Dental Fillings: Types, Procedure, Cost, and Care

What is a dental filling?

A dental filling is a material used to rebuild a tooth that has lost structure, most often because of a cavity (tooth decay). The dentist removes the decayed part of the tooth and fills the cleaned-out space so the tooth can work normally again and decay cannot spread.

Fillings are one of the most common dental treatments. They are usually placed by a general dentist, although a prosthodontist or other specialist may handle complex restorations.

Why you might need a filling

The main reason for a filling is tooth decay. When plaque bacteria feed on sugars, they produce acids that slowly break down enamel and form a cavity. Left untreated, decay can reach the inner layers of the tooth and cause pain or infection.

• A cavity found during an exam or on an X-ray
• A small crack, chip, or fracture in a tooth
• Worn enamel from grinding or aggressive brushing
• Replacing an old filling that has cracked, leaked, or fallen out

Types of filling materials

There is no single best material for every situation. Your dentist will weigh the size and location of the cavity, appearance, durability, and cost when recommending an option.

What to expect during the procedure

Most fillings are completed in one visit and take about 20 to 60 minutes depending on the size.

• The dentist numbs the area with a local anesthetic so you do not feel pain.
• The decayed tooth structure is removed with a drill or laser and the area is cleaned.
• For composite, the tooth is prepared and the resin is placed in layers, each hardened with a curing light.
• The dentist shapes the filling, checks your bite, and polishes the surface.
• Numbness usually wears off in a few hours; mild sensitivity for a day or two is normal.

Are amalgam fillings safe?

Dental amalgam contains mercury, which understandably raises questions. The U.S. Food and Drug Administration has concluded that amalgam fillings are safe for adults and children ages six and older.

In 2020 the FDA issued additional guidance recommending that certain higher-risk groups avoid amalgam when appropriate alternatives exist, including pregnant or nursing women, children under six, people with certain neurological conditions, and people with known mercury allergy. If you already have amalgam fillings in good condition, the FDA does not recommend removing them, because removal can release more mercury and destroy healthy tooth structure.

Caring for your fillings and how long they last

How long a filling lasts depends on the material, the size of the repair, where it sits in the mouth, and your daily habits. Composite fillings often last 5 to 10 years, amalgam can last 10 to 15 years or longer, and gold or ceramic may last even longer.

• Brush twice a day with fluoride toothpaste and clean between your teeth daily.
• Limit sugary and acidic foods and drinks.
• Wear a nightguard if you grind your teeth.
• Keep regular checkups so worn or leaking fillings are caught early.
• Call your dentist if a filling feels sharp, loose, or sensitive, or if a tooth hurts when you bite.

Cost and insurance

The price of a filling varies with the material, the number of tooth surfaces involved, and your region. Composite generally costs more than amalgam, while gold and ceramic are the most expensive. Many dental insurance plans cover a large share of basic fillings, though some cover amalgam fully and pay only the equivalent amount toward a tooth-colored filling. Your dental office can provide an estimate before treatment.