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Tooth Filling Guide: Step-by-step Dental Procedure and 4 Types

Woman smiling in zoom

Dentists use tooth fillings, or dental fillings, to fill cavities and repair damaged teeth. They restore the integrity and function of teeth affected by decay or damage and prevent further decay by sealing off areas where bacteria could penetrate and cause additional harm.

Other reasons for filling include addressing tooth sensitivity, repairing cracks or fractures in teeth, and improving the appearance of teeth with cosmetic imperfections.

Dental fillings can restore teeth’s natural structure and function, alleviate pain or discomfort associated with decay or damage, and prevent the progression of dental problems that could lead to more extensive treatments.

This article aims to provide a step-by-step, painless procedure for different types of fillings, such as amalgam filling, gold filling, temporary fillings, and composite resin.

Step-by-step Tooth Filling Procedure

Patient being checked by dentist

Whether you’re familiar with dental fillings or exploring them for the first time, this will give you insights into the process, types of fillings available, and their benefits for dental health.

Examination and Diagnosis

During the initial phase of the tooth-filling procedure, the dentist examines the affected tooth to assess the extent of decay or damage. This examination may involve visual inspection and tactile assessment, as well as the use of X-rays to obtain a detailed view of the tooth’s structure.

Using advanced diagnostic tools and techniques, the dentist carefully evaluates the condition of the tooth and surrounding tissues to determine the appropriate course of treatment.

Based on the findings from the examination and diagnosis, the dentist determines whether a filling is the most suitable treatment option. Factors such as the size and location of the decay, as well as the overall condition of the tooth, are taken into consideration when making this decision.

Whether it’s amalgam fillings, gold fillings, composite fillings, or other types of fillings, the dentist selects the right filling material based on the specific needs of the patient and the tooth in question. This careful consideration ensures optimal outcomes and helps maintain the strength of the natural tooth.

By accurately diagnosing the problem and recommending the most appropriate treatment, the dentist helps preserve oral health and prevent further dental issues. This proactive approach underscores the importance of regular dental examinations and timely interventions to address tooth decay and maintain optimal oral health.

Preparing for the Procedure: Anesthesia Options

Patients often have concerns about pain management and anesthesia options before undergoing a tooth-filling procedure. Dental professionals typically offer several anesthesia options to ensure patient comfort during the procedure.

Local Anesthesics: This is the most commonly used anesthesia for dental procedures, including tooth fillings. It involves injecting a numbing medication, usually lidocaine, directly into the gum tissue near the affected tooth. Local anesthesia blocks nerve signals in the area, effectively numbing the tooth and surrounding tissues to prevent pain during the procedure. This option allows patients to remain awake and alert while experiencing minimal discomfort.

Topical Anesthesia: Before administering local anesthesia, dentists often place a numbing gel on the injection site to lessen discomfort from the needle prick. Topical anesthesia numbs the surface of the gum tissue, making the injection process more comfortable for patients.

Nitrous Oxide Sedation (Laughing Gas): Nitrous oxide, or laughing gas, is a mild sedative dispensed through a mask placed over the nose. It helps patients relax during dental procedures and is usually used together with local anesthesia.

Cleaning the Cavity

Cleaning the cavity, also known as removing the decay, is a crucial step in the tooth-filling procedure that involves meticulous attention to detail to ensure the success of the restoration. Here are the steps involved:

  1. Isolation: The dentist begins by isolating the affected tooth using a dental dam or cotton rolls to keep it dry and free from saliva during the procedure. This isolation helps maintain a clean working environment and prevents contamination of the cavity.
  2. Anesthesia: If not already administered, the dentist may inject local anesthesia to numb the surrounding tooth and tissues, ensuring the patient’s comfort during the procedure.
  3. Decay Removal: The dentist carefully removes the decayed portion of the tooth using specialised dental instruments such as a dental drill or air abrasion. The goal is to eliminate all traces of decay while preserving as much healthy tooth structure as possible.
  4. Evaluation: Throughout the decay removal process, the dentist continuously assesses the tooth to ensure that all decayed material has been thoroughly removed.
  5. Cleaning and Disinfection: Once the decay has been removed, the dentist thoroughly cleans and disinfects the cavity to eliminate any remaining debris and bacteria.
  6. Etching (Optional): In some cases, especially when using composite resin fillings, the dentist may etch the cavity walls with an acidic solution to create a rough surface for better bonding of the filling material.
  7. Moisture Control: Before placing the filling material, the dentist ensures that the cavity is completely dry to facilitate optimal bonding and longevity of the restoration. This may involve using air syringes or cotton pellets to remove excess moisture from the cavity.
  8. Final Assessment: Once the cavity is cleaned and prepared, the dentist conducts a final assessment to confirm that the tooth is ready for filling. This includes checking for any remaining decay or irregularities in the cavity walls.

Placing the Filling Material

Placing the dental filling materials is the next critical step in the tooth filling procedure, where the dentist carefully fills the cleaned cavity to restore the tooth’s structure and function. Here’s a detailed overview of the process:

  1. Selection of Filling Material: Based on aspects such as the location and size of the cavity, as well as patient preferences, the dentist selects the appropriate filling material. Common options include amalgam, composite resin, gold, porcelain, or glass ionomer fillings.
  2. Preparation: Before placing the filling material, the dentist ensures that the cavity is thoroughly cleaned, dried, and free from any debris or contaminants. Proper moisture control is crucial to facilitate optimal bonding of the filling material.
  3. Application: Using specialized dental instruments, the dentist carefully applies the chosen filling material to the prepared cavity. The material is placed in layers, with each layer compacted and shaped to mimic the natural contours of the tooth closely.
  4. Shaping and Contouring: As the filling material is applied, the dentist shapes and contours it to ensure a snug fit within the cavity and proper alignment with the surrounding teeth. This step helps restore the tooth’s natural appearance and function.
  5. Curing (if applicable): For certain types of filling materials, such as composite resin, a curing light may be used to harden the material and bond it securely to the tooth structure. This ensures the durability of the restoration.
  6. Final Adjustment: Once the filling material is in place, the dentist performs a final assessment to ensure that the restoration is aligned correctly, smooth, and functional. Any excess material is cut and polished to achieve an optimal result.
  7. Post-Placement Care: After placing the filling material, the dentist provides instructions on post-treatment care, including oral hygiene practices and dietary recommendations. Patients must avoid chewing on hard or sticky foods after the procedure to allow the filling material to set and bond to the tooth entirely.

Shaping and Polishing

In the final steps of the tooth filling procedure, the dentist checks the patient’s bite to ensure proper alignment and function of the restored tooth. At this stage, any adjustments needed to achieve a comfortable bite are made.

After confirming the bite, the dentist shapes and polishes the filling to blend smoothly with the surrounding tooth structure. This involves smoothing out any rough edges and refining the contours of the filling to enhance both its appearance and function.

By meticulously shaping and polishing the filling, the dentist ensures a comfortable fit, natural appearance, and long-lasting durability of the restoration, promoting optimal oral health and function for the patient.

Post-Procedure Care

After the tooth filling procedure, the dentist conducts a thorough bite adjustment to ensure that the filling does not interfere with the patient’s normal chewing function. This involves checking the alignment of the teeth and identifying any high spots or areas where the filling may be causing discomfort.

Using specialized dental instruments, the dentist carefully adjusts the filling to achieve a balanced bite, ensuring that the upper and lower teeth come together properly when chewing or biting down. By eliminating any high spots or discrepancies in the bite, the dentist helps prevent potential issues such as premature wear or damage to the restoration.

Types of Dental Fillings Material

Dentist cleaning patients teeth

Your dentist will let you choose the kind of dental filling materials you want before the procedure.

Composite Resin Fillings

Composite resin material fillings offer several attributes that make them popular for dental restorations:

  1. Durability: While composite resin fillings may not be as durable as materials like amalgam or gold, they are still highly durable and can resist normal chewing forces. With the right care and maintenance, composite resin fillings can last for many years.
  2. Aesthetics: One of the benefits of composite resin fillings is their natural appearance. These fillings are tooth-coloured and can copy the colour of the surrounding teeth, making them similar to natural tooth structures. This aesthetic advantage makes composite resin fillings particularly popular for visible teeth.
  3. Cost: Composite resin fillings are more expensive than amalgam fillings but may be comparable in cost to other tooth-coloured options, such as porcelain fillings. While they may have a higher upfront cost, many patients are willing to invest in composite resin fillings for their aesthetic benefits.

In terms of suitability based on location and cavity size:

  • Front Teeth: Composite resin fillings are highly suitable for cavities in the front teeth due to their natural appearance. They smoothly blend in with the tooth structure, making them an ideal choice for visible areas.
  • Smaller Cavities: Composite resin fillings are well-suited for smaller cavities as they require less tooth structure removal than other filling materials. Their ability to bond instantly to the tooth surface also makes them a good option for conservatively restoring minimal decay.
  • Teeth Subject to Moderate Chewing Pressure: While composite resin fillings are durable, they may not be the best choice for teeth subject to heavy chewing forces, such as molars. In these cases, materials like amalgam or gold may be more appropriate due to their superior strength.

Amalgam Fillings (Silver Fillings)

Amalgam fillings, mostly known as silver fillings, have been used for decades in dental restorations. Here are some key attributes of this specific filling material:

  1. Durability: They are known for their exceptional durability. They can withstand heavy chewing forces and are less prone to wear and fracture compared to other filling materials. With proper care, amalgam fillings can last for many years.
  2. Aesthetics: While effective in function, amalgam fillings are less aesthetic than tooth-coloured options such as composite resin or porcelain. Due to their metallic appearance, they are more noticeable in the mouth, particularly on visible teeth. However, for some patients, the durability and cost-effectiveness of amalgam fillings outweigh aesthetic concerns.
  3. Cost: Amalgam fillings are generally more cost-effective than tooth-coloured options such as composite resin or porcelain. They are often the preferred choice for patients seeking an affordable dental restoration option.

In terms of suitability based on location and cavity size:

  • Back Teeth: Amalgam fillings are highly suitable for cavities in the back teeth (molars and premolars) where chewing forces are strongest. Their superior durability makes them an excellent choice for amalgam restorations in these areas.
  • Larger Cavities: Due to their strength and durability, amalgam fillings are well-suited for larger cavities that require robust support. They can withstand the pressure exerted during chewing and are less likely to fracture or fail in larger restorations.
  • Teeth with Limited Aesthetic Concerns: Amalgam fillings are often chosen for teeth where aesthetics are less of a concern, such as molars that are not highly visible when smiling. In these cases, the focus is primarily on restoring function and longevity rather than achieving a natural appearance.

Gold Fillings

Gold fillings, also known as gold inlays or onlays, are renowned for their exceptional durability and longevity. Gold is one of the most durable filling materials available, capable of withstanding the forces of chewing and grinding for many years. Unlike other materials that may wear down over time, gold fillings maintain their integrity and shape, making them a good choice for long-term dental restorations. This durability translates to fewer instances of replacement or repair, potentially reducing long-term dental costs for patients.

In terms of aesthetics, gold fillings have a distinct appearance that sets them apart from tooth-coloured options like composite resin or porcelain. While not discreet like tooth-coloured fillings, gold fillings have a warm, natural hue that some patients find appealing. Additionally, gold fillings do not stain or discolour over time, maintaining their lustre for years to come. However, their noticeable appearance may be a consideration for patients seeking a more discreet restoration, particularly for cavities in visible areas of the mouth.

Cost is another factor to consider when choosing gold fillings. While gold fillings are more expensive upfront compared to other materials, their exceptional durability and longevity may offset this initial investment over time. Additionally, gold fillings do not require more teeth to be removed compared to other materials, preserving more of the natural tooth structure. This preservation can contribute to the overall health and longevity of the tooth, potentially reducing the need for future dental treatments.

Ceramic Fillings (Porcelain Fillings)

Ceramic fillings, also known as porcelain fillings, offer a blend of durability, aesthetics, and biocompatibility that make them a great choice for dental restorations.

In terms of durability, ceramic fillings are highly resilient and can withstand the normal forces of chewing and grinding. While not as durable as materials like gold or amalgam, ceramic fillings still offer excellent longevity and can last for many years with proper care.

One of the most notable attributes of ceramic fillings is their natural appearance. These fillings can be precisely colour-matched to the shade of the other teeth, resulting in a smooth and aesthetically pleasing restoration. Additionally, ceramic fillings have a clarity that mimics the appearance of natural tooth enamel, enhancing their lifelike appearance.

Ceramic fillings are more costly than other fillings. This is partly due to the materials and manufacturing process involved in creating ceramic restorations. However, many patients are willing to invest in ceramic fillings for their superior aesthetics and biocompatibility.

Ceramic fillings are particularly suitable for cavities in visible areas of the mouth, such as the front teeth or areas that are highly visible when smiling.

Recovery After a Tooth Filling

Dentist explaining to patient

After undergoing a dental filling, understanding the recovery process is essential for maintaining oral health and ensuring the longevity of the restoration. Dental fillings, whether they are amalgam (including silver fillings), gold, composite (including composite resin fillings), or other materials, serve to restore teeth affected by decay or damage. This guide outlines what to expect after a dental filling procedure, including care tips for different types of fillings and how to manage potential discomfort.

Potential Sensitivity and Discomfort

After a dental filling procedure, it’s common to experience some sensitivity or discomfort, especially in the hours and days immediately following the treatment. This sensitivity can vary depending on the filling material used and the extent of the restoration. Here are some key points to consider:

Immediate Sensitivity: It’s normal to feel sensitivity to hot, cold, or sweet foods and beverages shortly after getting a filling. This sensitivity usually subsides within a few days as the tooth adjusts to the new restoration.

Type of Filling Material: Different filling materials may affect sensitivity differently. For example:

  • Composite Fillings: These tooth-coloured fillings can sometimes cause sensitivity immediately after placement due to the bonding process and shrinkage of the material.
  • Amalgam Fillings: Silver amalgam fillings may also cause sensitivity initially, but this often resolves quickly.

Depth of the Filling: Deeper fillings that are close to the tooth’s nerve may initially cause more sensitivity. This sensitivity should decrease as the tooth heals.

Managing Discomfort: If you experience discomfort after a filling, there are several ways to manage it:

  • Over-the-counter Pain Relief: OTC pain relievers such as panadol can help alleviate discomfort. Follow the dosage instructions on the packaging.
  • Avoid Temperature Extremes: Try to consume lukewarm or room temperature foods and drinks to minimize sensitivity.
  • Soft Diet: Stick to soft foods initially to avoid putting extreme pressure on the filled tooth.

Consult Your Dentist: If sensitivity persists over time, it’s essential to contact your dentist. They can evaluate the filling and ensure there are no complications, such as a high filling interfering with your bite or other issues that may need adjustment.

Temporary Dietary Restrictions

Following a dental filling, it’s advisable to observe temporary dietary restrictions to promote healing and minimize discomfort. Here are some general guidelines:

  1. Avoid Hard and Sticky Foods: Don’t eat hard candies, nuts, and sticky foods like toffee or chewing gum. These can dislodge or damage the filling.
  2. Limit Extreme Temperatures: After a filling, sensitivity to cold or hot foods and drinks is common. To reduce discomfort, opt for lukewarm or room-temperature items.
  3. Soft Diet: Stick to soft foods initially, such as soups, yogurt, pasta, and cooked vegetables. These are easier on the teeth and minimize pressure on the filled tooth.
  4. Careful Chewing: Be cautious when chewing on the side of the mouth with the new filling. Chewing on the opposite side can help protect the restoration during the initial healing period.
  5. Hydration: Stay hydrated by drinking water and aid in the recovery process.

These dietary adjustments are typically recommended for a few days to a week after receiving a dental filling.

Proper Oral Hygiene Practices

Proper oral hygiene practices are crucial after receiving a dental filling to maintain oral health and ensure the longevity of the restoration. Here’s why it’s essential and what you should do:

  • Preventing Further Decay: Dental fillings restore teeth damaged by decay. Maintaining good oral hygiene helps prevent new decay from forming around the filling or in other teeth.
  • Brushing Twice Daily: Brush your teeth twice a day with fluoride toothpaste. Pay special attention to the area around the filling, ensuring thorough cleaning to remove food particles and plaque.
  • Flossing Daily: Flossing helps eliminate food particles and plaque from between teeth and around the gumline. It’s essential to floss gently and carefully around the filled tooth to avoid dislodging the filling.
  • Use of Antimicrobial Mouthwash: Consider using an antimicrobial mouthwash to help minimise plaque buildup and maintain a healthy oral environment. Consult your dentist for recommendations suitable for your situation.
  • Regular Dental Check-ups: Book an appointment for your regular dental check-ups and cleanings.
  • Avoiding Damaging Habits: Avoid habits that can damage your teeth, such as nail biting, chewing ice, or using your teeth to open packages. These actions can damage fillings and natural teeth alike.
  • Dietary Considerations: Reduce your intake of sugary and acidic foods and drinks, as these can contribute to decay and compromise the longevity of dental fillings.

Healing Time

The healing time for a tooth filling can vary on factors such as the filling material used, the size of the filling, and individual oral health conditions. Generally, here’s what to expect:

  1. Immediate Sensitivity: You may experience sensitivity to hot, cold, or sweet foods immediately after the filling procedure. This sensitivity typically diminishes within a few days as the tooth adjusts to the new restoration.
  2. Initial Adjustment Period: The first few days after getting a filling are crucial for stabilizing the tooth. It’s important to follow any temporary dietary restrictions and avoid habits that could stress the filled tooth.
  3. Full Recovery: Complete healing of the tooth and surrounding tissues can take up to a few weeks. During this time, continue to practice good oral hygiene, including regular brushing, flossing, and dental check-ups.
  4. Monitoring: Your dentist may schedule a follow-up appointment to check the fit and comfort of the filling. They will also ensure there are no signs of complications such as persistent sensitivity or pain.

Considerations for Tooth Fillings

Woman patiently examined by dentist

When considering tooth fillings, it’s essential to address potential concerns such as dental anxiety and financial considerations like dental insurance coverage:

  • Dental Anxiety Management: Dental anxiety is common and can be managed effectively. Deep breathing, listening to calming music, or telling your worries with your dentist beforehand can help alleviate anxiety. Some dental offices also offer sedation options for more anxious patients.
  • Dental Insurance Coverage: Dental insurance usually covers a portion of the cost for fillings, although coverage can vary on the type of filling and your insurance plan. It’s better to check with your insurance provider before undergoing treatment to understand your coverage, copayments, and any limitations.

By addressing these considerations, you can approach dental fillings with greater confidence and ensure that both your emotional well-being and financial aspects are well managed.


Tooth fillings are important in keeping your mouth from decaying further and ensuring that your teeth will function normally. Additionally, it is essential to book an appointment at your dental clinic for regular checkups to monitor the condition of your metal or composite fillings and check for decayed teeth or new dental issues with the existing teeth.

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