cavity Preparation: The dentist removes the decayed areas of the tooth and shapes the cavity using water-cooled instruments to prevent overheating.
6. Cavity Lining and Composite Placement: After preparing the cavity, the dentist checks the area carefully, places a protective liner if necessary, and applies the composite filling material in layers. Each layer is hardened using a curing light.
7. Polishing the Filling: Once the filling is complete, the surface is polished to a smooth, glossy finish, ensuring a natural look and preventing plaque buildup.
8. Contact Point Adjustment: If the filling is placed on the side surfaces of the tooth, the dentist checks the contact points with dental floss to ensure proper fit between teeth.
9. Rubber Dam Removal and Rinsing: The isolation is removed, and the area is thoroughly rinsed and cleaned.
10. Bite Adjustment: Finally, the dentist checks the bite (occlusion) to make sure the filling is not too high. A filling that is too elevated can overload the tooth, leading to sensitivity or pain over time. If the patient feels discomfort later—especially while the anesthesia is still wearing off—a follow-up adjustment can be made promptly.
After a Dental Filling
A properly placed and polished dental filling can last for several years, provided that patients maintain good oral hygiene habits and attend regular six-month dental check-ups.
Sensitivity After Anesthesia
If local anesthesia was used during the treatment, the injection site may remain slightly sensitive for 1–2 days. Patients are advised to eat only after the numbness has completely worn off to avoid accidentally biting the cheek or lips.
Deep Cavities and Pulp Protection
In the case of deep cavities, a protective lining (base layer) may be applied to shield the dental pulp. After the anesthesia wears off, it is normal to experience temporary tooth sensitivity or mild discomfort. However, if the pain persists for more than 3–4 days, becomes stronger, radiates to other teeth, or spreads to the face, it is important to contact your dentist immediately.
Gum Sensitivity or Minor Bleeding
Mild gum irritation or slight bleeding may occur if the filling involved the contact surfaces between teeth. This usually resolves quickly, especially with proper oral hygiene.
Frequently Asked Questions about Dental Fillings
Why Should Amalgam Fillings Be Replaced with Aesthetic Composite Fillings?
Aesthetic and Functional Disadvantages of Amalgam
Traditional amalgam fillings are silver-colored and highly visible, making them less aesthetically pleasing compared to modern tooth-colored composite fillings. In addition, amalgam fillings cannot be shaped as precisely to the natural contours and morphology of the tooth as composite materials can.
Health Concerns Related to Mercury
Scientific research has shown that amalgam contains mercury, which can gradually leach into saliva and enter the body. Over time, this may contribute to various health issues such as:
- Allergic reactions
- Hair loss
- Skin conditions
Since mercury release is a continuous process, the symptoms of mercury toxicity may appear years later, making it difficult to trace back to the original cause.
Risk of Hidden Decay Under Amalgam
It is very common to find secondary decay beneath old amalgam fillings, often accompanied by dark or black discoloration of the tooth structure under the filling.
Preservation of Healthy Tooth Structure
At our clinic, we do not place amalgam fillings. This is because they require a cavity design that relies on mechanical retention to stay in place, often involving the unnecessary removal of healthy tooth structure. In contrast, composite fillings bond directly to the tooth, allowing a more conservative approach.
Long-Term Benefits of Composite Fillings
For these reasons, we strongly recommend the replacement of amalgam fillings with durable, tooth-colored composite fillings. These restorations not only provide a more aesthetic and natural appearance but also support better oral and overall health.
Why Can a Tooth Become Sensitive After a Filling?
In some cases, once the effect of the local anesthesia wears off, the filled tooth may feel sensitive, uncomfortable, or even painful. Several factors can cause this:
- Injection site sensitivity – The area where the local anesthetic was applied may remain tender for 1–2 days.
- Rubber dam clamp pressure – Temporary sensitivity may occur in the gum area where the clamp was placed during treatment.
- Pulp (nerve) reaction – The tooth pulp may respond to the sudden dental intervention with a dull or mildly throbbing pain, which usually subsides within a few days.
- Deep decay and irreversible pulpitis – In cases of deep cavities where the pulp was already inflamed, prolonged or worsening pain—especially sensitivity to pressure or biting—may indicate the need for root canal treatment.
- High filling – If the filling is slightly too high, the tooth may feel sensitive when biting. This requires prompt adjustment by the dentist, which can be done even after the treatment.
- Neighboring tooth sensitivity – If a rubber dam was not used for isolation, the water cooling may temporarily affect a nearby tooth with deep decay, making it sensitive as well.
Important to Know
- Do not eat while still numb, as you could accidentally bite your tongue, cheek, or lips.
- When replacing amalgam fillings, the removal process is always performed under strict rubber dam isolation with continuous suction. This ensures that no amalgam particles are swallowed or absorbed into the body.
