If you had cavities filled as a kid, you probably have a few dark spots on your molars that show up in photos when you laugh. Those are amalgam fillings, and for decades they were the standard.
We use composite, or tooth-colored, fillings at our Berkeley office. The reason is not only that they look better, although they do. It comes down to how they attach to the tooth and how much healthy structure we get to keep.
What tooth-colored composite fillings are made of
Composite fillings are made of ceramic and plastic compounds that chemically bond to tooth structure. That word bond is the important part.
An amalgam filling sits in a cavity like a plug. To hold it, the preparation has to be shaped with undercuts, which means removing sound tooth structure that is not diseased simply to keep the filling from falling out. A composite filling bonds directly to enamel and dentin, so we remove the decay and very little else.
Every millimeter of natural tooth we preserve is a millimeter working for you thirty years from now. That is the whole argument in one sentence.
What getting a tooth-colored filling is like
Most fillings are one visit and shorter than people expect.
We numb the area, remove the decayed tissue, and clean and condition the surface so the composite can bond to it. Then the material goes in layer by layer, each layer cured with a light. Building it up in layers is what lets us shape anatomy back into the tooth instead of leaving a flat patch.
Then we check your bite. This step gets rushed in some offices and it should not be. A filling that sits even slightly high feels wrong when you chew and can make a tooth ache for weeks. We adjust until it feels like nothing at all, then polish it.
Because the material sets immediately under the curing light, you can eat as soon as the numbness wears off. There is no waiting period.
Where tooth-colored fillings work best, and where they do not
Composite is the right choice for most small to moderate cavities, for chipped front teeth, for closing small gaps, and for replacing old fillings that have started to leak or stain.
It has limits worth knowing.
- Very large cavities may leave too little remaining tooth for a filling of any kind to be reliable. A crown or onlay is the more honest recommendation there.
- Composite is technique sensitive. It requires a dry field and careful layering, which is one reason placement quality varies between offices.
- Coffee, tea and tobacco can stain the surface over years, particularly at the margins.
- Grinding puts heavy load on any restoration, so a night guard matters if that is your situation.
When a filling is not the right tool, we say so rather than placing one and hoping. Redoing failed work is more expensive for you than doing the right procedure the first time.
How long tooth-colored fillings last
Longevity depends on size, location and habits more than on brand of material. A small composite in a front tooth with good hygiene can last many years. A large one in a molar of someone who grinds and drinks soda all day will not.
We monitor existing fillings at every checkup, watching margins for gaps and staining where new decay likes to start. Being a fully digital office means we can compare images over time and catch early breakdown while the fix is still small.
Replacing a filling at the right moment is routine. Replacing it two years late often means the decay has reached the point where a crown is needed instead.
Should you replace old silver fillings?
Not automatically. An amalgam filling that is sealed, comfortable and not failing is generally fine to leave alone, and disturbing sound work removes more tooth structure in the process.
We do recommend replacing amalgam when there is a real reason: a crack in the filling or the tooth around it, decay at the edges, a filling so large that the remaining walls of the tooth are flexing, sensitivity that traces to that tooth, or a visible one in a front tooth you dislike.
If you have wondered about it, ask at your next cleaning and we will look at each one with you and explain what we see. Cosmetic preference is a legitimate reason too, and we will treat it as such rather than talking you out of it.
Caring for a tooth after tooth-colored fillings
A filling repairs damage. It does not make the tooth immune to future problems, and new decay can start at the margin of any restoration.
Brush twice a day and clean between your teeth once a day, especially where a filling meets the neighboring tooth, since that contact point is the most common place we find new decay. Cut back on sipping sweet or acidic drinks across the day; frequency of exposure matters more than total quantity. Keep your professional cleanings, and mention any sensitivity to cold or pressure while it is still minor.
Why small cavities are cheaper than big fillings
The pattern we see over and over in Berkeley patients who have been away from the dentist a few years is not dramatic. It is a cavity that could have been a twenty-minute filling turning into a crown, or occasionally an extraction.
Nothing about that is a moral failing. Life gets busy, insurance changes, appointments slide. The fix is simply coming in and letting us sort out what needs attention now and what can wait.
Your Dental Story is at 2930 Martin Luther King Jr Way in Berkeley, with off-street parking and hours Monday through Thursday and Friday mornings. Call (510) 841-1128 or request an appointment online.