When Do We Need a Filling?
Depending on the health of our teeth and gums, we are usually advised to see a dentist for a check-up every six months. The reason for this is that, even if we do not have toothache, the dentist may be able to spot early signs of decay, either by examining the teeth or taking x-rays. The tooth can then be treated with a filling, thus preventing further decay and avoiding pain, more extensive treatment or even the loss of a tooth.
The hard coating on the outside of our teeth is called enamel. Inside this is a softer layer of dentine and in the centre of the tooth is the pulp containing the nerves and blood vessels. When we eat, food combines with the bacteria that is always present in our mouths and forms a sticky coating on our teeth. This is called plaque. For about 20-30 minutes after eating, particularly if we have had sugary foods, acids are produced in the plaque which attack the enamel of our teeth and in time cause a hole or cavity. To try and prevent this happening we need to brush teeth with a fluoride toothpaste and floss between the teeth. A regular scale and polish from the dentist or hygienist will also help.
If your dentist decides you need a filling, you will probably need to have the area numbed with a local anaesthetic injected into your gum. This can be topped up during treatment if necessary. The dentist will then drill away the decay with a combination of a high-speed drill, a hand drill and hand tools before filling the tooth and shaping it to ensure it looks right, will be comfortable in your mouth and not too high for chewing food. You may have some sensitivity in your filled tooth for a few days afterwards but if this continues you should go back to your dentist as the filling might need a slight adjustment.
Types Of Filling
There are two main types of filling material:
- Amalgam - This is a silver colour filling made from a mixture of metals including mercury, copper, silver and tin which form a soft material which hardens after a few minutes. These are more suitable for back teeth as they are not so visible, although some people prefer to have no silver fillings at all.
- Composite - Made from a mixture of plastic and glass, this material is tooth-coloured and therefore more aesthetically pleasing. Composite fillings are more expensive than amalgam and not generally available on the NHS except in certain clinically approved situations. The dentist builds up layers of the filling material, hardening each layer with a bright blue light. When filling a tooth with composite material, extra care has to be taken to keep the tooth dry as any saliva could stop the filling bonding properly. For this reason a rubber dam is often used. This is a thin piece of rubber placed in the mouth and around the tooth to be treated.
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Other Types Of Fillings
Porcelain ceramic and glass ionomer fillings are two common types of fillings, used in instances where composite resin is not suitable.
Ceramics are normally porcelain, and are highly resistant to staining. They are also incredibly durable; they can last over 15 years, but as a result, they are much more expensive than composite resin. Glass ionomer fillings are made with blend of acrylic and a special type of glass. These are commonly used in fillings just below the gum line, and as they release fluoride (to combat harmful bacteria), they can prevent tooth decay. As glass is used, the fillings are weaker than composite resin, and at higher risk of wear and tear.
How To Care For Your Teeth With Fillings
In order to best care of teeth after having fillings inserted, practice good oral hygiene and visit your dentist regularly.
This will reduce the chances of any issues occurring, and will enable your dentist to detect and treat them quickly if they do. If during an appointment your dentist suspects that a filling might be cracked or leaking, they will take x-rays to assess the situation. They will need to replace or repair the filling if it is found to be the case, as when the sides don’t fit tightly alongside the tooth, debris can build-up can cause decay and other complications.
You should clean your teeth twice a day using a fluoride toothpaste, and also floss regularly. Using an antibacterial mouthwash at least once a day can prevent the build-up of harmful bacteria, too.
Some patients report tooth sensitivity after having a filling placed, and this can be considered a relatively common disadvantage of the procedure.
Teeth can become increasingly sensitive to things like sweet foods and temperature, and while some issues of sensitivity can subside within a few weeks, others will continue to cause a patient difficulty. If your sensitivity has not subsided within two to four weeks after the filling has been fitted, or if you are experiencing a high level of sensitivity, contact your dentist. They can assess the best cause of treatment, which may be as simple as prescribing a desensitizing toothpaste, or it may be that a root canal procedure is required. Some people experience pain initially after having a filling, and it may be that your dentist needs to reshape it to resolve it.
The NHS has three bands of charges in its pricing structure. Fillings are covered by Band 2 with the current charge being £49. No matter how many fillings you have in one course of treatment, you will only be charged that fee. Free or subsidised treatment is available for those on low income or in receipt of certain benefits. Pregnant women, or those who have given birth in the previous 12 months, as well as children and young people in full-time education under the age of 19 are also entitled to free treatment. Exemptions and charges may vary according to whether you live in England Scotland, Northern Ireland or Wales.
Private dental charges may be dependent on the size of the filling and you will be charged for individual fillings rather than a course of treatment. The costs of private treatment will be higher than those within the NHS but can be covered by a dental insurance plan.