If you’ve been told you need a filling, the first questions are usually what it will be made of and what the visit involves. Here’s what each material is like, what happens in the chair, and what to expect afterward, plus how to tell whether you need a filling at all. At Icon Dental Center in Everett, fillings are done by our general dentists, Dr. Nadia Aboulhosn, Dr. Joanna Valentine, and Dr. Fiona Kwok, all of whom studied at the University of Washington.
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How to Tell If You Need a Filling
Common signs of a cavity include sensitivity to sweets, hot, or cold, and a toothache that may come and go. But early tooth decay usually causes no symptoms at all, which is why most cavities are found at a routine checkup, sometimes on X-rays before they can even be seen.
You might also notice a spot on a tooth, or an old filling that has cracked or broken. Not every dark spot is decay: coffee, tea, and red wine leave surface stains, while a brown spot with a small hole is more likely a cavity. A dentist can tell the difference.
Decay on the outer enamel usually doesn’t hurt. As it advances, it can cause sensitivity or a toothache, and once it reaches the pulp, the nerve at the center of the tooth, a filling alone may not be enough.
How Long Does a Filling Take?
A composite, amalgam, or glass ionomer filling is done in a single visit. Gold and lab-made ceramic fillings usually take two.
Numbing usually takes a few minutes to work. Composite hardens under a curing light in seconds, one layer at a time, so there’s no waiting for it to set, but it’s best to eat only after the numbness wears off.
Not sure whether your symptoms could be caused by a cavity? Call our Everett dental office, and we can help you decide whether it’s time to schedule an exam.
What Fillings Are Made Of
The five main types of dental fillings are composite resin, amalgam, gold, ceramic (porcelain), and glass ionomer. Which one your dentist recommends depends on things like the size of the cavity, where it is, and whether the filling will show when you smile.
| Material | Appearance | Common uses | Relative durability | Main advantage | Main drawback |
|---|---|---|---|---|---|
| Composite resin | Tooth-colored | Small to mid-size fillings; teeth that show | Good in small to mid-size fillings | Matches the tooth; less tooth removed | May need replacing sooner in larger fillings |
| Amalgam | Silver | Larger fillings where appearance matters less | High | Strong and the least expensive | Noticeable; more tooth removed; contains mercury |
| Gold | Gold | Inlays and onlays | Highest | Longest-lasting filling material | Costs more than amalgam; noticeable; usually two visits |
| Ceramic (porcelain) | Tooth-colored | An option for cavities too wide for composite | Good, but can fracture | Matches the tooth as one solid piece | Costs more than composite; can chip or crack |
| Glass ionomer | Tooth-colored | Baby teeth, near the gumline, under other fillings | Lower | Releases fluoride | Not as durable; only for low chewing force |
Composite resin
Composite is a tooth-colored mix of resin and fine glass or quartz particles, bonded directly to the tooth. Because it bonds, it usually means removing less healthy tooth than amalgam. It holds up well in small to mid-size fillings, but in larger ones it may need replacing sooner than amalgam or gold.
Amalgam
Amalgam is a silver-colored mix of mercury with silver, tin, and copper, and it has been used in fillings for more than a century. It’s strong, long-lasting, and the least expensive filling material. The trade-offs are that it’s noticeable and may mean removing more of the tooth to hold it in place.
Gold
Gold fillings are made in a dental lab, usually as an inlay or onlay, and cemented in place, which typically takes two visits. Cast gold is considered the longest-lasting filling material. It costs more than amalgam, and it’s clearly visible.
Ceramic (porcelain)
Ceramic fillings are tooth-colored and made as a single solid piece. They’re usually made in a dental lab over two visits, though some dental offices mill them on-site in a single visit. Ceramic can be an option when a cavity is too wide for a composite filling. It costs more than composite, and it can chip or crack, one of the main ways ceramic fillings fail.
Glass ionomer
Glass ionomer is a tooth-colored material that releases fluoride over time. It isn’t as durable as the other options, so it’s used where chewing force is low: in baby teeth, near the gumline, and as a base under other fillings.
Everett, WA
Think you might need a filling?
A routine checkup is the simplest way to find out.
Composite or Amalgam?
Composite works well for small to mid-size fillings and teeth that show, because it matches the tooth and needs less healthy tooth removed. Amalgam is strong, long-lasting, and the least expensive, but it’s noticeable.
The mercury in amalgam is a common concern. According to the FDA, most evidence shows that mercury from amalgam doesn’t cause health problems in the general population, but some groups may be at higher risk: pregnant or nursing women, women planning a pregnancy, children (especially those under 6), and people with impaired kidney function, an existing neurological condition, or an allergy to mercury or the other metals in amalgam. If that’s you, talk with your dentist about other materials. The FDA doesn’t recommend removing amalgam fillings that are in good condition with no decay beneath them.
Your dental plan can matter, too. Some plans cover a composite filling on a back tooth only at the amalgam rate, which the ADA calls a “least expensive alternative treatment” clause, and leave you to pay the difference. Icon Dental Center is in network with Delta Dental/WDS, Regence, Premera, Aetna, and Cigna. Whichever plan you have, check how it covers each filling material before you decide.
What Actually Happens
A direct filling usually goes like this:
- The area is numbed with a local anesthetic.
- The decay is removed.
- The filling material is placed; composite is usually built up in layers.
- Composite is hardened with a curing light.
- The filling is shaped and polished, and your bite is checked.
Getting a filling shouldn’t hurt, though you may feel some pressure. If something does hurt, tell your dentist.
Gold and lab-made ceramic fillings usually take two visits: one to prepare the tooth and take an impression, and one to cement the finished piece, with a temporary filling in between.
A filling isn’t always the right repair. When decay is extensive and there isn’t much tooth structure left, the tooth may need a dental crown instead. If decay has reached the pulp, a filling alone may not be enough, and other treatment may be needed to save the tooth. If the tooth can’t be saved, a tooth extraction may be needed.
Temporary Fillings
A temporary filling only has to last until your permanent restoration is placed, often between two visits while it’s being made in a lab. If a temporary filling comes out, call your dentist.
What to Expect Afterward
After a filling, numbness usually wears off in about two hours. Until then, avoid chewing on that side so you don’t bite your cheek, lip, or tongue without noticing.
Mild sensitivity after a filling is normal and usually fades within a week or two. If pain gets worse or doesn’t ease, or it hurts to bite down, call your dentist. A filling that sits too high can be adjusted.
New decay at the edge of a filling is the most common reason fillings need to be replaced, so keep brushing and flossing around them like the rest of your teeth.
Common Questions About Fillings
Does getting a filling hurt?
Getting a filling usually isn’t painful because the area is numbed first. You may still feel some pressure, and a numbing gel is often used to make the injection more comfortable.
How long do dental fillings last?
Dental fillings don’t last forever, but many last 10 years or more. Amalgam and gold generally outlast composite. How long a filling lasts depends on its size, the material, grinding or clenching, and whether new decay forms around it.
Can a filling fall out?
Yes. Older fillings can break or come loose and fall out. If a filling breaks or comes out, call your dentist soon.
Do I need a filling if the tooth doesn’t hurt?
You might. Early tooth decay usually has no symptoms, so a tooth can need a filling even when it feels fine. But very early decay, before a cavity forms, can sometimes be stopped or even reversed with fluoride, so a filling may not be needed yet. An exam and X-rays show which it is.
Need a filling? Learn more about dental fillings at Icon Dental Center →