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Restoring teeth

Fillings, crowns, veneers, inlays and onlays are used to restore decayed, worn or broken teeth.

You will meet the dentist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

If your teeth are decayed, worn or broken, they may need to be restored by your dentist.

Tooth decay (also called dental caries) is a very common health problem that affects about one third of adults in the UK. It’s mainly caused by sugary foods and drinks. When you eat anything that contains sugar, the bacteria on your teeth turn the sugar into acid. The acid softens and dissolves the hard outer surface (enamel) of your teeth. Over time, this can cause holes (cavities) to form in your teeth – this is tooth decay. Your teeth are more likely to be affected by decay if you don’t brush and clean between them regularly.

If you have tooth decay, you may need treatment to restore your teeth. There is a range of treatments including fillings, root fillings, crowns, veneers, inlays and onlays. The type of treatment you have will depend on the extent of the damage to your teeth. Your dentist will discuss your options with you.

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  • Fillings Fillings

    Fillings are used to fill cavities that have formed in your teeth. There are different types of fillings but the most common are amalgam (metal) and composite (tooth-coloured).

    If you need to have a filling, your dentist will usually give you an injection of local anaesthetic. This completely blocks pain from the area and you will stay awake during the procedure.

    Your dentist will remove the decayed and weakened parts of your tooth using a small drill. He or she will then clean it and may use a liner to coat it so that there are no open passages to the nerve that could cause pain. Your dentist will then fill the cavity. The filling will either begin to harden itself during the first few minutes or, for some materials, a blue light is used to make it set within a few seconds.

    After the procedure, it may take several hours before the feeling comes back into the treated area of your mouth. Take care not to bump or knock your mouth or bite your tongue, particularly when you're speaking, drinking or eating.

    Amalgam fillings

    Amalgam fillings are made of a combination of metals including silver, tin, copper and mercury. Amalgam is extremely hard-wearing and can withstand the grinding and chewing action of your back teeth for more than 20 years if you take good care of your teeth.

    You may be concerned about the safety of amalgam fillings as they contain mercury, which can be poisonous. However, amalgam fillings contain only a very small amount of mercury, which isn’t poisonous when it’s mixed with the other materials. Research shows that amalgam is safe and won’t damage your health. Some people are allergic to the metals in amalgam and may need to have another type of treatment, but this is rare. Ask your dentist for more information.

    Pregnant women are usually advised not to have amalgam fillings as a precautionary measure. This is because mercury can be passed on to your baby through the placenta. If you're pregnant, or think you may be, tell your dentist as he or she will probably advise you to wait until your baby is born before having an amalgam filling.

    Composite fillings

    Composite fillings are made to match the colour of your teeth and therefore look more natural than amalgam fillings. They are often used in teeth that show when you smile or talk. Tooth-coloured fillings aren't as hard-wearing as amalgam and so aren't always suitable for the grinding and chewing surfaces of your back teeth. Tooth-coloured fillings can also be used to build up the edges of chipped or worn teeth.

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  • Root fillings Root fillings

    If you have very deep decay or a dental injury, an area called the root canal (the centre of a tooth that is made up of blood vessels and nerves) can become damaged. This means it may be more likely to become infected. If this happens, you will need to have root canal treatment, which involves your dentist cleaning, shaping and filling the entire root canal of your tooth.

  • Crowns Crowns

    Crowns are used to strengthen teeth and improve their appearance. They are shaped like natural teeth and fit over your existing tooth. There are a number of reasons why you may have a crown including:

    • if your tooth is broken or has been weakened – this may have been caused by decay or a large filling
    • to cover up a filling that is discoloured
    • after root canal treatment to protect your tooth

    Crowns can be made from a variety of materials including porcelain, porcelain combined with a metal, gold mixed with other metals, or ceramic. The material that your crown is made from will determine what colour it is.

    Your dentist will give you an injection of local anaesthetic before you have the crown fitted. He or she will prepare and shape your tooth so that there is room for the new crown. Depending on the amount of damage to your tooth, your dentist may need to fill it first. If you have had root canal treatment, you may need to have a post crown. This involves inserting a small post (or peg) into your tooth that will hold the crown in place.

    Once your tooth has been prepared, your dentist will make a mould (called an impression) of your tooth so that a dental technician can make a crown that will fit it exactly.

    It may take a couple of weeks for your crown to be made, so in the meantime your dentist will fit a temporary one. The temporary crown won’t be as strong as your permanent one, but you will be able to chew as usual. You will have another appointment when your dentist will take off the temporary crown and cement the new, permanent one in place.

    After the procedure, it may take several hours before the feeling comes back into the treated area of your mouth. Take special care not to bump or knock your mouth or bite your tongue, particularly when you're speaking, drinking or eating. If you look after your teeth carefully, crowns can last for many years.

  • Treatment for fillings, crowns and veneers

    Our Bupa Dental Centres offer a range of routine, specialist and cosmetic treatments including fillings, crowns and veneers. Find out more.

  • Veneers Veneers

    Veneers are another way of repairing chipped or uneven front teeth. They consist of a thin layer of tooth-coloured material, usually porcelain, that fits over your existing tooth.

    Your dentist will prepare your tooth by removing some of the enamel outer layer. This is to ensure that the veneer doesn’t make your tooth bigger or feel uncomfortable. It also makes it easier to attach the veneer securely. Your dentist will then make a mould of your mouth so that a dental technician can make a veneer that fits in with the rest of your teeth.

    The colour of your veneer will be matched to your other teeth. You will need to go back for a second appointment to have the veneer glued onto your tooth. See our frequently asked questions for more information.

    If you take care of your teeth well, veneers will last for many years, but they can be damaged in the same ways as real teeth. It may be possible to repair veneers without needing to have a whole new one.

  • Inlays and onlays Inlays and onlays

    Inlays and onlays are similar to fillings. An inlay is placed on the surface that you use for biting, whereas an onlay goes over a larger area of your tooth. Inlays and onlays are very hard-wearing. They are usually made of gold or porcelain. Porcelain can be made to match the colour of your existing teeth.

    Unlike normal fillings, you will have an impression taken for inlays and onlays and they will then be made by a dental technician. At this appointment your dentist will also clean the hole and fit a temporary filling to protect your tooth while the inlay or onlay is being made. You will need to go back for another appointment when your dentist will remove your temporary filling and cement the inlay or onlay into place.

    Your dentist will probably give you an injection of local anaesthetic before you have your inlay or onlay fitted.

  • FAQs FAQs

    If I have my teeth whitened, will it also whiten my tooth-coloured filling?

    Answer

    No, tooth whitening treatments will only affect your natural teeth and not your fillings.

    Explanation

    The bleach used in whitening treatments only whitens your natural teeth. It won’t whiten any fillings, crowns or veneers you have. However, you may be able to have a lighter shade of composite (tooth-coloured) filling placed over your existing filling, or a new composite filling put in to match your whitened teeth, so they don't look a different colour.

    Before starting your whitening treatment, ask your dentist about the effect it will have on the appearance of any fillings.

    I'm getting a veneer fitted. Will my tooth look odd between appointments?

    Answer

    Your dentist will try to make sure that your tooth looks as acceptable as possible during the time between your appointments.

    Explanation

    Your dentist will shave off a thin layer of enamel from the surface of your tooth when preparing it for a veneer. The appearance won't be perfect while you wait for the veneer to be made but it shouldn't be too obvious. Try to plan with your dentist when you will have the veneer fitted so that you aren't waiting for it at the time of an important event. Your tooth will be more sensitive to hot and cold because the outer layer of protection has been removed. It will also feel a bit rough against your tongue.

    Your dentist may recommend you have a temporary veneer until your second appointment. He or she will try to make it as lifelike as possible. A temporary one is usually made of acrylic and can be more likely to stain. Also, it will only be stuck on with weak cement because your dentist needs to take it off easily at the second appointment. This means it could come off unexpectedly, for example, if you bite something too hard.

    What should I do if my filling falls out?

    Answer

    If your filling falls out, make an appointment with your dentist to have it replaced as soon as possible.

    Explanation

    Depending on what material your filling is made from, it can last for many years. However, it may fall out as a result of wear and tear, excessive biting pressure over time or because of tooth decay in the surrounding area.

    If your filling falls out, your dentist will clean the cavity and put a new filling in to replace the old one, but only if there is enough of your original tooth left to support it. If your old filling was made of amalgam (metal), you may be able to have it replaced with a composite (tooth-coloured) filling so that it looks more natural. However, this may depend on where in your mouth your filling is.

    It’s important to visit your dentist regularly, so that any problems with your fillings can be picked up early on.

    Will having a filling hurt?

    Answer

    No, before you have a filling, your dentist will usually give you an injection of local anaesthetic to block pain from the area.

    Explanation

    While your dentist is doing your filling you may be able to feel the instruments in your mouth and some pressure, but you won't feel any pain.

    Tell your dentist if you’re particularly nervous about having a local anaesthetic injection. He or she may be able to apply an anaesthetic gel to the area of your mouth that will be injected. This will numb your gum so that you won’t be able to feel the needle.

    After the procedure, it may take several hours before the feeling comes back into the treated area of your mouth. Be careful not to bump or knock your mouth or bite your tongue, particularly when you're speaking, drinking or eating. Don’t eat or drink anything too hot while your mouth is still numb. You may burn your lip or mouth without realising because you can’t feel the area.

  • Resources Resources

    Further information

    Sources

    • Dental decay: introduction. National Institute for Health and Care Excellence Evidence Search. www.evidence.nhs.uk, published June 2012
    • Tooth decay. BDA Smile. www.bdasmile.org, accessed 23 May 2013
    • Dental decay. British Dental Health Foundation. www.dentalhealth.org, accessed 23 May 2013
    • Fillings and restorations. BDA Smile. www.bdasmile.org, accessed 23 May 2013
    • Dental fillings. Dental Fear Central. www.dentalfearcentral.org, accessed 23 May 2013
    • Different filling materials. British Dental Health Foundation. www.dentalhealth.org, accessed 23 May 2013
    • Dental amalgam. British Dental Association. www.bda.org, published March 2008
    • Root canal treatment. British Dental Health Foundation. www.dentalhealth.org, accessed 23 May 2013
    • Crowns. British Dental Health Foundation. www.dentalhealth.org, accessed 23 May 2013
    • Crowns. BDA Smile. www.bdasmile.org, accessed 23 May 2013
    • Veneers. British Dental Health Foundation. www.dentalhealth.org, accessed 28 May 2013
    • Veneers. BDA Smile. www.bdasmile.org, accessed 28 May 2013
    • White fillings. British Dental Health Foundation. www.dentalhealth.org, accessed 28 May 2013
    • When a filling needs to be replaced. American Dental Association. www.ada.org, published July 2005
    • Tooth whitening. British Dental Health Foundation. www.dentalhealth.org, accessed 28 May 2013 
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