The part most people dread, the injection, is usually the least of it. A routine filling is done in a single appointment, the tooth is numb for the work that matters, and what you feel is pressure and vibration rather than pain. Knowing the order of events makes the time in the chair easier.
A filling replaces the part of a tooth that decay has softened. The dentist removes the damaged material, leaves sound tooth behind and rebuilds the shape with a hard filling material.
The dentist checks how deep the decay goes
Before anything starts, the tooth is examined and usually checked on an X-ray, which shows how close the decay is to the nerve. This decides how much needs to be done and whether numbing is needed. Some very small, shallow cavities can be treated without any anaesthetic. The appointment is longer for a deep cavity, or for a filling that wraps around several surfaces of a back tooth, than for a small one at the front.
Numbing takes a few minutes
A numbing gel is usually rubbed on the gum first, so the injection itself is more of a pinch than a sting. The anaesthetic then takes a few minutes to work fully. Lower back teeth are often numbed with an injection further back in the jaw, which also makes the lip and part of the tongue feel numb. If you feel anything sharp during treatment, raise your hand; the dentist can stop and give more anaesthetic.
The decay is removed and the tooth kept dry
With the tooth numb, the dentist removes the decay using a small drill and hand instruments. The aim is to take away what is soft and infected while keeping as much healthy tooth as possible. Cotton rolls, suction or a thin rubber sheet around the tooth keep it dry, because moisture weakens the bond between tooth and filling.
If the decay reached close to the nerve, a protective lining may be placed at the bottom of the cavity before the filling. At Lumi Dental this can include bioceramic materials such as Biodentine, which are used to protect the pulp.
Tooth-coloured fillings are built up in layers
Most fillings now use composite resin, a tooth-coloured material matched to the shade of your tooth. The surface is treated so the resin bonds to it, then the composite is added in thin layers, each hardened with a blue curing light before the next goes on. For a filling between two back teeth, a thin metal band is placed around the tooth to shape the side wall and recreate the contact with the neighbouring tooth. The dentist then shapes the surface to follow the natural grooves of the tooth.
Silver amalgam fillings are used less often than in the past, though they still have a place in some situations. Our comparison of white and silver fillings explains the differences.
Getting the bite right
Before you leave, you will bite on thin coloured paper that marks where your teeth meet. If the new filling touches first, it is smoothed down until your bite feels even, then polished. Because you are numb, it can be hard to judge the bite in the chair. If the tooth feels tall or sore when you chew once the numbness wears off, return for a quick adjustment; a high filling is easy to fix and can make the tooth ache if left.
The first few days
Composite fillings are set hard by the end of the appointment. Numbness usually wears off within a few hours, so wait until it does before eating, to avoid biting your lip or cheek. Our articles on how long numbness lasts and eating after a filling cover this first day.
Some sensitivity to cold or pressure is common for a few days, particularly after a deep filling, and usually fades gradually. Pain that keeps getting worse, throbbing that keeps you awake, or sensitivity that has not improved after a couple of weeks should be checked. Our guide to sensitivity after a filling explains the likely causes.
Common questions
Will I need an injection?
Usually, for anything beyond a very small, shallow filling. It is your choice, and the dentist can explain what to expect without it.
Can I drive or go back to work afterwards?
Yes. Local anaesthetic affects only the mouth, so most people return to their normal day straight away.
What does a filling cost?
It depends on the size of the filling, the number of surfaces involved and the material. Our filling cost guide covers general ranges, and health funds with extras cover often pay part of the fee, which can be claimed on the spot.
How can I avoid needing more fillings?
Brush twice a day with fluoride toothpaste, clean between the teeth, keep sugary food and drinks to mealtimes, and keep up regular check-ups with your dentist or OHT so decay is found while it is small.
Small cavities need small fillings, so the earlier decay is found, the simpler the repair. Our team can check your teeth and treat decay at our practice; see our current offers or book with a general dentist in Melrose Park. This article is general information and not a substitute for personal dental advice.
