White (composite) fillings

Information about white (composite) fillings and your treatment with Bristol Dental School.

Composite resin is a tooth-coloured filling material used to restore teeth for many reasons such as decay, tooth wear, dental trauma and replacement of lost tissue.  

Why do I need a composite filling? 

Fillings are required to replace lost tooth tissue to prevent food and bacteria entering the cavity and causing further disease. A filling is most commonly used to repair cavities (holes) in teeth caused by decay. Composite fillings can also be used to repair cracks and fractures in teeth. 

In some situations composite fillings are preferred because they can stick to the tooth tissue. However, there are some situations where composite fillings are not appropriate which include: difficulty keeping the tooth dry, cavities extending near or under the gums and very large cavities. 

Treatment

  • The tooth may be anaesthetised with local anaesthetic to keep you comfortable. 
  • A rubber dam (a protective rubber sheet) may be placed over the tooth to protect it from moisture which can affect the filling sticking to the tooth.  
  • The tooth isprepared with dental instruments to clean and shape the filling site. 
  • A blue gel is applied to the cavity and washed off after a few seconds. This cleans the tooth and prepares the cavity for the composite material.  
  • A thin bonding layer  and filling is applied to the tooth which is set using a blue light.  
  • The composite filling is shaped and polished.  

Benefits of treatment

  • Appearance: Composite fillings can be matched to the same colour as your tooth, and are known as ‘white’ fillings. 
  • Bonding: Composite fillings bond (stick) to the tooth. This means less tooth tissue needs to be removed for a composite filling to stay in place in comparison to filling materials that do not stick to the tooth structure. 
  • Strength: Composite fillings are hard and durable so can be used for back teeth. 
  • Survival: A composite filling can last 5-7 years, and in some instances 10 years or more. 

Risks of treatment

  • Case dependent: In certain clinical circumstances composite fillings are not suitable (e.g. when it is difficult to keep the tooth dry, the cavity extends near or under the gums and when the cavity is very large) 
  • Time: Composite fillings can take longer to place than other filling materials such as amalgam as there are more stages when placing them. 
  • Composite fillings may not last as long as amalgam fillings and can require more frequent replacement. 
  • Maintenance: Composites require maintenance as they can roughen, discolour or fracture/chip over time. 
  • Sensitivity: Patients may experience sensitivity after receiving a composite filling. This should not last for more than 2 weeks. 

Alternatives 

We will always discuss the options available to you in depth before any decisions are made. Such options may include: 

  • Alternative filling materials: 
    • Amalgam - a silver coloured filling 
    • Glass ionomer cement - often used as an intermediate filling 
  • Veneer: if the appearance of the front teeth needs to be improved, veneers may be considered. Unlike composite fillings, these require increased removal of tooth tissue and therefore are only suitable in certain cases. 
  • Inlay or onlay: if the tooth requires further reinforcement, an inlay/onlay restoration may be considered. Inlay/onlay restorations are similar to fillings but are constructed outside of the mouth (in a dental laboratory) and then cemented onto the tooth. 

What happens after treatment has finished

If you have received local anaesthesia during the filling treatment, this can last several hours. It is important to avoid eating anything on the side of the mouth anaesthetised and to avoid hot drinks until full sensation comes back. 

Some patients experience sensitivity following the placement of a composite filling. If this persists, please discuss it with the dental professional who placed the filling. 

To check that you and your dental professional are happy with the outcome of your treatment, you will be reviewed after your treatment is finished.  

When all of your dental treatment is complete, you will be discharged from the dental school. We advise that you find a dentist outside the dental school to continue to look after your teeth and restorations. 

Questions you may want to ask

  • How long will the composite filling last? 
  • What should I do if the composite filling chips/cracks? 
  • How should I brush and floss around my composite filling? 

Maintaining good oral hygiene at home

Maintaining good oral hygiene is crucial for healthy teeth and gums, and will help reduce the risk of decay and gum disease. Brush your teeth twice daily for 2 minutes with fluoride toothpaste and clean between your teeth with floss or interdental brushes. 

Smoking and alcohol increase the risk of oral disease. If you want to quit smoking or reduce your alcohol intake, please talk to the clinician you see for further advice. 

It is important to attend dental check-ups regularly, as this will help your dentist to identify any dental disease early.