Different types of dental fillings

Although it is important to avoid decay by brushing, flossing and reducing sugary foods, teeth do sometimes become compromised by decay or trauma. Fortunately there are several options for restoring both the strength and the appearance of a tooth.

A Victorian Dental Group practitioner will examine the tooth and may take an X-ray of the area, then pinpoint exactly what restoration is required and discuss the options with you. The material choice is usually guided by your practitioner — but where the clinical situation allows more than one reasonable answer, it can come down to your preference, and it is worth understanding what you are choosing between.

The options side by side

	Composite resin	Glass ionomer	Amalgam	Inlay / onlay / crown
Appearance	Tooth-coloured, excellent	Tooth-coloured, more opaque	Silver	Tooth-coloured or gold
Bonds to the tooth	Yes	Yes, chemically	No — held by shape	Yes, cemented or bonded
Tooth removed	Least	Least	More, to create retention	Depends; often conserving
Strength under load	Good	Lower	Very high	Highest
Releases fluoride	No	Yes	No	No
Visits	One	One	One	Two, with laboratory time
Typical use	Most fillings, front and back	Baby teeth, root surfaces, high decay risk	Not placed here	Large cavities; cracked or heavily filled teeth

Composite resin

The most common choice, and the default for most fillings today.

Composite is a tooth-coloured resin bonded directly to the tooth surface and set hard with a curing light. It comes in a wide range of shades, so a well-placed composite is close to invisible.

Advantages. Excellent appearance. Bonds to the tooth, which means less healthy structure has to be removed to hold it in place — the filling is retained by adhesion rather than by shape alone. Repairable. Completed in a single visit.

Limitations. Requires the tooth to be kept properly dry during placement, so it is more technique-sensitive than the alternatives. Can stain at the margins over years. Very large composites in heavy-load molars are less durable than a crown.

Glass ionomer cement

Another tooth-coloured material, with a specific advantage: it releases fluoride, which helps strengthen the surrounding tooth from the inside.

Advantages. Fluoride release makes it valuable for patients at high decay risk. Bonds chemically to tooth structure and is more tolerant of moisture during placement — useful in a small child's mouth, or near the gumline where dryness is hard to maintain. Commonly used for baby teeth.

Limitations. Less wear-resistant than composite and less strong under heavy biting force, so it is generally used where aesthetics and load are lower priorities.

Amalgam

The traditional silver material, strong and long-serving, and once the standard for back teeth.

Victorian Dental Group is an amalgam-free clinic. We do not place it.

What that does not mean is that your existing amalgam fillings are dangerous. There is no need to replace a sound amalgam filling purely because of its material — removing an intact one means cutting away healthy tooth to do it. If yours are failing, or you would prefer a tooth-coloured alternative, talk to us and we will explain the options.

If old amalgam is removed here, an amalgam separator captures the residue so it does not enter the sewage system.

Temporary fillings

Placed at emergency visits, or between stages of longer treatment such as root canal therapy, to keep you comfortable until the definitive restoration.

They are designed to be removed, so treat them gently: avoid sticky food on that side and do not delay the follow-up appointment. A temporary left too long will eventually leak.

Indirect restorations

When a cavity becomes too large for a direct filling, the answer moves to something made outside the mouth and cemented in — an inlay, onlay or crown.

The judgement is about how much sound tooth remains. A filling relies on the surrounding tooth for support; once the walls are thin, a large filling can act as a wedge and the tooth may split. A crown wraps and holds the tooth instead.

Inlay — sits within the cusps, like a filling made outside the mouth. Onlay — covers one or more cusps, protecting them from splitting. Crown — covers the whole tooth.

An onlay is often the middle option nobody mentions: more protective than a large filling, more conserving of tooth structure than a full crown.

What actually happens at the appointment

Numbing, where it is needed. Small, shallow fillings sometimes do not need it, and you can ask either way
Isolation — often a rubber dam or cotton rolls. Keeping the tooth dry is what makes a bonded filling last
Removing the decay, with a handpiece or, for some small cavities, drill-free air abrasion
Preparing and conditioning the surface so the material bonds
Placing the material in layers, each set with a curing light
Shaping the anatomy back — the grooves and contours matter for how you chew
Checking the bite with coloured paper, and adjusting until it feels even
Polishing, which reduces staining later

Most single fillings take twenty to forty minutes.

Afterwards

A composite is set hard immediately. You can eat as soon as the numbness has gone
Wait until the numbness wears off before eating — two to four hours for a lower tooth. Biting a numb lip or cheek is the most common injury after a filling, and it is worse in children
Some sensitivity to cold for a week or two is normal, particularly with a deep filling
The bite should feel even. If the tooth feels high after the numbness has gone, or you are catching it when you chew, come back — it takes two minutes to adjust and it prevents weeks of soreness
Sharp pain on biting, or pain that lingers after hot or cold, is worth reporting. A very deep cavity is close to the nerve, and occasionally a tooth does not settle

How long does a filling last?

The honest answer: no filling is permanent. A well-placed composite in a well-maintained mouth commonly lasts many years, and some last far longer. The variables that matter most are not the material:

Size. A small filling outlasts a large one, every time
Position. Back teeth take far more load than front
Grinding. Heavy grinders break restorations. See occlusal splints
Decay risk. New decay at the edge of a filling is a common reason for replacement
Cleaning, particularly between the teeth, where most replacement decay starts

Every replacement removes a little more tooth. That is the real argument for preventing the second filling rather than choosing a better material for the first.

Do all cavities need filling?

Not immediately, and not all.

Very early demineralisation — a white or brown spot with the enamel surface intact — can often be arrested and monitored with fluoride, dietary change and better cleaning. Filling it removes tooth that could have been saved.

A cavity through the enamel surface needs restoring. It will not remineralise, and it will grow.

This is a judgement your practitioner should explain, with the X-ray or the camera image in front of you. "Watch and review" is a legitimate plan, not a fobbing-off, provided there is a review date.

Which is right for you?

It depends on where the tooth sits, how much force it takes, how visible it is, how much structure is left, your decay risk and your budget. Your practitioner should show you the tooth on the intra-oral camera or radiograph and explain the reasoning, not just name a material.

Ask what happens if you do nothing, and how long each option is likely to last. Both are reasonable questions and you should get straight answers.

Questions we are asked

Does a filling hurt? The injection is the part people remember; the filling itself should not hurt. Tell us if you feel anything sharp — more anaesthetic can be given.

Can I have a filling without an injection? Sometimes, for small and shallow cavities, and more often with air abrasion. Ask.

Will my white filling stain? At the margins, gradually, particularly with heavy coffee, tea or smoking. Polishing at check-ups helps.

Can a filling be repaired rather than replaced? Often, yes. Repairing a small defect in a composite conserves tooth structure and is usually the better option.

Are white fillings as strong as amalgam? Modern composites are strong and well proven for most situations. For very large cavities in molars, the better comparison is not amalgam but an onlay or crown.

Is the mercury in my old fillings a risk? Mainstream health authorities have repeatedly reviewed this and do not recommend removing sound amalgam fillings. Removal itself releases more than leaving them in place.

What if I need a filling on a front tooth? Composite, almost always, shade-matched to your tooth. Whitening should happen first if you plan to whiten — the filling will not change colour afterwards.

Can children have white fillings? Yes. Glass ionomer is often chosen for baby teeth for the reasons above; composite is used where the situation suits it.

Who provides this here

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. Fillings are placed by our dentists. Where a tooth needs more than a filling — a crown, root canal treatment, or specialist care — we will say so, explain why, and quote it before anything starts.

Learn more

Read about the filling and restoration services offered at Victorian Dental Group, including our drill-free air abrasion technology.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · book online

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.

What filling materials are there?

Composite resin, the tooth-coloured material used for most fillings; glass ionomer cement, which releases fluoride; amalgam, the traditional silver material; and temporary materials used between stages of treatment. For larger cavities, an inlay, onlay or crown made in a laboratory is sometimes a better answer than a direct filling.

Does Victorian Dental Group place amalgam fillings?

No — we are amalgam-free, so new fillings are tooth-coloured. An amalgam separator is installed, so that when an old amalgam filling does need removing, the waste is captured rather than entering the sewer system.

Should I have my existing amalgam fillings replaced?

Not simply because they are amalgam. A sound amalgam filling that is sealing well should generally be left alone. Replacing it means cutting out healthy tooth structure as well, leaving a larger cavity and a shorter-lived tooth, and the drilling itself releases more mercury vapour than leaving the filling in place would. Amalgams are replaced when there is a clinical reason — decay underneath, a fracture, a leaking margin, or the tooth breaking down — not as a routine upgrade.

Is amalgam safe?

Health authorities in Australia and internationally regard amalgam as safe for the general population, and the mercury in set amalgam is chemically bound rather than free. Use has declined worldwide partly for environmental reasons under the Minamata Convention, and as a precaution it is avoided in children, and in pregnancy and breastfeeding. If you have concerns about your existing fillings, raise them — but the answer is a discussion of the evidence, not automatic replacement.

What is composite resin?

A tooth-coloured resin bonded directly to the tooth and set with a curing light, built up in layers and shaded to match. It is the usual choice for most fillings, front and back. It bonds to the tooth so less healthy structure needs removing than with amalgam, and it can be repaired or added to. It is technique-sensitive, takes longer to place, and like any filling it has a finite life.

What is glass ionomer cement used for?

It bonds chemically to the tooth and releases fluoride, which helps protect the adjacent tooth surface — useful in people at high risk of decay. It is less strong and less wear-resistant than composite, so it is generally used where biting forces are lower or access is difficult: root surfaces near the gum, fillings in baby teeth, temporary and interim restorations, and as a base underneath another material.

When is a temporary filling used?

At an emergency visit to settle a tooth and keep you comfortable, between stages of root canal treatment, or while waiting for a laboratory-made crown or inlay. Temporary materials are soft and wear down quickly — they are not meant to last. Tell us promptly if one comes out, as the tooth underneath is left unprotected.

How is the right filling chosen?

By examining the tooth and usually taking an X-ray, since the size and position of the cavity, how much sound tooth remains, the biting forces on it, moisture control and your decay risk all bear on the choice. Where a cavity is too large for a filling to hold up, that is said plainly and the alternatives discussed. You receive written costs beforehand. Victorian Dental Group, 291 Wattletree Road, Malvern East VIC 3145 — (03) 9088 5808, Monday to Friday 8:00am to 5:00pm.