There are a number of possible reasons:

• A tooth may have primary decay (fresh dental caries in a previously unrestored surface).
• It may have secondary decay (around or beneath an existing restoration).
• A tooth may be weakened because it is already heavily restored or perhaps a piece has already fractured off.
• A tooth that has had root canal therapy may need to be “built up” with filling material (called a “core”) so that there is enough structure above gum level to support a crown or “cap” that seals and protects the remaining tooth. A core may also be needed to support a bridge.
• There may be tooth wear – possibly from brushing too hard or from grinding your teeth at night – that needs to be repaired.

If the filling is expected to be small or medium in size, a composite is usually a good, quick and relatively inexpensive solution.  If the filling is expected to be large, it is less likely to last a long time.  It may be better to consider an inlay or crown.  Inlays and crowns are more expensive than fillings but usually last longer and have better aesthetics.

In this situation, a crown is usually the best treatment as it is stronger, has the best aesthetics and excellent longevity.  However, it is more expensive.  Composite filling material can be used if you wish.  It is quick and relatively inexpensive.  However, it is not the best treatment option since very large fillings are prone to failure, especially where they comprise two thirds or more of the surface area of the tooth.  If it fails, you will still end up needing a crown – so you might just be postponing the inevitable and end up paying twice – for repeat treatments on the same tooth.

It is an option not to treat tooth wear at all.  However, it may get worse and cause you sensitivity or pain; ultimately it may even mean you need root canal therapy.  Worn areas are also more prone to decay and staining, so they often appear unsightly and you may rather that this is restored.

If you have buccal (cheek-side of the tooth) or cervical (on the “neck” of the tooth) wear, a composite filling is a good, quick and inexpensive solution.

If you have wear on your incisal edges (the biting edges of your front teeth) or on the occlusal (biting) surfaces of your back teeth then a composite filling is a quick, inexpensive solution but likely to break because of the forces acting on it.  A better option may be a veneer (on front teeth) or a crown.  These are more expensive but are particularly good for severe wear.  They’re stronger, tend to last much longer and have excellent aesthetics.

A great advantage of composite fillings (you’ll sometimes hear them referred to as “adhesive dentistry” or “direct restorations”) is that only a little of the tooth is taken away when the surface is prepared.  Generally, more tooth is removed in preparing for a veneer, inlay or crown.  Less preparation is considered to be a good thing – conserving more of the original tooth structure for longer.  However, there are circumstances where a filling really isn’t the best choice (see above).

We normally advise replacement of fillings when this becomes necessary because, for example, there is secondary decay (see above).  Replacing a filling nearly always means losing a little bit more tooth structure, and we try to conserve this where we can.  However, if you don’t like how your silver fillings look we can replace them for you – it is your choice.

Current prices are given on our website and on display in reception.  Also, the expected cost of each filling will be given on your estimate / care plan.

Please remember that the estimate is just an estimate; the eventual size, complexity and, therefore, cost of each filling may differ.  This is because it’s impossible to be certain of the size and difficulty at the outset. Sometimes, decay will be much deeper and more extensive than expected.  We can’t be sure until we see inside the tooth.

As a rough guide, tooth-coloured fillings cost from £290 to £450.

Many factors affect the longevity of fillings.  For example:

• How good your oral hygiene is;
• Your diet – especially acidic food and drink;
• Grinding your teeth;
• Where the filling is in your mouth;
• How heavily your teeth come together when you bite; and
• How large the filling is to begin with.

It’s impossible to predict with certainty how long a filling will last.  However, our own clinical audit data show that 96% of fillings we place on anterior (front) teeth last more than 5 years.  We also guarantee them for the first year (unless they are damaged by external force or you’ve asked us to place them where we’ve advised there is a better or more appropriate treatment option).

We advise brushing your teeth with fluoride toothpaste last thing at night and after you eat during the day. Cutting down on sugary foods & drinks and frequent visits  to your dentist – as often as they recommend will help maintain your teeth and keep them in good condition.