Perhaps one of the most common treatments that people experience anxiety over is fillings. This routine procedure is carried out frequently by most dentists, however, if you have dental phobia, understanding what to expect in more depth is a helpful way of overcoming your fears.
Cavities, cracks, and breaks in the enamel of your teeth can grow over time and the inside of the tooth can become infected. To repair minor damage in a tooth and prevent further decay, a dentist may recommend a filling.
A filling is a type of restoration used to fill the gap in your tooth’s enamel left by damage or decay. There are several different types of fillings, and your dentist will use the material they regard to be the best option.
Reasons for Needing a Filling
The most common reason for needing a filling is tooth decay. This is caused by plaque bacteria which feeds on sugar and starch left on your teeth after eating or drinking. Plaque contains acids that will dissolve your tooth’s enamel leading to the formation of holes.
Another possible cause is acid erosion. When this occurs, your tooth’s enamel will be worn down through exposure to acids in certain food and drink or from elsewhere in your body such as through acid reflux or a hiatus hernia.
Trauma to your teeth such as chips and abrasions may lead to the need to have a filling.
There are several methods used by dentists to assess whether you have cavities that need filling. These include:
- Use of a mirror to identify discoloured patches on your teeth that indicate decay
- Use of a sharp-tipped probe to identify soft and weakened enamel
- Use of temporary dye that will adhere to decayed portions of your tooth but wash off the healthy areas
- Use of X-rays to reveal the presence of dentin beneath the surface of the tooth’s enamel
- Using laser fluorescence which measures any changes in the tooth caused by decay
Types of Fillings
Dental amalgam fillings are the most common type of fillings. These are made using a variety of metals and are generally used on your back teeth where they will be less visible. Amalgam is widely used as it is a hard-wearing option.
When you’re having a filling in a front tooth, your dentist will typically recommend a tooth-coloured material.
The most common materials used in fillings include:
- Amalgam – These silver-coloured fillings are made using metals such as copper, mercury, silver, and tin. This is generally the most cost-effective and durable option.
- Composite – These tooth-coloured fillings are made using a mixture of glass and resin. Procedures using composite fillings have more stages and typically take up to 20 minutes longer.
- Glass ionomer – These tooth-coloured fillings are made from powdered glass. When bonded with your tooth, they release fluoride which is useful in preventing decay
The Benefits of Fillings
Having fillings will:
- Prevent your cavity from growing
- Provide strength to a fractured tooth
- Prevent tooth decay
- Improve the structural integrity of your tooth
- Improve the function of your tooth
The Filling Procedure
Getting a filling can be daunting if you have a phobia, however, understanding this routine procedure may make you feel more confident.
Your dentist will carry out the procedure under local anaesthetic. This means that the area surrounding the damaged tooth will be numbed. Anaesthetic is fast-acting allowing the dentist to continue to the first stage of the procedure quickly.
Using either a drill, laser, or an air abrasion instrument, the dentist will carefully remove the decayed portion of your tooth. The exact choice of tool will be determined based on the extent and location of the decay, and the preferences of the dentist. If you have phobias surrounding particular instruments, speak to your dentist as they may be able to use alternative tools.
Next, the dentist will check that all of the decay has been successfully removed by probing your tooth. Once your dentist is satisfied that the decay is no longer present, they will clear the cavity of any debris and bacteria to prepare for the filling.
If you have decay close to the root of your tooth, your dentist may use a liner made from composite resin or glass ionomer. This will serve to protect the nerve.
If you’re having tooth-coloured fillings, your dentist will apply the material in several layers. To harden or ‘cure’ each layer, a special light will be used.
Once the filling is in place, the dentist will trim or smooth off the material so that there are no rough patches before polishing it.
Following the Procedure
As the local anaesthetic wears off, your mouth may feel numb causing problems eating, drinking, and talking. This is completely normal, and normal sensations will return soon after.
If you need to eat while your mouth is numb, take care to chew on the opposite side of your mouth from the filling and avoid accidentally biting your tongue or the walls of your mouth.
Immediately after having a filling, you may feel some sensitivity to temperature, pressure, air, and sweet food and drinks. This usually goes away within a few weeks. During this time, try your best to avoid whatever is causing sensitivity. You will not usually need to take any painkillers for this.
For a short period of time after the procedure, you may feel some pain. Again, this should only last for a few weeks.
If you’re having problems with pain or sensitivity after a few weeks, or you’re experiencing pain when biting, contact your dentist. Sometimes the filling needs to be reshaped.
If the pain is persistent, it may be caused by decay that is close to the tooth’s pulp. If this is the case, a root canal treatment may be necessary.
What are the signs that I need a filling?
You may need a filling at any point in your life. The signs that suggest that you may need one include any pain while biting, sensitivity to hot and cold drinks and food, and toothache. It is not uncommon to notice food getting stuck in teeth that have cavities.
Why do I need a filling?
Fillings are one of the most common procedures to prevent further damage or decay to your teeth. You may wonder why you need a filling.
Your dentist will recommend a filling if you have a cavity or minor fracture as it will repair these. Having a filling will not only minimise the need for further, more complicated procedures, but it will also reduce any sensitivity caused by the destruction of your tooth enamel.
While you may feel anxious about having the procedure, the sooner you have it, the better. If the decay is allowed to spread, you may need an extraction.
Often, the rear teeth such as your premolars and molars will be the most susceptible to decay. This is because there are lots of hard-to-reach areas that can easily be missed when cleaning your teeth.
Damage to your tooth could also be caused by biting your nails, grinding your teeth, and using your teeth to open packages and bottles.
Are amalgam fillings toxic?
Amalgam is a popular choice of filling material, however, it has been reported that this option is dangerous or toxic. Various online articles have suggested that there is a link between amalgam fillings and autism, Alzheimer’s disease, and multiple sclerosis.
While it is true that amalgam fillings can release mercury vapour at low levels, especially while they’re put in or removed, there is no evidence that suggests mercury in such small amounts will have any negative effects on your health. There is no scientific evidence to back up any of the suggestions that amalgam fillings will cause any of the conditions listed above.
If you are anxious about anything you have read about amalgam fillings, speak with your dentist about your concerns.
What are indirect fillings?
Indirect fillings are tooth-coloured fillings that are made in a dental laboratory. These are used when the remaining structure of a molar or premolar tooth cannot hold a filling, but where the damage is not so severe a crown is needed.
Before you can have an indirect filling, the dentist will need to take an impression of the damaged tooth. This will be done once any decay or existing fillings have been removed from the tooth.
The impression will then be sent to a dental laboratory where the filling will be made. So that your tooth is protected while the filling is being made, a temporary filling will be used. This will be removed on your second visit before the indirect filling is put into position.
Once the dentist is satisfied with the position of the filling, it will be cemented into position.
The two types of indirect fillings are:
- Inlays – Similar to conventional fillings, these work within the cusps of the tooth
- Onlays – Sometimes referred to as partial crowns, inlays cover the cusps
These types of restorations last much longer than conventional fillings and are made of composite resin, gold, or porcelain. Because they cover the whole area on the top of the tooth, any force produced while chewing is equally distributed across the entire restoration.
Why do I feel pain in my tooth after having a filling?
There are several causes of pain after having a filling. Each cause will manifest differently.
- If you experience pain while biting then the filling may need to be reshaped.
- Pain, while your teeth are touching, can be caused by two metal fillings pressing against each other. This will usually go away on its own.
- A toothache may occur when the decay is deeper than first thought. In this case, a root canal will remove any damaged pulp and rid the tooth of any infection.
- If you have a referred pain or sensitivity in other teeth, this is just the filled tooth passing on the pain signals to neighbouring teeth. This should subside on its own within a few weeks.
Are there any risks or complications surrounding getting a filling?
It is fairly normal to worry about potential risks or complications surrounding a procedure. If you have dental phobia, understanding these can help.
Having dental restorations such as fillings is a very common procedure, and they have a high success rate with very few potential complications.
Allergies to the metals used in amalgam fillings is a possibility, however, this is extremely rare. In cases where a patient has a known allergy to certain metals, different materials will be used.
Over time, your filling may wear down, however, it should last for several years. Clenching or grinding your teeth as well as biting hard objects and neglecting to thoroughly clean your teeth will all increase the speed at which your fillings will deteriorate.
Why would a filling need to be replaced?
Dental fillings occasionally need to be replaced. The reasons for this would be:
- Normal wear and tear – Over time your fillings will start to wear down. A dentist will usually spot this through a routine check-up.
- Fitting failure – If the seal provided by the filling breaks down, bacteria can get inside your tooth and cause decay. This can lead to your dental pulp becoming infected or the development of an abscessed tooth. A root canal will be needed to evacuate the infected pulp.
- If the filling or decay is too large – In this instance, your dentist may recommend replacing the filling with a dental crown.
How can I avoid needing a filling in future?
Prevention is always better than the cure, and if you want to avoid the need to have fillings you should ensure you brush your teeth thoroughly for two minutes each morning and again at night. You should also make sure that you regularly change your toothbrush and use a toothpaste that is recommended by dentists.
Using dental floss to clean between your teeth can help remove any food debris or bacteria that brushing may miss. Additionally, rinsing your mouth using mouthwash will also prevent bacteria from building up.
Regular visits to your dentist or dental hygienist for a scale and polish will help remove any tartar that builds up over time and is also a good chance to have your teeth assessed.
Finally, try to reduce the consumption of sugary foods and drinks.
What questions should I ask my dentist about fillings?
There are probably lots of things you may want to know about the filling you’re getting. Ask about the type of material being used, which tooth is affected, and whether there is anything in particular that you should do to look after the filling once it’s in place.
What should I do if I am anxious about getting a filling?
If you have anxiety surrounding getting a filling, find a Dental Phobia Certified dentist to carry out the procedure. Registering with a dentist that has this certification means that you’re in the hands of someone who has empathy towards your fears and anxieties.
Your dentist will be on hand to talk about the procedure in-depth, and will also be able to take everything at your pace.
You may want to take someone along with you to the appointment for moral support. If possible, get an appointment while the practice is at its most quiet. This helps minimise any additional stress surrounding your visit.
If the sound of dental instruments such as drills affects you, consider wearing noise-cancelling headphones.
Finally, consider talking to your dentist about sedation options. Many practices now offer injection-free sedation that allows you to undergo treatment while remaining perfectly calm.