Tooth Fillings

Having a filling should not be painful. The topical anaesthetic in a gel form is applied to the gum beforehand followed by a local anaesthetic injection to numb the tooth and gum and make the experience as easy as possible. The purpose of having the injection is to switch off the pain sensation in the tooth.

Teeth may be mildly tender to touch for a couple of days after they are restored. Pain on pressure for longer than that is highly likely to be a high spot on the filling especially if you can identify one shiny spot on the surface. While even this will often settle given time it is usually better for the surface to be polished down a little to avoid nerve damage under the tooth or a broken filling. If the filling was very deep it may be the case that the pain is related to the nerve in the tooth becoming irreparably damaged and further treatment will likely be necessary. Sometimes an angry tooth can be dressed and refilled at a later date when the nerve has calmed down. Otherwise, an extraction or root canal treatment may be required.

Composite white fillings range in cost from 80-120 euro depending on the size of the cavity and the amount of healthy tooth remaining to bond to. Black metal fillings aren’t used in our practice and are likely to be banned worldwide in the coming years. Interestingly this is not due to any health implications due to the mercury content but rather due to the environmental implications of the disposal of that mercury.

In order to get a cavity in your tooth, certain bacteria in your mouth will break down the sugar in your diet over time. This creates an acidic environment which causes the mineral to flow out of the tooth. The bacteria live in the softened, decayed tooth. As the decay becomes deeper and closer to the middle of the tooth the nerve in the tooth begins to sense the bacteria and their toxins and become inflamed. Also, the tooth will be lacking some of its protective coating of enamel and dentine allowing it to sense the cold and hot to a much greater level. Filling the tooth, therefore, works on two levels. Firstly it removes the bacteria-filled decay thereby stopping its progression and secondly the filling restores the missing tooth structure. Teeth may also become broken through non-decay based loss. Examples of this would be trauma from a blow or erosion from an overly acidic diet or reflux. A lot of people in the modern world grind their teeth together when they are asleep and this can also lead to chipping and lost enamel. Nail-biting is also damaging. Fillings can restore tooth structure loss in all these scenarios. Tooth fillings nowadays are usually made of composite. This is best described as ting pieces of a glass crushed up in resin and is excellently aesthetic.

Most tooth filling appointment last from thirty minutes to one hour. The length of the appointment depends on the size and complexity of the filling and would be longer if more than one filling is planned. For example, if two fillings are beside each other it can be efficient to do them at the same time to get a good meeting between the two teeth.

With the older style fillings, there was a layer of base under the filling which often had a clove-like taste. New fillings nowadays generally don’t have any taste. An older filling that is giving a new taste should be investigated as it may have worn through or be broken and leaking. Also, an old filling may be trapping food or traumatizing the gum around the tooth

With the more modern composite fillings, they are functionally hard immediately after placement. This means there is no reason not to eat straight away. The filling may become a little harder over the first twenty-four hours but it is plenty hard when you leave the surgery. More of a concern eating wise would be the degree of numbness present. This also does not stop you eating but it is advisable to go nice and slow and try to eat on the other side if possible. The food should be lukewarm or cold and not too chewy.

A dark spot on the surface of a white filling is usually a rough spot that is picking up some stain from your diet. White fillings are now so tooth like that it can be difficult to spot initially and only become obvious after a while. On an older filling, it may be just wear and tear. This can easily be polished at the surgery. A dark spot beside an older filling may indicate some new decay or ageing of the filling and should be investigated.

A tooth may be tender for a couple of days after a new restoration. A mildly tender tooth lasting longer than this that feels slightly like it’s in the way almost certainly indicates a high spot which may need to be trimmed down. While less of a problem than it used to be white fillings can tend to be a little sensitive to cold for a time after the procedure. Some mild cold sensitivity for up to six weeks can be considered normal. The emphasis here in the world mild. If you have any more tenderness or pain than mild we would like to know about it. In a deep filling, this may indicate that the nerve in the tooth is damaged. Sometimes a dressing may be able to settle the nerve down followed by refilling at a later date.

Otherwise, if the nerve is beyond repair an extraction or root canal treatment may be required.

Very early cavities that are still in the enamel outer layers of the tooth may be resealed by an application or two of high fluoride paint. Normal adult toothpaste has a fluoride content of 1450 parts per million. The fluoride paint applied to early decay is 23000 parts per million fluoride and encourages the tooth to add mineral content and the mineral it adds is especially hard. Occasionally a cavity may form close to the surface of the tooth whilst a person is not so good at minding their teeth or maybe having a lot of sugar in their diet or both. Once the diet is improved or the oral hygiene the decay may slow down or indeed stop. This situation is known as arrested decay. Arrested decay unfortunately often has a dark colour but otherwise can be viewed as a hard tooth that does not need to be filled. Otherwise, if decay is inside the tooth and has progressed beyond the enamel and into the softer more sensitive dentine then it needs to be removed and the tooth filled.