Fillings – Options and Frequently Asked Questions

Fillings – Our London Dentist Offers Advice

Perhaps the most common reason for a visit to the dentist for treatment is to have a filling. Most of us will have at least a few fillings during our lifetimes and most of us will probably not look forward to the treatment, especially those who have seen Dustin Hoffman in Marathon Man!

Fillings however, are a routine dental procedure and probably take up the bulk of the daily work for most dentists. – our Harley Street dentist offers advice. There are now a wider variety of fillings that can be had, from the standard amalgam filling to the more modern and more costly white fillings, which are more likely to be used on the more visible teeth. The standard darker coloured amalgam is usually reserved for back teeth which are not seen as easily. The reason that these are referred to as amalgam is that they are an amalgamation of several different metals, usually including silver, copper, tin and mercury. Although not an attractive option (hence the use of white fillings on visible teeth), they are very strong and durable which is essential for the back teeth which we use mainly for chewing and grinding and they should have a good life span. They have also been used for over twenty years and so have a good track record.

There have been debates about the use of amalgam due to the mercury element which is poisonous to humans; however the British Dental Association has denied there being any risk to patients. If you are concerned about this, then you should talk to your dentist about other options which are available, such as glass or ceramic fillings as these contain no mercury although may not be as strong as amalgam.

What exactly happens when a filling is done?

The need for a filling is usually spotted during a routine check up where the dentist will identify if a filling is necessary although on occasions perhaps, a tooth breaking may be an obvious sign that a filling is needed.

On the visit to the dentist to have the filling, the dentist will first of all administer an anaesthetic into the gum by means of an injection. This anaesthetic should take effect quite quickly and you will feel little or no sensation around the tooth that is to be filled.

The dentist will then remove any decay either by using hand tools or drilling the decaying area of the tooth. In some cases, air abrasion or even lasers may be used. The high pitched drill that we are all familiar with is used to remove the initial enamel and decay but once the softer part of the tooth is reached (the dentin), he is likely to change to a lower speed drill.  Once this has been done the dentist will prepare the tooth for the filling which may include lining the tooth to ensure the filling stays in place. These linings sometimes also contain fluoride to prevent further decay.

On occasions you may notice the dentist shining a light onto the filling. This is usually done on resin type fillings and is used to harden the material and strengthen it.

Once this has been done, the more ‘unpleasant’ part of the procedure is over and the dentist will smooth and polish the tooth.

It is perfectly normal for a short while afterwards for the tooth to feel a little sensitive but this feeling should go within a week or two and during this time it is advisable to avoid eating anything which may put undue pressure on the tooth. If you find that once the anaesthetic wears off, you have an uneven bite, it is important to let your dentist know so that this can be rectified before it starts to cause any problems. A more unusual sensation is a kind of small electric shock called a galvanic shock which can occur when metals from upper and lower fillings meet.

In some cases a temporary filling may be placed if a second visit is needed, perhaps there is a hole in the tooth but it is also infected. The dentist may then prescribe antibiotics but also place a temporary filling to prevent any more debris from entering and causing further damage.

Whilst fillings and especially amalgam ones, have a lengthy life span, it is very likely that they will require replacing at some point as they will inevitably stain and if under regular pressure from chewing etc, they are likely to wear out over time. The average life span of an amalgam filling is twelve years, although this will vary depending on each individual patient’s eating habits and general oral care and hygiene.

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