Composite fillings, inlays, onlays and other modern restorations have quietly replaced the old “silver fillings” in most quality clinics – but many patients still don’t really know what sits inside their teeth, how long it lasts, or when it should be replaced. A clear, patient‑friendly review of dental fillings not only reduces anxiety, it also helps people make better decisions when their dentist suggests a particular material or technique.
Below is an SEO‑ and NLP‑friendly English rewrite and expansion of the Hungarian article, adapted for a WordPress blog and enriched with extra explanations and headings.
Why Dental Fillings Are Still the Most Common Treatment
Dental fillings remain one of the most frequently performed procedures in everyday dentistry. Most patients eventually visit a dentist because of tooth decay, a broken edge, or sensitivity that leads to the diagnosis of a cavity. A filling is the standard way to restore a tooth that has been damaged by caries or minor trauma but does not yet need a crown, root canal, or extraction.
In simple terms, a filling has three main jobs:
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Remove bacteria and decayed tissue safely
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Seal the tooth tightly to prevent new bacterial invasion
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Rebuild the original shape so you can chew comfortably and smile confidently
Even though fillings are so common, many people are unsure about the different materials, how long they last, and when they should be replaced. That uncertainty feeds myths and fear – which is exactly why a clear explanation is so useful.
When Do You Actually Need a Filling?
A dental filling is usually recommended in two situations:
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Tooth decay (caries)
Acid‑producing bacteria create a softened, decayed area in the enamel and dentine. Once this process reaches a certain depth, the weakened tissue must be removed and the tooth rebuilt. -
Fracture or chipping
A tooth can break because of trauma, biting on something hard, clenching, or old, large restorations that have weakened the remaining structure. If the defect is limited and the tooth is otherwise healthy, a filling can restore form and function without needing a crown.
The goal is always to intervene early: small cavities can be treated conservatively, preserving more of your natural tooth and often avoiding root canal treatment or more complex prosthetic work later.
The Old Standard: Amalgam Fillings
For decades, amalgam fillings were the standard solution for back teeth. Amalgam is a metal alloy containing several metals (traditionally including mercury bound in a solid matrix), valued for its strength and durability.
However, there are several reasons why many modern clinics now use it rarely or not at all:
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Some patients are concerned about metal sensitivity or intolerance over time.
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Amalgam does not bond to tooth tissue; it is packed into a prepared cavity, which may require more removal of healthy tooth structure.
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Differences in expansion between the metal and tooth can, over many years, create microscopic cracks inside the tooth.
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The dark, metallic colour is clearly visible when you open your mouth.
Because of these concerns and the availability of better alternatives, many dentists now recommend replacing old, large amalgam fillings with modern tooth-coloured materials when clinically justified. In new cases, amalgam is used only in very specific circumstances or not at all in contemporary aesthetic dentistry.
Cement-Based Fillings: Strong Base, Limited Solo Use
Cement-based fillings (various glass ionomer or related cements) offer certain advantages:
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They bond chemically to the tooth structure.
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They can release fluoride ions, which may help reduce the risk of recurrent decay in high‑risk patients.
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They are relatively kind to the pulp in deeper cavities.
Because of their mechanical properties, cement materials are often used:
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As a base layer or liner under another filling material
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In areas where moisture control is difficult
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In small non‑load‑bearing cavities, especially in children or temporary restorations
On their own, pure cement fillings are less commonly used for large, load‑bearing surfaces. Dentists frequently combine them with composite or other materials to build a strong, long‑lasting restoration that also looks good.
Composite (White) Fillings: The Modern Aesthetic Standard
Composite fillings are currently the most widely used material in modern restorative dentistry, especially for visible areas. These are sometimes called “white fillings” or “aesthetic fillings”.
Key advantages:
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Tooth‑coloured appearance
Composites are available in multiple shades and translucencies, allowing the dentist to match your natural tooth colour very closely. Even in front teeth, the result can be almost invisible. -
Adhesive bonding
Composite resin is bonded to enamel and dentine via adhesive systems. This means the dentist can often preserve more healthy tooth structure compared with traditional non‑bonded techniques. -
Versatility
Composite can be used for small to moderately large cavities, chipped edges, cosmetic reshaping, closing small gaps, and repairing certain fractures. -
Biocompatibility
Modern composites are designed to be well‑tolerated; allergy or intolerance is rare compared with older metal combinations.
The main drawback: like any material, composite does not last forever. Over time it can wear, chip, or develop tiny marginal gaps. After some years (exact lifespan varies from person to person and tooth to tooth), the dentist may recommend replacing or refurbishing the filling to maintain a perfect seal and appearance.
Inlays and Onlays: When a Simple Filling Is Not Enough
When a defect is too large for a conventional filling but the tooth still has enough healthy structure to avoid a full crown, a dental inlay or onlay can be an excellent solution.
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Inlay
Fits inside the cavity, within the cusps (peaks) of the tooth. -
Onlay
Covers one or more cusps; in some cases it covers the entire chewing surface, acting like a partial crown.
Key features:
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Custom made by a dental laboratory from a precise impression or digital scan.
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Materials can be high‑strength composite, ceramic, or metal alloys.
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Stronger and more dimensionally stable than a large direct filling placed in one visit.
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Offers excellent contact points, anatomy, and longevity when properly designed and bonded.
Inlays and onlays are particularly useful for:
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Teeth with wide cavities affecting multiple surfaces
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Heavily restored teeth that need reinforcement but not a full crown
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Patients who want highly aesthetic, long‑lasting solutions in the posterior region
The process typically involves two visits: one for preparation and impression, and a second to cement the finished piece.
How Long Do Fillings Last?
There is no single number that applies to everyone; lifespan depends on:
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Size and location of the filling
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Bite forces and any habits (grinding, clenching, chewing ice or hard foods)
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Oral hygiene and diet (sugar frequency, acidity, snacking pattern)
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The quality of the original technique and materials
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Regularity of dental check‑ups and professional cleanings
As a very general orientation:
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Small composite fillings can often serve well for many years if kept clean and loaded moderately.
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Larger restorations (especially in molars) may need replacement earlier, simply because they carry more stress.
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Inlays/onlays and high‑quality crowns, properly maintained, often outlast large direct fillings in heavily loaded areas.
Regular check‑ups allow the dentist to identify early marginal issues, secondary decay, or fractures before they become painful emergencies.
Common Myths About Fillings – Clarified
“If it doesn’t hurt, it doesn’t need a filling.”
Wrong. Early decay is often painless. By the time pain appears, the cavity may already be deep, close to the nerve, or complicated.
“White fillings are only for front teeth.”
Outdated. Modern composites and onlays are designed specifically for back teeth; they are strong enough for chewing when placed correctly.
“Once I have a filling, that tooth is fixed forever.”
Not exactly. A filling restores the tooth, but it is still vulnerable to new decay around the edges or from poor hygiene and diet. Maintenance is crucial.
“Metal fillings are always dangerous.”
The scientific picture is more nuanced. Modern guidelines have restricted the routine use of amalgam, especially in children and pregnant or breastfeeding women, and many clinics prefer to avoid it. But not every existing metal filling must be removed – decisions should be individual, based on clinical findings, symptoms, and patient preference.
What to Ask Your Dentist Before Getting a Filling
A patient‑focused clinic encourages questions. Useful points to discuss:
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Which material do you recommend for this tooth – and why?
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Are there aesthetic options for this area?
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How large is the cavity, and is a simple filling enough or would an inlay/onlay be better?
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How long can I realistically expect this restoration to last?
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What can I do at home to protect this tooth and prevent new cavities?
These questions help you understand not just “what” is being done, but “why”, which builds trust and makes long‑term cooperation easier.
Everyday Care to Protect Your Fillings
Even the best technique and material cannot compensate for poor daily habits. To protect both natural teeth and restorations:
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Brush twice a day with a fluoride toothpaste, using a soft brush and proper technique.
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Clean between teeth daily with floss or interdental brushes to prevent decay at the contact points.
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Limit frequent sugar intake and sugary drinks between meals.
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Wear a night guard if you grind or clench, to protect both teeth and fillings from overload.
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Visit your dentist and hygienist regularly for professional cleaning and check‑ups.
This way, your fillings, inlays, and crowns become part of a stable, long‑term oral health strategy rather than emergency fixes.
A Modern, Patient‑Friendly Approach to Fillings
A contemporary clinic does not see fillings as “drilling and plugging holes” but as minimally invasive, carefully planned restorations integrated into a wider preventive concept:
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Early diagnosis using good lighting, magnification, and X‑rays
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Conservative cavity design that preserves as much natural tooth as possible
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Thoughtful material selection for each case (cement base, composite, inlay/onlay, crown)
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Transparent communication so patients understand their options and long‑term implications
If you are unsure about an existing filling, have visible dark spots, or feel roughness or food trapping between teeth, it is always worth asking for a professional evaluation. The earlier a problem is identified, the simpler, more comfortable, and more cost‑effective the solution will be.
With the right material, technique, and maintenance, modern fillings can be strong, discreet, and long‑lasting – helping you keep your natural teeth functional and attractive for many years.