Remove decayed tissue and rebuild the missing part of the tooth.
Learn how dental fillings repair cavities and small areas of tooth damage, compare composite, amalgam, glass ionomer, gold and ceramic restorations, understand the filling procedure, costs, sensitivity, lifespan and replacement signs, and know when a filling may no longer be enough to restore a tooth.
A filling is usually used after a dentist removes decayed tooth tissue from a cavity. The right material and restoration size depend on the tooth, the location and extent of decay, remaining tooth structure and your individual needs.
Remove decayed tissue and rebuild the missing part of the tooth.
Tooth-colored resin is widely used on front and back teeth.
Before a cavity forms, fluoride and prevention may help remineralize enamel.
Every restoration needs monitoring and may eventually need repair or replacement.
This simplified figure shows the path from a cavity to a restored tooth. Actual cavity shape, depth and restorative technique vary from patient to patient.
The dentist removes softened or infected tooth structure, prepares the area and places a restorative material that rebuilds the lost contour.
The goal is to control the disease process and restore enough tooth structure for function. Larger damage may require an onlay or crown instead of an increasingly large filling.
Dental fillings are restorations used to repair cavities and selected areas of tooth damage. According to the National Institute of Dental and Craniofacial Research (NIDCR), a dentist treats a cavity by removing decayed tooth tissue and filling the resulting space with a restorative material. The filling replaces lost tooth structure, helps seal the prepared area and allows the tooth to function again.
A filling is not the same as simply covering over decay. The diseased or weakened tissue must be assessed and appropriately managed first. The final restoration is then bonded, packed or cemented into the prepared tooth depending on the material and technique.
Tooth decay is a disease process, not a one-time event. NIDCR explains that bacteria in dental plaque use sugars and starches from foods and drinks and produce acids that attack enamel. Teeth naturally lose and regain minerals during the day, but repeated acid exposure can push the balance toward mineral loss.
Repeated acid attacks begin removing minerals from enamel. A white spot can be an early sign.
Before a hole forms, fluoride, saliva and improved habits may help stop or reverse early demineralization.
Continued mineral loss weakens enamel until the surface breaks down into permanent structural damage.
Once a true cavity exists, a dentist usually removes decayed tissue and restores the missing structure.
That distinction matters: not every early white spot needs to be drilled, but a cavitated lesion cannot grow enamel back into the missing hole. Diagnosis depends on location, activity, cavity depth, patient risk and the dentist's examination.
Read the NIDCR explanation of the tooth-decay process for an evidence-based overview of demineralization, fluoride and cavity formation.
The best filling material depends on the tooth and clinical situation. The American Dental Association notes that dentists consider the cavity's size and location, appearance, durability, cost and insurance coverage when helping patients choose a restorative material.
A tooth-colored mixture of resin and glass/quartz filler. It bonds to tooth structure and is widely used for small- to medium-size restorations on front and back teeth.
A strong silver-colored metal mixture containing elemental mercury combined with silver, tin and copper. It has a long clinical history and performs well in selected high-load or moisture-challenging situations.
A tooth-colored cement that can release fluoride. It is useful in selected low-stress areas, root-surface cavities, pediatric situations and other cases where its properties fit the clinical need.
A hybrid material that combines glass-ionomer chemistry with resin components to improve handling and strength for selected restorative applications.
A laboratory or digitally fabricated indirect restoration made from gold alloy. It is highly durable but usually costs more and may require more than one visit.
A tooth-colored indirect restoration, often porcelain or another dental ceramic, used when a larger or more precisely fabricated restoration is appropriate.
| Feature | Composite Resin | Dental Amalgam |
|---|---|---|
| Appearance | Matched to tooth color and generally less noticeable. | Silver/gray metallic appearance. |
| Common Uses | Front or back teeth; often small- to medium-size restorations. | Selected posterior restorations, large preparations or situations where moisture control is difficult. |
| Placement | Usually bonded in layers and requires good isolation from moisture. | Condensed into a prepared cavity and does not rely on the same adhesive technique. |
| Tooth Preparation | Bonding can allow more conservative preparation in some situations. | Preparation may require a shape that mechanically retains the material. |
| Durability | Good durability; performance depends on cavity size, bite and technique. | Strong and long-lasting, with a long record in stress-bearing posterior restorations. |
| Cost | Often costs more than amalgam. | Typically one of the lower-cost direct filling materials. |
| Special Considerations | Possible sensitivity or allergy to resin components is uncommon but possible. | Contains elemental mercury; FDA gives special recommendations for certain higher-risk groups. |
The choice should not be reduced to “white is always better” or “metal is always stronger.” Cavity size, tooth location, moisture, remaining structure, bite, patient preference, health history and cost all matter. See the ADA's overview of dental filling options.
Dental amalgam is a mixture of metals in which elemental mercury is combined with a powdered alloy. FDA states that the majority of evidence does not show that mercury exposure from dental amalgam causes adverse health effects in the general population. However, because some groups may be more susceptible to potential effects of mercury exposure, FDA recommends using non-amalgam restorations when possible and appropriate for those groups.
Pregnant women and developing fetuses, women planning pregnancy, nursing women and infants, children especially under age six, people with certain neurological disease, impaired kidney function, or known sensitivity to mercury or other amalgam components.
FDA does not recommend removing an intact amalgam filling in good condition unless a health professional considers removal medically necessary. Removal sacrifices tooth structure and temporarily increases mercury vapor exposure.
Do not remove a sound amalgam filling simply because it is silver-colored. Ask a dentist whether there is recurrent decay, fracture, leakage, poor margins, a documented material sensitivity or another clinical reason for replacement.
Review the current FDA dental amalgam information if amalgam safety is important to your treatment decision.
The exact visit varies with the tooth, cavity and material, but a routine direct filling often follows the same broad sequence.
The dentist confirms the tooth, decay extent and whether a filling is an appropriate restoration.
The area may be numbed for comfort, particularly when decay extends into sensitive dentin.
Decayed and unsupported tissue is removed while preserving healthy structure whenever possible.
The selected material is placed, shaped, hardened or set and polished; the bite is then checked.
Composite restorations generally require careful moisture control. The tooth is conditioned and bonded, resin is placed in increments when appropriate, each layer is light-cured, and the restoration is shaped and polished. The dentist also rebuilds contact with neighboring teeth and the grooves or contours needed for chewing.
A newly restored tooth that contacts too early can feel sore when chewing. Dentists use bite-marking material and adjustments to help the restoration fit into your normal occlusion. If the tooth feels “high” after numbness wears off, contact the dental office rather than trying to wait through significant biting pain.
Dental filling cost varies by material, number of tooth surfaces, tooth location, cavity size, provider and region. Published national data can be useful for budgeting but should not be treated as a quote. Current CareCredit procedural data lists the following U.S. averages and reported ranges.
| Filling / Restoration | Published Average | Published Range |
|---|---|---|
| Silver amalgam | About $139 | About $108–$256 |
| Composite resin | About $226 | About $173–$439 |
| Glass ionomer | About $152 in current CareCredit cost tables | Other published references may vary by indication and region |
| Gold | About $466 | About $361–$817 |
| Porcelain inlay/onlay | About $976 | About $755–$1,774 |
Use those figures as a national reference only. A one-surface filling can cost less than a large multi-surface restoration, and an indirect ceramic inlay/onlay is not directly comparable to a simple direct filling. For a dedicated budgeting tool, use the Dental Filling Cost Calculator.
Many U.S. dental plans treat fillings as basic restorative care, but there is no universal coverage percentage. A plan may apply a deductible first and then pay a percentage of the allowed fee up to the annual maximum. Network status, waiting periods, missing eligibility information and frequency rules can all matter.
Some plans may base reimbursement for a tooth-colored posterior filling on the fee for a lower-cost covered material. The patient may owe the difference depending on the contract.
Even a covered filling can become more expensive out of pocket if most of the plan's annual maximum has already been used for other dental care.
Before treatment, ask the dental office for the procedure code, tooth number and surfaces involved. Your insurer can then explain the expected allowed fee, deductible, coinsurance and whether the selected material affects reimbursement.
No dental restoration lasts forever. Longevity depends on much more than the material name. A small well-isolated filling in a low-stress area may behave very differently from a large restoration replacing several cusps on a patient who grinds heavily.
The more natural tooth structure a filling replaces, the more force the restoration and remaining tooth must manage.
Clenching and bruxism can increase fracture and wear risk for both the tooth and restoration.
Plaque at restoration margins can contribute to new decay around an otherwise intact filling.
Frequent sugar exposure maintains cavity risk, while chewing very hard objects can fracture restorations or teeth.
Bonded restorations are technique-sensitive, and good isolation during placement can influence performance.
Cracks, thin cusps and limited remaining enamel/dentin can make a crown or onlay more appropriate than repeated large fillings.
ADA patient information emphasizes that fillings do not last a lifetime and may need replacement. Regular dental examinations help identify deterioration before a small problem becomes a larger restoration.
A tooth can feel different for a short period after restorative treatment. The tooth has been prepared, a new material has been placed, and the bite may need time to settle. Temporary temperature sensitivity or mild tenderness can occur, especially with deeper cavities.
Seek assessment if pain is worsening instead of improving, the tooth hurts strongly when biting, the restoration feels high, cold or heat pain lingers, pain starts without a trigger, swelling develops, the filling fractures or falls out, or you develop fever or facial swelling.
Persistent spontaneous or lingering thermal pain can indicate that the pulp inside the tooth is inflamed or infected. In that situation, simply replacing the filling may not solve the problem and root-canal treatment or another plan may be required.
Fillings should be replaced because of a clinical problem, not simply because they are old. A dentist looks at the restoration, tooth and symptoms together.
| Possible Finding | What It Can Mean | Possible Next Step |
|---|---|---|
| Fractured filling | Part of the restoration has broken or chipped. | Repair, replacement or a larger restoration depending on remaining tooth. |
| Recurrent decay | New cavity has formed at or below a filling margin. | Remove decay and restore again if enough sound tooth remains. |
| Open / defective margin | The restoration may no longer seal or contour correctly. | Monitor, repair or replace depending on severity and evidence of disease. |
| Tooth crack | The natural tooth has fractured around or beneath the filling. | Onlay, crown, root canal or extraction depending on crack extent. |
| Wear | The restoration has lost anatomy or contact from chewing/grinding. | Polish, repair or replace based on function and remaining thickness. |
| Persistent pain | May indicate bite trauma, deep inflammation, crack or pulp disease. | Diagnostic assessment before replacing anything. |
A filling works best when enough healthy tooth remains to support a direct restoration. As damage gets larger or deeper, a different treatment may better protect the tooth.
Often used for small- to medium-size cavities when the tooth retains enough strong structure.
An indirect restoration can replace a larger area with precise lab or CAD/CAM fabrication while preserving more tooth than a full crown in selected cases.
Covers and protects a substantially weakened tooth when a filling would leave cusps or walls at high fracture risk.
May be required when decay, cracks or trauma cause irreversible inflammation or infection inside the pulp.
Reserved for teeth that cannot predictably be restored or retained. Replacement options can then include bridge, implant or denture treatment.
Non-cavitated early decay may be managed preventively instead of restored immediately when clinically appropriate.
If a dentist recommends full coverage because too little tooth remains for another filling, compare the restorative fee using the Dental Crown Cost Calculator. If a tooth cannot be saved and must be replaced, a fixed bridge may be one option; the Dental Bridge Cost Calculator can help with budgeting.
Primary teeth can develop cavities and may need restorations even though they eventually fall out. Baby teeth maintain space, support chewing and speech, and help guide permanent teeth. Whether a cavity is restored, monitored or treated with another method depends on lesion size, tooth position, symptoms, the child's cavity risk and how long the tooth is expected to remain.
Pediatric restorative materials can include composite, glass ionomer, amalgam in selected circumstances, and preformed crowns for more extensive damage. For young children or patients who have difficulty tolerating treatment, behavior guidance and visit planning may affect material choice and treatment sequence.
FDA amalgam note: Children—especially those younger than six—are among the groups for whom FDA recommends avoiding new amalgam fillings when possible and appropriate and when suitable alternatives are available.
Untreated dental infection can also create health problems, so pregnancy should not automatically mean postponing necessary dental care. Tell the dentist that you are pregnant or trying to conceive and provide relevant medical information. The dental team can choose appropriate materials, anesthesia and timing based on the situation.
FDA includes pregnant women, developing fetuses and women planning pregnancy among the groups for whom non-amalgam restorations are encouraged when possible and appropriate. This is a material-selection recommendation, not a recommendation to remove functioning amalgam restorations during pregnancy.
A filling repairs damage from a cavity; it does not eliminate the disease risk that produced the cavity. New decay can form on other parts of the same tooth, on nearby teeth or at the edge of the restoration. Prevention therefore remains essential after treatment.
A chipped filling with no pain may not be a medical emergency, but it still deserves timely dental evaluation. Contact a dentist promptly if a filling falls out, a tooth fractures, biting becomes painful, food packs into a new gap, or sensitivity suddenly increases.
Seek urgent assessment for facial swelling, fever with dental pain, rapidly increasing swelling, difficulty swallowing or breathing, uncontrolled bleeding, significant facial trauma, or other symptoms suggesting spreading infection or a medical emergency.
This guide uses current government and professional dental sources for the core clinical statements. Cost figures are included only as planning benchmarks because actual dental fees depend on provider, region, restoration size and insurance terms.
Common questions about cavity fillings, materials, cost, aftercare, sensitivity, replacement and prevention.
A dental filling is a restoration used to repair a tooth after decayed or damaged tooth structure is removed. The material seals and rebuilds the prepared area so the tooth can function again.
Not always. Very early decay that has not formed a cavity may sometimes be arrested or reversed with fluoride and changes in oral hygiene and diet. Once tooth structure has broken down into a cavity, a dentist generally needs to restore the defect.
There is no single best material for every tooth. Dentists consider cavity size and location, remaining tooth structure, moisture control, bite forces, appearance, allergies or sensitivities, cost and insurance coverage.
Composite resin can be used on front or back teeth and is commonly chosen for small- to medium-size restorations. Suitability depends on cavity size, ability to keep the area dry and the forces on that tooth.
FDA information says available evidence does not show that mercury exposure from dental amalgam causes adverse health effects in the general population. FDA recommends non-amalgam alternatives when possible and appropriate for certain higher-risk groups.
Not simply because they contain amalgam. FDA does not recommend removing an intact amalgam filling in good condition unless a health professional considers removal medically necessary, because removal sacrifices tooth structure and temporarily increases mercury vapor exposure.
No filling lasts forever. Longevity varies with material, cavity size, tooth location, bite forces, grinding, oral hygiene, diet, recurrent decay and how much healthy tooth remains.
Mild short-term sensitivity to temperature or biting can occur after a restoration. Persistent, worsening, spontaneous or severe pain, or a bite that feels too high, should be assessed by the dentist.
Yes. Fillings can loosen, fracture or be lost because of wear, recurrent decay, a cracked tooth, biting forces or trauma. The exposed tooth should be evaluated promptly.
Yes. When too much tooth structure is missing or the remaining tooth is weak, a dentist may recommend an inlay, onlay, crown, root-canal treatment with a restoration, or extraction depending on the condition of the tooth.
Dentists commonly use local anesthesia when removing decay and preparing a tooth, although the need depends on the size and location of the cavity and individual sensitivity. Pressure or vibration may be felt even when the tooth is numb.
Cost varies by material, number of surfaces, tooth location, provider and geography. Current CareCredit procedural data lists averages around $139 for silver amalgam, $226 for composite, $466 for gold and $976 for porcelain inlay/onlay; local fees can differ substantially.
Many dental plans classify routine fillings as basic restorative care, but deductibles, coinsurance, annual maximums, waiting periods, network fees and material downgrades can affect what the plan pays.
Follow the dentist's instructions. If local anesthetic was used, take care not to bite the cheek, lip or tongue until sensation returns. Material-specific guidance may affect when you should chew on the restored tooth.
A small defect may sometimes be restored with bonded material, but cracks vary widely. Larger cracks or weakened teeth may need an onlay or crown, and cracks involving the pulp or root can require more extensive treatment.
It is new tooth decay that develops at or near an existing restoration. It may occur if plaque accumulates at a margin, the filling breaks down, the tooth cracks or cavity risk remains high.
Glass ionomer is a tooth-colored restorative material used in selected situations. It can release fluoride, but its strength and wear characteristics differ from composite and amalgam, so location and cavity size matter.
Yes. Cavities in primary or permanent teeth may need restoration. The material and technique depend on the tooth, cavity, child's age and cooperation, moisture control and expected time the tooth needs to remain functional.
Brush twice daily with fluoride toothpaste, clean between teeth, limit frequent sugary or starchy snacks and drinks, use fluoridated water when available, and attend dental visits based on your dentist's recommended schedule.
No. It is educational information. A dentist must examine the tooth, and sometimes use dental X-rays, to determine whether decay is present and which restoration is appropriate.
Use these ToothCalculator.com tools when you need a cost estimate for filling treatment or a larger restoration that may be recommended instead.
A small cavity may need a relatively simple restoration, while deeper decay can lead to larger fillings, crowns, root-canal treatment or tooth loss. If you have pain, sensitivity, a visible hole or a broken filling, arrange a dental examination rather than relying on symptoms alone.
Review The Dental Fillings Guide