The Tooth Filling Process – Put Your Mind at Ease
Scared about an upcoming tooth filling?
It can be a daunting task having to go to the dentist to have the treatment done. Strange sounds, unfamiliar smells and the unknown. Questions pop up every step of the way but it’s not the easiest place to remember to ask.
Want to know about the tooth filling procedure, but when your dentist broke the news to you your mind went blank?
Questions during the procedure itself, but it’s difficult to ask when you’ve got instruments in your mouth.
And you may need information afterwards, but the dentist can’t understand a word you’re saying when you’re dribbling down your chin!
By gaining more of an understanding of what’s going on around you and being involved in the procedure you’ll find you’re more informed, calmer and happier. Children can be scared of the dark until they turn the light on and know what’s in the room. It’s the same in dental surgery.
So I’ve compiled all the questions you probably want to ask but never get round to before, during and after the procedure.
I’m going to hold your hand every step of the way, and hopefully, by the end, you’ll be relaxed and ready to get your tooth filling done!
FAQS you didn’t ask before the procedure…
Why might you need a tooth filling?
A tooth filling or ‘restoration’ as your dentist will say is simply a repair to a tooth. It’s the dental equivalent of placing Polyfilla to seal a hole in a wall.
You generally need this if your tooth is either broken or decayed (rotten).
Tooth decay is when bacteria causes your teeth to become soft and rot away. Bacteria seeps into your tooth’s inner areas, so to stop the rotting we must remove the part of the tooth which has this bacteria in. If decay is left untreated it will continue to eat away at the tooth, which ultimately can lead to tooth loss.
Removing the decay as early as possible is better as it means more of your natural tooth is left. Less filling is always favourable.
Once the decay is removed the hole will be clean but we can’t leave it like that.
You then need the tooth filling placed in the missing section to restore it to its former glory.
Fillings can also be used to fix chips, rebuild worn teeth, for temporary solutions or for composite veneers, but today we’re going to focus on the standard tooth filling procedure.
That is, you remove the rotten part and fix it.
What’s the difference between NHS and private fillings?
You may have an NHS dentist who gives you a choice of the standard NHS filling or a private filling.
You didn’t know there was a difference so what do you do?
Here’s a little explanation.
The NHS service is there to provide ‘HEALTH’ at a reasonable cost to the taxpayer. This means no expensive filling materials or fancy cutting edge procedure.
You will have the treatment needed to make your mouth healthy. And that is perfectly adequate, but your dentist doesn’t have the ability to do anything fancy if you opt for this.
Therefore, NHS fillings generally consist of silver amalgam fillings at the back and white composite only at the front.
The private filling option is also there foremostly to make sure your teeth are healthy, but your dentist is no longer restricted. They have the ability to make beautiful looking invisible fillings.
There are no demands from the NHS to see a certain number of patients per day and there is no tight budget.
Your dentist can, therefore, use better materials and take their time to produce a filling which looks like a real tooth, even using white fillings on your back teeth.
Like anything in life, you get what you pay for.
So how much does a tooth filling cost?
NHS fillings come under band 2 of the NHS. At the time of writing, this is set by the government at £59.10, but this increases every April.
Private fillings can start from as little as £70 for a simple chip, or increase to a few hundred pounds for perfectly blended composite bonding, for example.
FAQs you won’t ask during the procedure…
What’s the procedure for a tooth filling?
By knowing what’s going to happen during the tooth filling procedure there’ll be nothing to surprise you. So what normally happens?
- At your examination, you’ll probably need an x-ray. If your dentist spots decay they’ll be able to see how extensive it is from this.
- Your dentist will discuss with you which material they think is best for your filling and give you a choice if there is one available.
- If needed, they’ll use a local anaesthetic to numb the area to make the procedure comfortable.
- They’ll clean out the decayed tooth using a water drill, then a rumbling drill.
- Once the decay has been removed and the tooth is clean, they’ll place the filling.
Will you need anaesthetic?
This depends on how deep your filling is.
You’ve probably heard of the enamel layer of your tooth. This is the outer layer which is completely dead and has no nerves in.
Inside this enamel layer though is something called dentin. This layer is alive and it’s possible to feel sensations from it.
When your dentist cleans out decay from your tooth they’ll know from the x-ray which layer it goes in and if you need anaesthetic.
Unless the filling is particularly small I’d always recommend using an anaesthetic. It gives you the peace of mind that the procedure will be easy and comfortable, and it gives your dentist confidence they won’t cause sensitivity and will be able to do their job properly.
The last thing we want is to have to redo the tooth filling if we couldn’t get it perfect the first time around.
Can you have the tooth filling under general anaesthetic or sedated?
If you are nervous there is sometimes the choice of having a tooth filling while drowsy and carefree, or completely asleep.
This means you won’t have to remember the local anaesthetic.
Ask your dentist about the options.
But remember, GA always comes with its risks. I’d always recommend trying a filling under a local anaesthetic first.
What about the drills and the water?
So you’ve had your anaesthetic and your face feels twice the size it was 10 minutes ago.
Perfect.
Now it’s time to clean out the decay and get your tooth healthy again.
Your dentist will use two instruments to clean out the decay.
The first sounds like a high pitched buzz and has a water jet.
We use the water to wash the area and keep everything at the right temperature. This instrument opens the cavity so your dentist can see the decay better.
The second instrument has no water, but it rumbles round more on your tooth. This only removes the decayed tooth.
Your dentist may alternate these as they play hide and seek with the decay until it’s all found.
Whats this air jet for?
Tooth decay is easier to see if your tooth is dry and clean.
The air jet (or as your dentist will call it, the ‘3 in 1’) ensures your dentist has removed all of the decay and has a clean tooth to refill.
OK, it’s time. What tooth filling materials are available?
There are several common materials used for tooth filling. Briefly let’s look at these.
Composite (white fillings)
Composite is a synthetic resin material. Before it has set the composite has plasticine like consistency which your dentist will mould and shape to match your tooth.
It’s then set with a blue light to make it hard and have strength.
The colour can be matched to your tooth too so it’s invisible.
Amalgam (silver fillings)
This is an ‘amalgam’ of different metals, hence the name.
Like composite, it’s used as a permanent filling for teeth.
You’ll hear it mixing up in the background when you have this tooth filling. This mixing starts the setting process of the tin, silver, zinc copper and mercury that make up the ingredients.
Some may be concerned about the mercury content in amalgam fillings, however, the FDA considers it safe for children age 6 and upwards.
Amalgam has been used for 60+ years and is great because it doesn’t get contaminated by water. It’s also strong and durable so great for back teeth.
The obvious disadvantage is the colour. Not everyone wants silver coloured fillings.
Glass ionomer cement (white fillings)
Whereas amalgam and composite are generally used for permanent tooth filling, glass ionomer cement is generally used for temporary fillings for teeth or for children’s permanent fillings.
They are not as strong as amalgam or composite but can be done quickly if kids struggle to sit in the chair.
Ceramic fillings
These are white coloured fillings made by a lab technician, that are then cemented into your mouth.
Because of this extra step, they are more expensive, however, they look great and are less prone to staining than composite fillings.
Gold coloured fillings
Like ceramic fillings, these are made by a lab technician bespoke for your tooth. Because gold is so expensive, more often than not they’re a gold coloured alloy.
How long will the whole procedure take?
I’d schedule anything from 30 minutes for a single filling, to a few hours for multiple large fillings or composite bonding.
Your dentist will give you a good idea at the check-up how long it will take. Just ask.
FAQs you can’t ask after your tooth filling…
After the procedure, you may have some questions. It’s not easy to ask them when you’re dribbling down your chin so I’ll answer the most common ones for you now…
How long will your mouth be numb for?
This depends on a few things.
Which type of local anaesthetic was used, how much was put in and which tooth was numbed will all impact on how long the anaesthetic lasts for.
Anything from 30 minutes to 6-8 hours can be normal, so don’t worry if you can’t eat your dinner properly.
But be careful not to bite your lip, cheeks or tongue.
Will it feel funny afterwards?
Of course, it’ll feel different.
And your tongue will love to go and play with your new tooth filling for a few days, finding every lump and bump that wasn’t there before.
This is normal. Just relax and you’ll soon find it becomes part of you again.
Will your tooth hurt afterwards?
Sensitivity after a filling is completely normal and expected.
Usually, the deeper the filling, the more sensitivity you will have.
Normally this feeling will go after a few days, but in some cases, it could last longer. Rest assured, the sensitive feeling is ordinarily very mild and easy to deal with.
Using sensitive toothpaste (like Sensodyne) and a few painkillers will help with this, but if at any point you’re worried then call your dental practice for advice.
Can you eat and drink straight after?
Usually, we say to leave it an hour before eating or drinking.
This is to make sure your filling sets properly.
If you bite down on it and the filling is still soft it could break or distort.
How long will my tooth filling last?
This depends on so many factors and it’s really hard to say.
Things impacting longevity include what type of filling you’ve had, how much of the tooth was bad before and how well you maintain your oral health.
And finally, if you have any other questions or concerns…
Your dentist and the staff at your dental practice are always here for you.
If you ever have any questions about a tooth filling just call the practice and let them know. The reception staff will happily answer them, or if they can’t they’ll pass them onto the dentist and get back to you.
AUTHOR
Dr Gareth Edwards BDS (Hons) MFDS RCPS (Glasg) qualified as a dentist with honours. Now practising in the Bournemouth & Poole area, he has a keen interest in aesthetic dentistry including orthodontics. He is a certified Invisalign provider.
