Dental Filling Guide: Costs, Benefits, Types, and Procedures

Do you need a tooth filling, or are you putting off getting one because you're nervous about it? Nobody loves visiting the dentist, but cavity fillings are a very common restorative dentistry procedure to help prolong the life of your teeth.

Do cavity fillings for teeth hurt? Many people worry about tooth filling pain, but thanks to modern dentistry filling materials and techniques, the procedure is usually pain-free. You may experience some sensitivity after a filling but there are ways to reduce any discomfort. Below you can read more about how fillings are done, how long they take, and what precautions you should take after getting a filling.

We also explain the different types of dental fillings, the materials dentists use, and how much fillings cost.

We hope this guide answers all your questions about dental fillings and prepares you for your next trip to the dentist.

What is a filling?

A tooth filling is a type of dental restoration which repairs damage caused by tooth decay and prolongs the life of the tooth.

Cavity fillings are a very common dental procedure; 50% of respondents in a global study reported having between 1 and 10 fillings. And 91% of adults in the US have had cavities, many of whom have had dental fillings if they have access to dental care. 

To treat a tooth with dental caries (tooth decay) in this way, a dentist first drills out all the decayed material and cleans the cavity. They then fill the hole in the tooth with one of a number of cavity filling materials.

Once the cavity filling is complete, the tooth can function as normal for many more years.

If left untreated, tooth decay will continue to erode the tooth, leading to cavity pain. An abscess may eventually form somewhere around the tooth, requiring more drastic treatment like root canal work or even an extraction.

You may not relish the idea of having a dental filling, but it's really the best way to stop decay in its tracks and preserve the tooth for as long as possible.

Types of dental fillings – what are dental fillings made of?

There are various different tooth filling materials that dentists use according to the type of cavity filling. For a front tooth filling, for instance, dentists typically use a tooth-colored material.

Each material has its own benefits and drawbacks in terms of:

• Cost
• Appearance
• Strength
• Durability
• Ease of application

Below you can read about the main differences between the most common tooth filling materials.

Amalgam (silver) fillings

Silver-colored amalgam cavity fillings are made from a mixture of metals; around 50% mercury along with silver, tin and copper.

This is the cheapest tooth filling material available and is relatively easy to apply. It's also the strongest, which is why it's often used on stress-bearing surfaces. It's a particularly good option for large or deep cavity fillings.

One obvious downside is the esthetics; metal cavity fillings are unsightly and so are usually avoided for front teeth. Some people also prefer to avoid amalgam fillings because of concerns about their mercury content. Although some mercury vapor can be released while placing or removing these fillings, the ADA states that “based on available scientific information, amalgam continues to be a safe and effective restorative material.”

The American FDA has recently updated their stance to be a bit more cautious, now saying “while the majority of evidence suggests exposure to mercury vapor from dental amalgam fillings doesn’t lead to harmful health effects for most people, there may be some effects in people with certain health issues such as those who are hypersensitive to mercury.”

Do you want to read more about the potential risks of dental amalgam, the clinical studies into its use, and whether you should choose amalgam or composite fillings? We explore all of this in more detail in our composite vs. amalgam filling article.

Dental resin composite fillings

Composite tooth fillings are typically made from a mixture of acrylic resin and powdered glass. The resin-based composite material is shaded to match your natural tooth color as closely as possible, making the filling hardly noticeable.

However, this dental filling material isn't quite as durable as amalgam. It, therefore, may not be recommended for deep fillings and those on biting surfaces. It is also more technically difficult to apply, meaning the process takes a little longer.

Other uses of composite resin material include composite resin veneers and repairing broken or chipped teeth.

Glass ionomer fillings

Glass ionomer cement is another white tooth filling option. It's not as strong as composite resin fillings, so its use is often limited to temporary fillings, such as in children's milk teeth. It may also be used to fill decayed areas on teeth roots below the gum line since it doesn't have to bond to a dry surface.

Glass ionomer has the added benefit of releasing fluoride, which helps prevent further decay.

Gold fillings

Gold fillings are also an option, but their distinctive look means they are not everyone's first choice. They are very strong, and the most durable of all these filling materials, but also the most expensive.

Gold fillings can't be applied and shaped directly into the tooth cavity. Instead, they are usually made in a lab based on an impression of the tooth. This means more time in the dentist's chair – something that many people are keen to avoid. If you're set on gold and you nee your teeth straightened, gold braces may work for you.

There is one type of filling we're not going to cover in this article: root fillings. You can read all about root canal treatment in our full article on this topic.

Comparison of tooth filling materials

The table below summarizes the key properties of each of these types of tooth filling:

Temporary tooth filling kits

Are you wondering about doing a DIY temporary tooth filling? You can buy temporary tooth filling kits online and in pharmacies, but are they safe to use?

Well, using a DIY tooth filling kit is fine as a temporary tooth filling measure while you wait to see a dentist to get a permanent tooth filling. Kits like this one contain the same materials that dentists use, and can help reduce pain and avoid further damage to your teeth before you get a proper cavity filling put in.

But – we cannot stress this enough – they are not a permanent tooth filling. The tooth filler material isn't designed to last more than a few days, and you risk further damage to your tooth if you don't get professional treatment. Plus, if you have underlying tooth decay that isn't treated, you may eventually develop a painful dental abscess and need much more drastic treatment.

Procedure for filling a cavity

Do you want to know what happens when you get a dental filling? The procedure for permanent tooth filling varies slightly according to the type of filling, but here are the main steps that dentists follow:

Step 1: Checkup

When you go for a dental checkup, your dentist will use a small mirror to inspect every surface of each tooth. They will check for signs of decay as well as any cracks or fissures that might be susceptible to decay in the future, and will advise you if you have any teeth that need fillings or other treatment. They might also take a dental x-ray to get a better idea of the condition of your teeth.

Of course, you may already know that you need a filling. Perhaps you've noticed a small cavity in your tooth, have been experiencing tooth pain or sensitivity, or an old filling has come out.

Step 2: Anesthetic

If the decay is only on the surface of the tooth, the dentist may not need to administer an anesthetic at all. They can drill the damaged tooth enamel without it causing any pain.

In most cases, however, the dentist will inject a local anesthetic to numb the area around the tooth. They might also use a numbing gel on the gum to minimize discomfort from the injection itself.

Step 3: Removing decay

After the anesthetic has taken effect, the dentist will remove any parts of the tooth damaged from decay. This is done using a high-speed dentist's drill, air abrasion tool, or laser.

This is the least pleasant part of the process for many people, but thanks to the anesthetic, it shouldn't hurt. You'll just feel the vibrations and pressure from the drill and other tools. It can sound quite loud, especially with teeth on your upper jaw, but it's fine for you to take some music to listen to on headphones if you want to take your mind off this.

Once the tooth is free from decay, the dentist will make sure the hole is a suitable size and shape to hold the filling material firmly in place. They will also make sure it's completely clean and sterile, ready for the filling material to be applied.

Step 4: Filling

For an amalgam filling, the material is mixed immediately before application. The dentist presses it into the space to be filled, and it soon hardens by itself.

With a direct composite filling, the surface will first be etched with an acid gel to make the bond stronger. After around 15 seconds, the gel is washed off, leaving a roughened surface behind. Next, the dentist applies a thin layer of bonding agent to the surface about to be filled. This foundational layer helps the composite material form a strong bond with the tooth. Note that some manufacturers now combine these two steps into a single product which doesn't need to be washed off.

The bonding agent and composite filling material must be cured with a blue light to harden them. Depending on how deep the filling is, the dentist may build the dental composite up in stages, hardening one layer at a time. It has a putty-like consistency before it's cured, so the dentist can press it right into the cavity and mold it to the correct shape.

If you're getting indirect gold or porcelain fillings, the process differs at this stage. The dentist will take a mold or impression of your tooth which is sent away to a lab. You'll get a temporary filling and will need to come back several days later, once your permanent filling has been made, to complete the process.

Step 5: Shaping and polishing

Once the dental filling is in place and the material has hardened, it's time to refine the shape and polish it. The dentist will shape it to match the original tooth as closely as possible.

If the filling is on a biting surface, they will use a piece of articulating paper to check that it's a good fit. You'll be asked to bite down on a thin strip of paper, which leaves marks on your teeth to show the dentist how the new filling is making contact with your other teeth. They may make small refinements to improve the biting contact, before giving the tooth a final buff and polish.

The video below shows how a tooth with dental caries is prepared and filled with white composite material. (Note that it skips the parts where the composite material is cured with a blue light.)

How long does filling teeth take?

As you can see, there are many variables which affect how long it takes to get a filling. Amalgam placement is quicker than composite; deep fillings take longer than shallow ones and skipping anesthetic, of course, speeds up the process.

Most fillings take between 20 minutes and one hour from start to finish. Dentists can perform two or more fillings in a single visit, provided they are not too complex.

Ask your dentist how long your filling is likely to take so you know what to expect. If you're feeling nervous, it might help to have your dentist explain each part of the process as they're doing it.

Do fillings hurt?

One of the most common questions people have on this topic is “Does getting a filling hurt?“. It's quite natural to be worried about pain during and after a filling. Rest assured that modern anesthetic techniques mean the area around the tooth is completely numb during the procedure.

The injection itself can be slightly painful; you might feel a pinching or stinging sensation for a few seconds but then it's done. Dentists can reduce this discomfort by using a numbing gel on the gum before administering the injection.

It's possible to complete small cavity fillings without an injection if the decay is only on the surface of the tooth. Trust your dentist's advice – they know which types of fillings will require anesthetic and which won't.

In the video below, a licensed dental assistant explains what you should expect during a tooth filling.

Tooth pain after a filling

Once your anesthetic wears off, you shouldn't experience any pain from the tooth itself. The injection site may be a little sore for a day or two, though.

If you do find your tooth hurts after a filling, there may be a problem that your dentist needs to fix. For instance, the filling may have cracked or moved out of place, exposing the tooth nerves underneath. If it's painful when you bite, it may have been placed too high and will need to be polished down a little more.

It's possible for the dental pulp inside the tooth to become inflamed – a condition known as pulpitis – usually as a result of some decayed material being left behind during the filling procedure. Pulpitis can sometimes heal by itself, otherwise, root canal treatment will be needed to fully remove the infected tissue.

In some rare cases, people experience allergies to certain tooth filling materials. When this happens, the dentist can replace the filling with a different material.

If you still find that your tooth filling hurts after a couple of days, it's best to visit your dentist again. If you experience severe pain after a filling, contact your dentist straight away – you may need to make an emergency appointment to have it seen to.

Tooth sensitivity after a filling

Pain after a filling is uncommon, but it's more likely you'll experience tooth sensitivity for a day or two. In particular, recently filled teeth can be sensitive to hot and cold foods and drinks. If you notice this problem, avoid these triggers for several days and see if the sensitivity reduces.

You could also use a special toothpaste for sensitive teeth for a while, and try to avoid biting down directly on the filling. If your tooth sensitivity after a filling is really bothering you, an anti-inflammatory painkiller like ibuprofen should help.

If your filling is still sensitive 2-3 weeks after your tooth filling procedure, you might want to visit your dentist again to have it checked.

Cavity filling aftercare

In most cases, there should be no need for further dental visits after a cavity filling. Your dentist will advise you on any specific filling aftercare such as when you can eat and drink again, any foods to avoid temporarily, and which painkillers to take if you experience pain after your filling.

If your mouth is numb, take extra care talking and biting until the anesthetic has worn off. It's easy to bite your cheek without realizing it while you can't feel it.

After that, all you need to do is take good care of your teeth by maintaining a good oral hygiene routine.

However, you should contact your dentist if you notice any of the following in the days after a filling:

• There is a sharp edge on the tooth
• Your bite is uncomfortable (the filling is getting in the way when your teeth meet)
• There is a visible crack in the filling material
• The filling has come loose
• You're experiencing severe pain
• Your tooth remains sensitive 2-3 weeks after the procedure

Can you eat after a filling?

If you have had a composite filling, it's usually okay to eat and drink straight away. You might want to wait until any anesthetic has worn off – firstly because you may accidentally bite your cheek and secondly because you're likely to dribble!

Because metal fillings take longer to completely harden, dentists usually advise not eating or drinking anything for 1-2 hours afterward, and not consuming hard or chewy foods for at least 24 hours. Stick to things like soup, mashed potatoes, yogurt and smoothies during this time.

These are general guidelines only; follow your dentist's advice about drinking or eating after a filling, since you may need to take special precautions.

Preventing further tooth decay

After a filling, your dentist should give you some advice for maintaining better oral hygiene to reduce the likelihood of you needing more fillings or other dental treatment in the future. This will include flossing daily and brushing twice a day with a fluoride toothpaste.

Your diet can also affect the condition of your teeth. Cutting out sugary snacks, for example, can make a big difference. Find out more about how tooth decay occurs and how to prevent it so you can avoid more fillings at your next dental visit!

How much do fillings cost?

Filling prices vary according to a number of factors, but first, you should determine whether you can get the treatment you want through your insurance. Composite fillings are more expensive than amalgam and are not offered by some insurance plans.

How much are fillings with insurance?

Your insurance plan will likely cover between 50% and 80% of the cost of your teeth fillings, with the average filling price for amalgam being around $132.

How much does a white filling cost with a private dentist?

When paying for private dental care, filling prices will depend on several factors:

• Your tooth filling material
• The size of the cavity to be filled
• The location of the tooth
• How long the filling will take

You may find that very small dental fillings cost less with a private dentist than they would with insurance. In most cases though, especially with larger cavities, the tooth filling cost without insurance is substantially higher.

Of course, you can also get a silver filling with most private dentists (although some choose not to offer them). Although they are cheaper, many patients choose to pay the extra for a white filling in return for better esthetics.

In the following table you can get an idea of teeth filling prices for different materials:

Remember that these prices apply per filling, not per treatment course.

If your dental quote seems high, try shopping around in your area. Teeth filling prices can vary significantly from one dental clinic to another.

Additionally, read our guide to dental Medicaid to see if you are eligible for state-funded dental insurance. 

How long do fillings last?

Different filling materials have different levels of durability. Gold generally lasts the longest (15+ years) followed by amalgam (10-15 years). Composite resin isn't quite as long-lasting (5-10 years), especially when placed on a biting surface. Glass ionomer is the least durable (up to 5 years), which is why it's usually only used for temporary fillings and on milk teeth.

Composite materials are improving all the time and they can last as long as amalgam if they are not placed under strain from biting. However, composite is susceptible to staining, particularly around the edges, so it may start to look visually unattractive before it wears out physically.

Filling replacement

You might be wondering how to know if you need a new filling to replace an old one. You should visit your dentist if any of the following occur:

• All or part of an old filling falls out
• You notice a filling is loose and wobbling about in its hole
• The site of an old tooth filling hurts

During a routine dental checkup, your dentist will examine your existing fillings and will let you know if any need to be replaced. The process for replacing a filling is similar to placing a new filling – except the dentist has to remove the old filling material rather than the decayed part of the tooth.

If you have old silver fillings, you might want to replace them with tooth-colored filling material instead – regardless of any medical need.

Tooth filling FAQs

How do I know if I need a filling?

A toothache is a common sign that you need a filling. You may also notice a hole in your tooth, see discoloration, or experience sensitivity. But don't wait until you feel tooth pain to see a dentist.

Attend regular dental checkups so your dentist can spot the early signs of decay and intervene before the problem worsens.

What if I have a hole in my tooth but no pain?

Tooth decay begins in the outer layer of tooth enamel where there are no nerves, and it's not until it spreads deeper inside the tooth that it will start to cause you pain. Early intervention is best.

If you notice a hole in your tooth or see discoloration, make an appointment to visit your dentist, even if you aren't in pain. They will check whether you need a filling (and will examine your other teeth for signs of decay).

Catching decay early on means a smaller filling, which:

• Takes less time
• May not require an anesthetic injection
• Costs less (with private dental care)
• Leaves more of your original tooth intact

How long do fillings take?

The time needed for filling cavities depends on the size and location of the filling, the materials, and anesthetic needs. Usually, tooth cavity fillings take between 20 minutes and one hour in total.

Can you have white fillings with insurance?

Yes, in some cases, but you won't always get to choose the material. Your dentist will choose between amalgam (silver) and composite (white) fillings depending on your clinical need. White fillings with insurance tend to cost a bit more than amalgam fillings, and they aren't offered by all insurance. 

How long after a filling can you eat?

For composite fillings, you should be able to eat normally as soon as any anesthetic wears off. For silver fillings, it's best to avoid eating for 1-2 hours and then stick to soft foods for 24 hours. Either way, follow your dentist's advice.

You might want to avoid very hot or cold foods for a while, since these can make tooth sensitivity after a filling worse.

How long after a filling can I drink?

It's normally fine to drink straight after getting a composite filling, and an hour or two after a metal filling. Be aware that your filled tooth may be sensitive to hot and cold drinks for a while. Very sugary or acidic drinks can also cause sensitivity, so you may want to stick to water at first after filling a cavity.

Avoid any alcoholic drinks while you're taking any medication, including painkillers.

What to do if your tooth hurts after a filling?

Some sensitivity is normal and may last for 2-3 weeks. Severe pain is abnormal. Similarly, if you have mild pain that lasts for days or seems to be getting worse, speak to your dentist. There may be a problem with your filling that they need to check.

What do I do if my tooth filling fell out?

The first step is to call your dentist, who will ask you to come in for an appointment for refilling your teeth. But until your appointment here are a few things you should do:

• Remove the filling from your mouth
• Use salt water rinses to keep it clean
• Use clove oil to numb the area and to alleviate tooth pain
• Make a homemade temporary tooth filling from dental wax
• Use an over-the-counter tooth repair kit

How long do composite fillings last?

Composite fillings don't last forever. You may need to replace your composite filling every 5 to 7 years. Going to regular dental appointments will help you stay on top of your dental health.