What a filling does
A filling closes the defect that decay or a broken-off piece leaves behind in a tooth. First we remove the diseased tooth tissue, then we fill the resulting cavity with a material that restores the tooth’s shape and function. The aim is a tight seal that leaves no gap for new bacteria, and a chewing surface that feels natural when you bite down.
A filling becomes necessary when:
- decay has destroyed hard tooth substance and the defect needs to be cleaned and closed.
- a piece has broken off, for example after a fall or from biting on something hard.
- an old filling has started to leak and new decay forms at the margin.
The earlier a defect is found, the smaller it stays and the more healthy tooth substance can be preserved. That is exactly what regular check-ups and dental hygiene are for.
The materials today
Several proven materials are available for a filling today. Which one fits is decided at the individual tooth.
Composite (tooth-coloured resin)
Composite is a tooth-coloured material made of resin with fine ceramic or glass particles. It is worked directly into the tooth, built up in layers and cured with light. Through adhesive technique it bonds firmly to the tooth substance, so we have to sacrifice little healthy tooth. Composite is the most common choice for small to medium defects, front and back, and is barely distinguishable in colour from your own tooth.
Ceramic inlay and onlay
If the defect is larger, a direct filling reaches its limits. We then make an inlay or onlay from ceramic. It is produced to fit outside the mouth and then bonded in place. Ceramic is very stable, holds its shape and is aesthetic, which makes it suitable for larger, load-bearing defects in the back teeth. We go deeper into the transition from filling to inlay in our comparison of composite or inlay.
Glass ionomer (for specific cases)
Glass ionomer cement releases fluoride to the tooth over time and adheres even in a not entirely dry environment. That makes it useful for specific situations, such as a base lining, on milk teeth or as a temporary solution. For heavily loaded chewing surfaces in adults it is less suitable, because it is less wear-resistant than composite or ceramic.
Why we no longer use amalgam
For decades, amalgam was the standard material for back teeth. We no longer use it, for several reasons:
- Mercury-free. We work without amalgam and therefore without its mercury content.
- Aesthetics. Tooth-coloured materials are unobtrusive, while dark metal fillings are visible.
- Adhesive technique. Composite and ceramic are bonded to the tooth substance. Amalgam was held purely mechanically, which meant more healthy tooth had to be removed.
Intact old amalgam fillings do not need to be replaced for the material alone. But if a filling starts to leak or a margin breaks, we replace it with a tooth-coloured solution.
Direct or indirect: one or two visits
The choice of material is closely tied to how the filling is placed.
- Direct restoration. The composite is built up and cured directly inside the tooth in a single visit. One appointment is enough. This is the usual route for small to medium defects.
- Indirect restoration. The inlay or onlay is made outside the mouth. This usually needs two visits: an impression and temporary protection, then bonding the finished piece in place.
Both routes have their place. For larger, load-bearing defects, the slightly more involved indirect solution is often the more durable one.
How the right choice is made
There is no single best material, only the right one for the tooth in question. We weigh up above all:
- Size of the defect. Smaller defects favour a direct composite filling, larger ones an inlay.
- Location in the mouth. Visible front teeth set high aesthetic demands, back teeth high demands on stability.
- Chewing load. Anyone who bites hard or grinds their teeth needs a particularly hard-wearing material.
- Remaining substance. How much healthy tooth is left helps decide whether a filling still holds or an inlay makes more sense.
We discuss these points with you and recommend the solution that preserves the most healthy tooth substance in the long run.
Longevity and care
How long a filling lasts depends on the material, size, location and above all on care. What matters are daily cleaning of the interdental spaces, a gentle brushing technique and regular check-ups, at which we inspect margins and transitions. This way we spot small leaks early, before new decay forms underneath.
From filling to inlay to crown
As the defect grows, the right restoration shifts. Small to medium defects are restored with a filling. When too much substance is destroyed, a filling no longer holds reliably, and an inlay follows. If the tooth is so weakened that even an inlay can no longer support it sufficiently, a crown takes over, encasing the tooth all round. Where this transition lies is covered in our comparison of inlay or crown. If the decay reaches the nerve, a root canal is needed first, before the tooth is permanently restored.
Costs and next step
Dental fillings are generally not covered by compulsory basic insurance. Treatment follows the SSO tariff. Before larger restorations such as an inlay, you receive a written cost estimate from us, so you know what to expect before treatment. If you are unsure which solution fits your tooth, book an appointment. We look at the tooth and discuss the options with you.