Dental fillings

Decay between teeth is not visible on examination alone, which is why radiographs are used, and a diagnosis should be explainable in terms of what the image or the examination shows. Early decay confined to enamel is sometimes monitored and managed preventively instead of filled immediately, so 'watch' is a legitimate plan. If several fillings are proposed on a tooth or teeth without symptoms, it is entirely reasonable to ask to see the radiographs, to have the extent explained, and to seek a second opinion with those images.

They are different instead of simply better or worse. Composite bonds to the tooth, which allows a more conservative preparation, and it matches tooth color. Amalgam is not bonded and requires a mechanically retentive shape, but it is forgiving of moisture and has a long clinical record on load-bearing surfaces. Composite is more technique-sensitive and needs a dry field to perform well. The right choice depends on the size and position of the cavity, the bite, and how well the tooth can be isolated.

Some sensitivity after a filling is common, particularly where the cavity was deep and close to the nerve, and it usually reduces over days to weeks. Sensitivity to cold that goes away quickly is a different pattern from lingering pain, pain to heat, or spontaneous pain that wakes you: the latter group suggests the nerve is irreversibly inflamed and needs reassessment. A filling that feels high can also cause tenderness to biting, and that is corrected in minutes.

No honest single figure exists, because it depends on the size of the restoration, which surfaces are involved, the bite, grinding, oral hygiene and diet. A small restoration in a low-risk mouth behaves very differently from a large one in someone with active decay or a heavy grinding habit. What matters more than a number is whether the margin is still sealed and whether new decay has started around it, both of which are assessed at examination and on radiographs.

Yes, and that progression is common: as a tooth is restored repeatedly the cavity gets larger and the remaining walls get thinner, until a direct filling no longer holds the tooth together. At that point an onlay or crown becomes the more durable option. The judgment is about how much sound structure remains. If you are being offered a very large filling, it is worth asking directly whether cuspal coverage would be the better use of the same money.

The appointment is normally carried out under local anesthetic where the cavity is deep enough to warrant it, so the procedure itself is not usually painful. Very small or superficial restorations are sometimes placed without anesthetic by agreement. Afterwards, sensitivity for a period is common. The most frequent avoidable problem is biting the numb lip or cheek, so it is worth waiting until sensation returns before eating.

Very early demineralisation confined to the enamel surface can sometimes be arrested or remineralised with fluoride, dietary change and improved cleaning, which is why some areas are monitored, not restored immediately. Once decay has broken through into dentine and formed a cavity, that process is not reversible and the tissue needs removing. The distinction is a clinical judgment based on examination and radiographs, and it is a reasonable thing to ask about explicitly.

A core build-up is a filling placed with a specific purpose: to rebuild enough bulk for a crown to sit on, instead of to be the final restoration itself. It is billed under its own procedure code, which is why it appears as a separate line on a quote alongside the crown. If a tooth is visibly broken down and a crown has been proposed with no build-up listed, it is worth asking whether one is expected.

Decay at the margin of an existing filling is frequently painless until it is well advanced, because it progresses under the restoration instead of on an exposed surface. Fractured margins, wear and leakage are also assessed visually and radiographically, not by symptoms. That said, replacing sound, serviceable fillings that are not failing is not indicated, so the reason should be explainable. Ask what specifically has changed since the last examination.

Composite can be matched closely to the surrounding tooth, and layering different shades and translucencies is what makes a front-tooth restoration blend. The result depends on the size of the restoration, where the margins fall, and how much time is allowed for shade matching and finishing. Composite can also pick up staining at the margins over years. If appearance is a priority, raise it before the appointment so time and technique can be planned instead of improvised.

There is no fixed limit, and it comes down to how much local anesthetic can safely be used, how long you can comfortably keep your mouth open, and the complexity of each cavity. Several small fillings on one side of the mouth are often combined efficiently in a single visit; larger or more numerous restorations are sometimes split across appointments. It is reasonable to ask how the plan has grouped the work and why.

No: a temporary filling is a weaker material meant to seal a tooth for a limited period, for example between root canal appointments or while symptoms are assessed, and it is not designed to withstand normal chewing indefinitely. If a temporary is in place, ask when the definitive restoration is planned, since leaving a temporary in place too long risks it wearing through, leaking, or coming out.