Tooth decay is one of the most common diseases globally, and if you have teeth, you are not immune to it. The decay is caused by acids from bacteria that create tiny holes in tooth enamel and exposed root surfaces. It can also be caused by acids in the food you eat and beverages you drink.
Left untreated, tooth decay progresses into the next layer of the tooth called dentin , which is softer and less resistant to acids. When this happens, your tooth may become more sensitive.
Without proper treatment, the decay will progress into the inner portion of your tooth (the pulp), where the nerves and blood vessels are. The bacteria irritate the pulp tissues, and the pulp can become infected and start to swell. Because tooth structure is hard, the swollen tissues have no room to expand, and pressure builds inside the tooth. The pressure then compresses the tooth nerve, resulting in pain. In severe cases, the infection can progress into your jawbone, leading to missing teeth and other medical and dental issues.
If your tooth is damaged by tooth decay, a filling is normally recommended to restore your tooth to its normal shape, function, and appearance. Fillings are also used to fix chipped teeth or partially broken teeth.
There are five different surfaces on a tooth that can be repaired with a filling. The more surfaces a filling needs to cover (even if it's just a portion of one or more surfaces), the more complex it is to place the filling. In any case, your dentist's goal will be to maintain as much of your original tooth structure as possible.
The benefits of fillings include:
Fillings are typically made of amalgam or composite resin materials. Your dentist will recommend the best option for you based on:
Amalgam: Amalgam fillings are durable and resistant to wear. They are darker in color than other filling materials, which means they are more noticeable. They are not usually used on teeth that are more visible when you talk and smile. Amalgam fillings typically last from 10 to 15 years,1 or longer if they are well placed and properly maintained with good oral hygiene. Changes in your oral habits, or conditions such as dry mouth (xerostomia), or habits such as grinding or clenching (bruxism) your teeth, can shorten this timeframe.
Composite resin: Composite fillings can be color-matched to the same shade as the adjacent teeth and result in a more natural appearance. However, they can become stained from products such as coffee, tea, or tobacco . They may wear faster than other filling materials and may also chip more easily. Composite fillings do not tend to last as long as amalgam fillings (typically up to 10 years).2
A filling procedure varies based on your circumstances and preferences and the methods used by your dentist. The general steps are:
Your dentist will give you specific instructions on how to take care of your fillings. You should request a copy of the instructions. Although the instructions may seem straightforward at the time of your dental appointment, you may have questions and need to refer to them later.
After you leave the dentist's office and while you are still numb:
Depending on the extent of your tooth decay, you may also require:
Some people may want to replace all of their amalgam fillings at once. This can be for cosmetic reasons or because they are concerned about mercury in the fillings. It's important to know that the trace amounts of mercury in fillings have no effect on the body after the filling has hardened in the tooth. Mercury does become vaporized when fillings are removed, which increases your exposure.
Replacing any filling also requires the removal of additional healthy tooth structure, which should be avoided for as long as possible.
If your dentist tells you that many or all of your amalgam fillings need to be replaced in a short time frame, make sure you are aware of the possible risks and concerns. Your dentist is aware of potential risks and will discuss your options to achieve the best outcome for your oral health and your expectations.
If your dentist diagnoses tooth decay in your child's primary teeth, it is especially important to determine the urgency for filling them. Before you agree to have your child's primary teeth filled, be sure to discuss the following situations.
There may be alternatives to a filling depending on the extent of your tooth decay or the severity of the chip in your tooth.
When considering alternatives to fillings, your objective should be to preserve as much original tooth structure for as long as possible. This is because any restoration to your tooth will fail eventually and need to be replaced. When any restoration is replaced, healthy tooth structure may need to be removed for the next restoration. If you can address your tooth decay with a filling, it is generally the smartest and most economical treatment alternative.
Allowing tooth decay to go untreated will result in the destruction of healthy tooth structure and the need for more extensive dentistry. Deep decay may extend into the tooth pulp , which may require root canal therapy . Your dentist may also recommend a crown or onlay following root canal therapy.
If left untreated, the bacteria in a deep cavity will eventually reach the pulp and have an open pathway into your jawbone. This can cause pain, swelling , or numbness. It can also lead to tooth loss (edentulism) or the need for tooth removal (tooth extraction).
Though rare, infections resulting from advanced tooth decay can be deadly and can also affect other medical conditions you may have.