Dental Fillings

A filling repairs a tooth after decay has been removed. At Pearl32 Dentistry and Wellness in Laguna Hills, we use tooth colored composite, bonded in layers and hardened with a light. One appointment usually covers one to three teeth. A filling restores the shape and the bite. It does not make the tooth new again, and a very large filling is not the right repair for a weakened tooth. In that case we discuss an onlay or a crown.

What is a tooth colored filling?

A resin composite bonded into the cleaned cavity. The material blends resin with fine glass particles and is matched to the shade of your tooth. It bonds to enamel and dentin, so we remove less healthy structure than a silver filling required. It is placed in layers of about 2 millimeters, each hardened with a curing light, then shaped to the anatomy of the tooth and polished. Composite handles small and moderate cavities in front and back teeth. For a deeper repair with a cusp missing, a different restoration is the sounder choice.

How does the appointment go?

About 30 to 60 minutes for most fillings. We numb the tooth with local anesthetic, usually after a surface gel, and wait until the area is fully numb before beginning. A rubber dam or cotton isolation keeps the tooth dry, which is what makes the bond hold. The decay is removed, the cavity is cleaned and a bonding agent is applied. Composite goes in layers and is hardened as we work. We shape it, check your bite with marking paper and polish the surface. You can eat once the numbness fades, usually in two to three hours.

When is a filling not enough?

When too little tooth is left to support it. A filling relies on the walls around it. Once a cavity runs under a cusp, or a remaining wall is thinner than about 2 millimeters, that wall flexes and eventually splits. A cracked cusp on a molar is a common way people lose a tooth that carried a large filling for years. In those cases an onlay or a crown covers the cusps and holds the tooth together. We mill both in house, so most are finished in one visit. If decay has reached the nerve, root canal treatment comes first. We show you the x-ray and explain which applies before you decide.

How long do fillings last?

Typically 7 to 10 years for a composite filling, and longer in a mouth with low decay risk. Small fillings in people who floss and keep sugar to mealtimes can run well past that. Large fillings in back teeth, and fillings in patients who grind, fail sooner. Failure usually means a margin that has opened and begun to leak, or a chip at the edge. We check margins with an explorer and x-rays at each recall visit. Catching a leaking margin early means a repair instead of a crown. Night grinding is managed with a guard, which protects the work.

Should old silver fillings be replaced?

Only when there is a reason. An amalgam filling that is sealed, uncracked and free of decay around it is doing its job, and replacing it removes more tooth structure. We replace one when an x-ray shows decay at the margin, when the filling or the surrounding tooth has cracked, when the material is breaking down, or when the tooth needs a different repair anyway. Some patients ask for replacement for appearance, which is a fair choice on teeth that show. We tell you what we see, including the cost in tooth structure of drilling out a filling that still works.

Why is a new filling sensitive?

Because the tooth was irritated, and it usually settles. Cold sensitivity for one to three weeks after a deep filling is common and fades as the pulp calms. Sensitivity when you bite is different: it often means the filling is a fraction high. That is a two minute adjustment, so call (949) 830-0074 rather than waiting for it to wear in. Sensitivity that worsens after three weeks, wakes you at night, or lingers a minute after cold needs review. That pattern can mean the nerve is inflamed, and root canal treatment may be needed. Same day slots are held for exactly this.

What do fillings cost?

We quote fillings in writing after an examination, itemized by tooth and by the number of surfaces. We do not publish prices, because the depth of the decay and the number of surfaces change the work, and only an exam with an x-ray shows that. You see the quote before treatment begins.

We are in network with most major PPO plans and Delta Dental HMO, and we check your remaining annual benefit before booking. Patients without insurance often use the membership plan, which has three levels billed monthly and is a membership plan, not insurance. For larger treatment plans, outside payment plans are available through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). Third party financing is available and the practice is not the creditor.

Questions people ask about dental Fillings

Does getting a filling hurt?

You should feel pressure and vibration, not pain. We use a surface gel before the injection and wait until the tooth is fully numb, which takes 5 to 10 minutes. Tell us if you feel anything sharp, because more anesthetic solves it. For patients who find dental work hard, nitrous oxide, oral sedation and IV sedation are available and we discuss them beforehand.

How long before I can eat?

The composite is fully hardened before you leave, so there is no waiting for the material. The limit is the numbness, which lasts two to three hours and makes it easy to bite your cheek or tongue without noticing. Keep to soft food and skip very hot drinks until sensation returns. Children should be watched during that window for lip biting.

Will the filling match my tooth?

We shade match the composite against your neighboring teeth before starting, and most fillings are hard to spot afterward. Composite does pick up stain at the margins over years, especially with coffee, tea, red wine or tobacco. Polishing at recall visits helps. On front teeth where appearance matters, cosmetic bonding or a veneer may be the better long term repair, and we will say when that applies.

Can a filling be repaired instead of replaced?

Often, yes. A chipped edge or a small worn area can be repaired by bonding new composite to the existing filling, which saves tooth structure and time. Repair is not the answer when decay has reached under the filling, when the margin has opened widely, or when a cusp has cracked. We check margins at every recall visit, so small problems are caught while a repair is still possible.

What happens if I leave a small cavity untreated?

It gets larger, and the treatment gets larger with it. Decay moves through enamel slowly and through dentin faster, so a small filling this year can become an onlay or a crown in two years. Once it reaches the nerve, root canal treatment is added. We are open Monday to Friday, 8 AM to 5 PM, and we hold same day emergency slots when a tooth breaks or begins to ache.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.