Fillings

Fillings are to restore a tooth to its function and stop the progression of decay in the tooth which if left untreated, can result in tooth infection and eventual loss.

Normally fillings are used when the tooth has been damaged by decay or trauma. There are a range of modern filling materials ranging from low mercury containing amalgams and silicate cements through to hybrid composites (white fillings).

Usually the tooth will require numbing and any decay will be removed prior to filling placement. Preparations that come close to the nerve of the tooth will be given an insulating material to slow the conduction of hot and cold to the nerve of the tooth.

A filled tooth is never quite the same strength as the original tooth nor will it feel just like the original tooth. But it’s not far off.

FAQs for fillings

A temporary filling may be used as a protective barrier while a patient waits for an indirect filling (inlay, onlay or crown) to be designed and cast. Any repair procedure that involves more than one session will likely require a temporary filling. This is because it is not very hygienic or safe for cavities to remain exposed as they may fill up with bacteria, continue to erode on contact with acid, or they might crack under the pressure of chewing and biting.

It is common for temporary fillings to be provided after root canal treatments. Even if a crown is the intended repair option, a temporary filling gives the irritated nerve tissue and pulp time to heal before more work is carried out.

If a patient is in severe pain with a decayed tooth, it may be necessary for a dentist to provide an emergency filling. These are almost always temporary and are designed to be replaced with something more secure and more closely suited to the problem. The risk of infection remains high if a patient is allowed to continue eating and chewing on an exposed cavity.

It is worth thinking carefully about mercury amalgam fillings, even if they represent the cheapest option. While they were very popular and quite common a couple of decades ago, they have long fallen out of fashion. This is because there are concerns about the safety of mercury in the body.

A number of European countries have banned the use of mercury fillings outright and the FDA has recommended that they not be given to pregnant women, children below 16 years, or patients with weak immune systems. Ultimately, there are two sides to the story. Yes, many campaigners and safety organisations believe that mercury fillings are detrimental to health. But, the UK and US governments and the majority of dental groups and associations disagree with this.

If your dentist gives you the option of mercury amalgam fillings, it is entirely your decision whether or not to accept or reject them. This material has the capacity to set in the presence of water which others cannot. This is a major advantage when dealing with cavities below the gumline.

If you are worried about the safety of existing mercury amalgam fillings, have a chat with your dentist about the issue. They will be happy to answer any questions that you might have and check your mouth for signs of damage or danger. If you happen to fall sick and you think that your mercury fillings may have something to do with it, consult your doctor. Unless this happens, there is no reason to believe that your fillings pose a danger.

Keep up with your regular dental care routine. This means brushing and flossing twice a day, attending regular dental check-ups, and informing your dentist about any changes as soon as they appear. Do not apply unnecessary pressure to your teeth – such as opening items with your teeth or taking on that chewy toffee. The mouth is not designed for either of these purposes and you risk fracturing the already weakened filled tooth or the filling material. Over time, fillings do degrade and eventually may need to be replaced.

A number of signs may appear. Your tooth could become very sensitive and you may experience sharp pains. You might be able to feel jagged edges or cracks when you probe the area with your tongue. If this is the case, your dental filling has probably cracked and needs a fast and efficient repair. Routine radiographs can also detect when the integrity of a filling is compromised. On these occasions, the patient may be unaware of any symptoms as the damage is slight , however leaving a tooth this way does risk exposing the tooth to further damage and increase the need for more invasive treatment. The radiograph will only show the extent of the damage and does not record the rate at which this has happened. You would need two x-rays some time apart to assess the rate of decay. In some clinical cases, it is a sensible option to assess this as it is recognised that when any filling is replaced, tooth tissue is lost to the drill as the dentist cuts to sound tooth tissue.

If you have been numbed for the procedure, it is advisable that you refrain from eating or drinking very hot or very cold drinks until the numbness has worn off so that you avoid damaging your mouth unwittingly. Some fillings require a setting time and, if you put pressure on them too early, you risk damaging the integrity of the filling. Your dentist will warn you of this at the end of your appointment.

It is very common for there to be an increased level of sensitivity immediately after a filling has been created. This will probably last for around two or three weeks, but will gradually lessen and become easier to tolerate. If the tooth is so sensitive that it causes pain to chew or talk, an over-the-counter painkiller is a good way to regulate the sensation.

The discomfort is usually mild and only temporary. It can be controlled by steering clear of triggers (for example, very cold or very hot substances). You can also switch to a desensitising toothpaste. You need to keep a close eye on all pain symptoms, so that you can report back to the dentist.

If pain and sensitivity do not subside as and when expected, the dentist may need to make some changes to the filling. This can be a little frustrating for patients, especially if they have already sat through a number of sessions, but it is all part of creating a filling that will last for a decade or more. The better quality the filling, the more durable and long lasting it will be.

In some very rare cases, patients have an allergic reaction to the filling materials. This is not seen often and can usually be avoided, because patients with this condition normally have a family history of such problems. The main symptoms are a skin rash or chronic itchiness. Once again, this is quite rare and can be resolved by removing the filling and replacing it with one made out of a more suitable material.

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