A dental filling is a common restorative procedure designed to repair a tooth damaged by decay, also known as a cavity. When bacteria create an opening in the hard outer layers of the tooth, the resulting lesion must be cleaned and sealed to prevent further deterioration. The procedure replaces the compromised tooth structure with a durable material, restoring the tooth’s form, function, and integrity. This treatment halts the progression of the decay process, protecting the sensitive inner pulp from infection.
Preparing for the Filling Procedure
The filling process begins with the administration of a local anesthetic, typically lidocaine or articaine, delivered via injection near the affected tooth to block pain signals. Patients usually feel a brief, sharp pinch followed by a sensation of pressure and tingling as the surrounding tissues become numb. This numbing effect is temporary, lasting anywhere from one to six hours depending on the specific agent used.
Once the area is fully desensitized, the dentist uses a high-speed dental handpiece, commonly referred to as a drill, to access the decayed tissue. This instrument creates a distinctive sound and vibration, but the anesthesia ensures no pain is felt during this stage. The purpose of this step is the complete removal of all soft, infected dentin and enamel.
The dentist must meticulously clean the area to eliminate all traces of bacteria and decay before placing the new material. Removing the decay also involves shaping the remaining tooth structure to create a clean, stable base for the filling material to adhere to. Water spray is used constantly during drilling to keep the area cool and prevent damage to the tooth’s inner pulp from heat friction. Failure to remove all decay would allow the bacteria to continue damaging the tooth underneath the new restoration.
Choosing and Applying the Filling Material
The selection of the filling material is often a discussion between the patient and the dentist, with the two most common types being tooth-colored composite resin and silver-colored amalgam. Composite resin is made from a blend of acrylic resin and finely ground glass particles, allowing it to be matched precisely to the natural color of the tooth. This makes it the preferred choice for teeth that are visible when a person smiles or speaks.
Placing a composite filling is a multi-step process that requires a dry environment. The tooth surface is first treated with a mild acid gel called etchant, which microscopically roughens the enamel to improve mechanical adhesion. A bonding agent is then applied to create a strong seal between the tooth and the resin.
The composite material is applied in small, incremental layers, and each layer is hardened, or “cured,” using a specialized high-intensity blue light. This layering and curing process is necessary to ensure the material cures completely and minimizes shrinkage. Composite fillings bond directly to the tooth structure, which often allows the dentist to remove less healthy tooth material compared to amalgam.
Amalgam, a mixture of metals including silver, copper, and tin, is a durable and cost-effective option, historically used for back teeth that withstand heavy chewing forces. Unlike composite, amalgam is simply packed firmly into the prepared cavity and then carved to match the tooth’s anatomy. It hardens on its own over several hours without the need for a curing light.
After the chosen material is placed and hardened, the dentist uses a series of burs and polishing tools to refine the shape of the new filling. This final step ensures the filling does not interfere with the patient’s natural bite and that there are no rough edges. The dentist checks the bite using articulating paper, which marks the high points of the filling, guiding adjustment until the occlusion feels normal.
What to Expect After the Appointment
Immediately following the procedure, patients must navigate the temporary effects of the local anesthetic, which can persist for two to six hours. It is advisable to avoid chewing food until the full sensation returns to prevent accidentally biting the tongue, cheek, or lip while they are still numb. Once the numbness wears off, it is common to experience temporary sensitivity in the filled tooth.
This post-operative sensitivity often manifests as a sharp, short twinge when the tooth is exposed to hot or cold temperatures, or even air. It occurs because the drilling and filling process can cause temporary irritation to the pulp tissue inside the tooth. For most patients, this sensitivity will subside naturally within a few days to a couple of weeks. If the filling was particularly deep or close to the tooth’s nerve, the discomfort may linger for up to four weeks.
If the filling feels “high” when biting or chewing, where the new material seems to strike the opposing tooth before the rest of the teeth meet, the patient should contact their dentist. An improperly adjusted filling can cause unnecessary pressure and persistent pain, which can be easily corrected with a quick bite adjustment. Proper maintenance, including consistent brushing, flossing, and regular professional cleanings, will maximize the lifespan of the restoration.