Having a filling

A filling repairs a tooth that is worn, chipped or decayed so it lasts longer. We use tooth-coloured composite — a resin mixed with fine glass particles — which suits both front and back teeth, and both adult and baby teeth.

• A numbing gel goes on the gum first, then local anaesthetic numbs the tooth and the area around it. A very small filling sometimes doesn't need numbing at all.
• Any decay is removed with a fine drill and hand instruments, and the cavity is cleaned, washed and dried.
• The composite is placed in thin layers, each set hard with a bright light, until the tooth is back to its original shape.
• The filling is trimmed to fit, polished so it resists staining, and we check your bite feels comfortable.

Fillings are routine, but no procedure is free of risk.

• Biting or rubbing a numb lip, cheek or tongue without realising. Children need watching until the numbness has worn off.
• Sensitivity to hot and cold for a few weeks after the filling.
• Sensitivity on biting for a few days. If it doesn't settle, the filling may need a small adjustment — let us know.
• Chipping or breaking. Composite is a plastic material and is not as strong as a crown or veneer, so a filling — particularly on a front tooth or a large one on a back tooth — can chip or break in time.
• The filling failing through wear, fracture, or new decay at its edge. The usual response is to remove it, assess the cause and replace it; sometimes the tooth needs a crown or, if it can't be saved, removal.
• Allergic reaction to the filling material — rare; a rash or itching afterwards can be a sign.
• Reactions to the anaesthetic or medications used, usually within the first two hours — paleness, palpitations, sweating, dizziness or nausea, and very rarely a serious allergic reaction. This is why we need your full medical history.

When decay runs close to the nerve at the centre of the tooth, there is always a chance the nerve is affected — either straight away or months later. Your dentist will tell you if this applies to your tooth.

If the nerve doesn't recover, you have two options, each at a separate cost:

• Root canal treatment to keep the tooth — a better bite, no gap, and your other teeth protected from extra wear.
• Removing the tooth — leaves a gap, often a chewing tooth, and puts more load on the teeth around it.

• Watching a very early spot of decay with fluoride and changes to diet and cleaning, where it hasn't yet broken through the enamel.
• A crown or onlay where the cavity is too large for a filling to be reliable.
• Removing the tooth, which we'd only suggest if it can't realistically be repaired.

If the decay isn't dealt with, it keeps spreading through the tooth. What can follow includes sensitivity, pain, infection of the nerve, an abscess, the tooth breaking, and eventually needing root canal treatment or removal — each more involved and more costly than the filling would have been.

Baby teeth can be filled, and often should be. They matter for speaking, eating and smiling, and they hold the space for the adult teeth coming through behind them — some stay until about 13 years of age or longer. If a baby tooth shows decay, we'll advise whether it's best filled, left to fall out on its own, or removed.

A filling lasts longest with daily care at home and a check-up every 6 months, or as your dentist advises. Those visits aren't included in the cost of the filling.

• Brush twice a day, clean between the teeth, and follow any instructions we give you on the day.
• Avoid biting very hard things — ice, pens, fingernails — particularly on a front-tooth filling.
• Come in for examinations and cleans as advised, and tell us straight away if a filling feels high, rough or sensitive.

Repairs. One repair of a chipped or broken filling is covered by your treating dentist. Further repairs are charged.

If you don't keep up the maintenance, problems can develop to the point of being difficult, costly or impossible to treat, and you would be liable for the full cost of correcting them.