A dental filling is a common restorative procedure designed to repair a tooth damaged by decay, trauma, or wear. The process involves removing the compromised portion of the tooth structure and replacing it with a durable material to restore its shape and function. Cavities are the most frequent reason a filling is necessary, but the procedure can also address minor fractures or chips. Restorations prevent the decay from spreading deeper into the tooth, which could otherwise lead to more extensive treatments like a root canal.
Preparing for the Restoration
The first step in preparation is ensuring complete comfort throughout the procedure, which is accomplished through the use of a local anesthetic. A topical numbing gel is often applied to the gum tissue first to minimize the sensation of the injection itself. The dentist then administers the local anesthetic directly near the nerve serving the affected tooth. This medication temporarily blocks the nerve signals that transmit pain, allowing the procedure to be performed without discomfort.
The numbing effect typically sets in within a few minutes. Once the area is completely numb, the dentist must isolate the tooth to prepare the site for the filling material. This isolation is usually achieved using cotton rolls or a dental dam. Keeping the tooth free from saliva and moisture is necessary for certain filling materials to adhere properly to the tooth structure.
The Restoration Process
With the tooth isolated, the dentist begins the restoration by removing the decayed or damaged material. A dental drill is used to excavate the tooth structure, which generates sound but should only feel like pressure due to the anesthesia. Complete removal of the decay prevents the infection from growing beneath the final filling. Once the decay is cleared, the remaining space is cleaned and disinfected.
The dentist then prepares the cavity by shaping the remaining tooth structure to ensure the filling material will fit securely. The choice of material is influenced by the location of the tooth and aesthetic preference, with the most common options being composite resin and amalgam. Composite fillings are tooth-colored and blend naturally with the surrounding teeth. Amalgam fillings, made from a metal alloy, are known for their durability and are often used in back molars.
For composite fillings, a series of steps is necessary to ensure a strong bond between the material and the tooth. The prepared surface is treated with an etching solution, which creates microscopic pores in the tooth structure. A liquid bonding agent is applied to these pores and then cured, or hardened, with a specialized blue light. The composite material is then placed into the cavity in thin layers, with the blue light used to harden each layer.
Once the material is placed, the dentist shapes it to match the natural contours of the tooth surface. The final step involves checking the patient’s bite to ensure the new filling does not interfere with how the upper and lower teeth meet. If necessary, the dentist makes minor adjustments until the bite feels comfortable. The filling is then polished to create a smooth surface.
Immediate Aftercare and Sensitivities
Immediately following the procedure, the patient will still be experiencing the effects of the local anesthesia. The feeling of numbness typically lasts one to three hours. It is important to wait until the full sensation returns before attempting to eat, as chewing while numb can result in accidentally biting the cheek, lip, or tongue. Hot beverages should also be avoided until sensation is restored, preventing accidental burns.
Mild discomfort or sensitivity is a common experience after the filling, especially if the original decay was deep. The tooth may be sensitive to temperature changes, particularly cold, or to pressure when biting down. This sensitivity occurs because the underlying nerve tissue was slightly irritated during the preparation process.
Patients who received a composite filling should avoid hard, sticky, or crunchy foods for the first 24 to 48 hours to allow the material to fully settle and adhere. Most temporary sensitivities resolve within a few days to two weeks as the tooth recovers from the procedure. However, if the pain worsens instead of improving, or if the feeling of the filling being too high persists, the dentist should be contacted for an evaluation.