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Does my tooth need a filling? What you need to know.

by Dr. Sean


Dentists (like us) like to harp on about getting regular check-ups and preventative care.

Some people are lucky and have a low risk of tooth decay or gum disease. We occasionally see a patient in their 80’s without a single cavity or filling. Their good fortune is no doubt linked to:

  1. Good oral hygiene (yes – flossing included) throughout their life
  2. Diet – not just low on sugars but low in dietary acids (those found in soft drinks, juices, etc).
  3. Saliva – good quality saliva provides significant protection to the oral tissues.
  4. Other factors – fluoride (preferably in contact with the teeth soon after they erupt into the mouth), bacteria levels in mouth, etc.

Unfortunately, most people aren’t so lucky and may require one or many fillings throughout their life.

Yours truly has five fillings – related to a significant consumption of a sugary cereal during school years.


So how do you know if you need a filling?

You will have pain, correct?

Unfortunately, this is most often not the case. Dental disease (whether it be decay or gum disease) has the inconvenient trait of being almost painless or mild in its early stages. So if you haven’t been to the dentist in years, get in quick!

Dental decay generally becomes painful by the time it hits the nerves, ie. Very deep! By this stage, sometimes a ‘filling’ is not possible and more extensive treatment is required – such as root canal treatment or tooth extraction.

On occasion, a smaller cavity will be noticed if the tooth chips or fractures, or if food starts to collect where it never used to.

Some cavities will get sensitive when you have a hot or cold drink.

Take the example below:

  • This patient came in for a routine checkup. It had been many years.
  • She had no complaints, no pain, just some bleeding from the gums.
  • The first photo shows the tooth (top left molar) as it sits in the mouth- all good yeh?
  • An x-ray was taken and a large cavity found.

The tooth was opened up and look what was underneath!

Tooth Filling

This patient was very lucky in that we provided a filling for this tooth and so far so good. Due to the size and depth of the filling, the tooth may need future work- either root canal or extraction.

If picked up earlier, a simple (and a lot smaller) filling would have done the trick!


So remember:

  1. Don’t put off your check-ups – 6 monthly checks and regular x-rays (very 1.5-2 years) are the best way to prevent dental problems and catch things early. Most dental disease is painless until it is a long way advanced!
  2. If you think you need a filling or have been told you need fillings, don’t delay! They will not spontaneously heal and delaying can lead to bigger cavities, longer term problems, more time in the dental chair and significant financial burden.


I only want white fillings.

That’s great, we only place tooth coloured (white) fillings.

The material of choice that we use is called “composite resin”. It is a great material for most situations. We do not use dental amalgam due to concerns regarding its mercury content and the fact that NOBODY has ever requested a black filling.

Sometimes composite is not strong enough for very large fillings. We can then recommend other types of fillings or tooth restorations (eg. Ceramic or porcelain crowns). Rest assured we can always use tooth coloured materials.


Should I replace my amalgam fillings?

We recommend only replacing amalgam fillings if there is a legitimate reason to do so. This may be because of decay under the filling, cracks in the tooth or filling or cosmetic concern. Removal of amalgam fillings when there is no good reason to do so can weaken the tooth, irritate the nerves of the tooth and lead to other problems. If you would like to remove your amalgam fillings, we are quite happy to discuss the pros and cons with you.


How long will a filling last?

This is largely dependent on the individual and their lifestyle/habits.

A well placed composite filling should last a minimum of 5-10 years. They are quite capable of lasting a lot longer under the right circumstances.

Fillings will last a long time when:

  1. Oral hygiene is consistent and strict (good brushing, daily flossing, nag nag)
  2. Diet that is kind to the teeth (minimal dietary acids, sugars, very hard foods and regular exposure to fluoride such as drinking tap water and using toothpaste)
  3. There is an absence of factors such as a grinding/clenching habit, nail biting, etc.
  4. It has been placed well by the dentist!

Unfortunately, a really well placed, perfectly sculptured filling will fail at about the same rate as an average placed filling if there are dietary, oral hygiene or other factors at play.


My filling is sensitive.

If recently done, a filling may stay sensitive for a few days.

Your tooth has just be traumatised and takes a while to recover. We generally tell our patients to expect some mild sensitivity for up to a week after placement. This is usually not the case and most people report no problems at all.

Sometimes fillings will remain sensitive for longer periods and you should then contact your dentist.

If you have an old filling that has recently become sensitive, go to your dentist ASAP.

Your old filling may be failing – it may have new decay under it, it may no longer join the tooth properly or the nerve could be irritated.


Will it cost me an arm and a leg?

The cost of fillings varies based on how many surfaces it will need to cover.

It also depends on the material used and the tooth involved.

As a rough guide, see our pricing page.

Obviously, we need you here to give you a correct quote. A full, thorough examination with x-rays is recommended prior to undertaking any fillings. This way we can get an overall picture of your teeth and find out why you require treatment and what we can do to reduce your risks of further problems.


In a nutshell, be kind to your teeth and hip pocket by taking a preventative approach to your dental health. Regular dental checks and avoiding delays with treatment will keep you in good shape. Call Bay Dental Brighton for an appointment today!

– Dr. Sean


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