How Do Fillings Work?

While most people have experienced the filling process for “fixing” a cavity, many do not actually understand the process.  Some of that lack of understanding is due to the local anesthetic, which prevents you from feeling what is going on during a dental filling.  The rest may be due to a lack of explanation, which we hope to remedy here in this blog.

Why Are Fillings Necessary?

SDFThe hard structures of a tooth are the only part of the human body without the capability to heal themselves.  Unlike a broken bone, broken or decayed enamel and dentin cannot repair itself and regrow new enamel and dentin.

When someone develops a cavity, bacteria in dental plaque eats sugar and produces acid.  The acid slowly softens and dissolves enamel, allowing the bacteria to penetrate into the tooth.  As it progresses further toward the center of the tooth, it leaves decayed tooth structure behind.  This decayed tooth structure is no longer hard, and it cannot withstand the forces of chewing.  It easily breaks or washes away during normal function, leaving a hole (or “cavity”) in the tooth.

Why the Drilling?

In order to stop the decay process, we must remove the bacteria from the tooth and reach a level of healthy, unaffected tooth structure.  So the drilling gets us to a “clean slate”, preventing further spread of the decay and creating the best scenario for long-term success.

What is the Filling Material?

At PFD, we use tooth-colored composite resin in most cases.  This material has several benefits over other dental filling materials.

More Conservative

Composite filling material adheres to tooth structure really well.  By interlocking with the tiny pores in a tooth, it creates a strong bond that keeps out saliva and bacterial contamination.  Because of this great bond, composite fillings do not require specific dimensions and shapes to be strong and stay within a cavity preparation unlike older materials.  This means we remove the decay and only the decay, not healthy tooth structure.  Conserving tooth structure is always a good thing because, as we said earlier, you cannot regrow it!

More CosmeticCavity composite filling 2

The reason most of our patients love composite resin fillings is because they blend in with the natural tooth color.  Unlike ugly old metal fillings, composite fillings are virtually invisible to the non-dental eye.  With these fillings, there is no fear that people will notice them when you open wide to laugh!


Composite resin not only bonds to the tooth structure really well; it bonds to itself.  This is what makes it repairable!  If a portion of a composite filling chips or breaks, we do not have to remove the rest of the filling and replace it.  We simply repair it by bonding new filling material to the remaining filling.  Often, the repair process for a composite filling does not require any anesthetic, and only requires minimal drilling (just to clean and roughen the existing filling’s surface for optimal bonding).

What Can I Expect from a Filling?

Do you have a new cavity?  Or even maybe your first cavity?  We do everything we can to make the filling process as smooth and comfortable as possible.


Not all fillings require numbing.  Some small cavities or filling repairs do not cause pain, and therefore, do not require anesthetic.  If the anesthetic is the part that freaks you out, ask Dr. Jill and Dr. Cara if your filling could be done without it.  They will be honest with you and tell you whether that’s a good idea.  Sometimes, we can even give it a try without anesthetic and let you change your mind at any point in the procedure.  If it becomes sensitive or painful, we can always add anesthetic.


The amount of drilling is usually proportional to the size of the cavity and the presence of any prior filling material.  If the cavity is small, and there is no existing filling on the tooth, you can expect only a short amount of drilling.  If the tooth has a large old filling present and significant decay underneath, the time spent drilling may be longer.

We provide noise-cancelling headphones and Netflix or Pandora to reduce the amount of drilling that you hear.


Our doctors have the filling process down to an art, and they work very efficiently with the help of our awesome dental assistants to place the filling material as quickly as possible.  There are two important reasons that we work fast:

  1. The filling material and its necessary components taste really bad!
  2. The filling material requires a “dry field” for the highest bond strength. We use small pieces of cotton and the large suction tool to control any saliva or other moisture in the area so that we produce the best results.

Bite Adjustment & Polishing

Once the filling material is in place, we make adjustments to achieve the perfect contour and bite relationship with the opposite tooth.  (This requires a little drilling.)  Then we polish the new filling to help it blend in seamlessly with the rest of the tooth.  Because a filling is not tooth enamel, you may be able to feel a slightly different texture, but it should not feel rough, bumpy or sharp in any way.

Because you are numb, sometimes you cannot detect a discrepancy in the bite or a rough spot until the anesthetic wears off.  If something feels abnormal once you are no longer numb, simply call us for a quick adjustment.

More Questions about Fillings?

Call 972-347-1145 today to schedule a consultation with Dr. Jill and Dr. Cara.  They will be happy to explain the entire process to you and help you stop any cavities by restoring them with tooth-colored fillings.

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