Fillings and tooth restorations

A filling restores a tooth that has been damaged by decay, a chip or a fracture — removing what has broken down and rebuilding the tooth so it works and looks as it should.

It is the most common treatment in dentistry, and modern materials and techniques have made it considerably less unpleasant than its reputation.

When a filling is needed

• Decay. A cavity does not heal. Left alone it grows, and the further it travels the more of the tooth is lost — eventually reaching the nerve, at which point the treatment becomes root canal or extraction rather than a filling
• A chipped or broken tooth, whether from trauma or biting something hard
• A failing older filling, where the margin has broken down and decay has started underneath
• Wear, at the gumline or on the biting surface, from grinding or acid erosion

How decay actually works

Bacteria in plaque ferment sugars and produce acid. That acid dissolves minerals out of the enamel. Saliva then buffers the acid and puts minerals back.

Decay happens when the demineralising outpaces the repair. Which is why how often you eat sugar matters more than how much: every exposure starts an acid attack lasting roughly twenty minutes or more, so six small snacks do far more damage than one dessert.

This is also why dry mouth is such a strong risk factor. Less saliva means less buffering and fewer minerals available for repair.

Catching it early is the whole game

Decay progresses through predictable stages. In the earliest — a white spot where minerals have been lost but no cavity has formed — it can often be arrested and remineralised with fluoride and improved home care, with no drilling at all.

Once the surface breaks and a cavity forms, that option is gone. This is the entire argument for six-monthly examinations and for radiographs that show decay between teeth: not to find more work, but to find it while the answer is still "nothing" or "a small filling" rather than "a crown".

Early decay causes no symptoms. By the time a tooth hurts, it is usually well advanced.

What happens at the appointment

1. Assessment. Your practitioner checks the size and depth of the cavity, using radiographs where the decay sits between teeth
2. Anaesthetic, if needed. A topical numbing gel is applied to the gum first, so the injection itself is more comfortable. Very small or shallow fillings sometimes need no anaesthetic at all
3. Removing the decay. Either with a dental handpiece or, where suitable, with our drill-free air abrasion technology — a fine stream of particles rather than a rotating bur, with no vibration and no drill noise. Not every cavity suits it, and your practitioner will tell you if yours does
4. Preparing and filling. The tooth is cleaned and dried, and the material placed in layers
5. Setting, shaping and polishing. Composite is cured with a light, then shaped and polished so it matches the contour of the original tooth
6. Checking the bite. You will be asked to bite on coloured paper so any high spot can be adjusted. Speak up if it feels high — a filling left proud is uncomfortable and can make the tooth ache for weeks

Most single fillings take under an hour.

The materials

Composite resin — tooth-coloured, bonded directly to the tooth, available in a wide range of shades so the result is close to invisible. The standard choice for most fillings, front and back.

Glass ionomer cement — also tooth-coloured, bonds well and releases fluoride, which helps protect the surrounding tooth. Useful for patients at high decay risk, for areas taking less biting force, and commonly for baby teeth.

Amalgam — the traditional silver material. Strong and long-serving, but visually obvious. Victorian Dental Group is an amalgam-free clinic and does not place it. If you have existing amalgam fillings removed here, we use an amalgam separator to capture the residue so it does not enter the wastewater system. Talk to us if you are considering replacing old amalgams; there is no need to replace a sound one purely because of its material, and removing a sound filling costs you tooth structure for no clinical gain.

Temporary fillings — placed at emergency visits or between stages of longer treatment, to keep you comfortable until the definitive restoration.

Deep fillings

Where decay has travelled close to the nerve, the tooth sits in a grey area between a filling and root canal treatment.

In that situation your practitioner may place a protective lining over the deepest part and restore the tooth, giving the nerve a chance to settle. This often works. Sometimes it does not, and the tooth goes on to need root canal treatment weeks or months later.

That is not a failed filling. It is the reasonable attempt to avoid root canal treatment where there was a genuine chance of doing so, and you should be told at the time that it is a possibility rather than discovering it later.

When a filling is not the right answer

Fillings rely on the surrounding tooth for support. Once too much structure has gone, a large filling can act as a wedge and the tooth may fracture — sometimes below the gum, where it cannot be saved.

At that point a crown or onlay is the better restoration, because it wraps and holds the tooth rather than sitting inside it. Your practitioner should show you the tooth and explain which side of that line it falls on.

Afterwards

• Numbness lasts one to three hours. Avoid chewing until it wears off — biting a numb lip or cheek is the most common post-filling injury, and it is easily done. Watch children particularly closely for this
• Composite is fully set before you leave, so you can eat as soon as the numbness goes
• Some sensitivity to cold for days or occasionally a few weeks is normal, particularly after a deep filling
• Contact us if the bite feels high, if sensitivity is worsening rather than settling, or if you get spontaneous or throbbing pain — that can indicate the nerve is involved

Fillings in children

Baby teeth get filled for good reasons: they hold space for the adult teeth, they are needed for eating and speech, and decay in them is painful and can damage the adult tooth developing underneath.

Glass ionomer is often chosen for children because it releases fluoride and is quicker to place. Where a child cannot manage treatment in the chair, we will discuss the alternatives honestly rather than forcing it.

How long do fillings last?

Many years, and often much longer, depending on the size, its position, your bite and your home care. No filling is permanent — all restorations eventually need replacing, and each replacement is a little larger than the last, which is why preventing the first one matters most.

What shortens a filling's life: grinding, a high decay rate, poor cleaning at the margin, and very large restorations in heavy-load positions.

If you grind your teeth, an occlusal splint protects fillings along with everything else.

Preventing the next one

• Brush twice daily with fluoride toothpaste, spit and do not rinse — rinsing washes away the fluoride that does the work
• Clean between the teeth daily, because that is where most adult decay starts
• Reduce how often you have sugar, not just the quantity
• Drink tap water, which is fluoridated in Melbourne
• Sugar-free gum after meals stimulates saliva
• Tell us if your mouth is dry, because it changes everything about your risk

Cost and claiming

Fees depend on the size of the filling, the number of surfaces involved and the material. Your practitioner will confirm the cost before starting.

We claim on the spot through HICAPS — bring your card and pay only the gap. Fillings usually fall under general dental, which most extras policies cover well. Eligible children aged 0–17 may be covered under the Child Dental Benefits Schedule. See payment options.

Book an appointment

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145

Phone (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · closed weekends and public holidays

Book online at any hour.

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