In short: a cavity is the destruction of tooth structure by the acids produced by plaque bacteria and dietary sugars. As long as enough healthy tooth remains, we treat it by cleaning out the infected tissue and restoring the tooth with a composite (a tooth-coloured material). How long a filling lasts depends above all on the quality of the work: isolation (rubber dam), premium materials, careful placement and magnification.

How does tooth decay form?

When dietary sugars and plaque bacteria sit on a tooth surface for an extended period of time, the acidic by-products eat away at the mineral content of the tooth structure. Whilst superficial tooth decay can remineralise if kept clean, once it extends through the outer layer (enamel) and into the softer dentine layer underneath, a cavity develops that requires treatment. We diagnose this with a combination of clinical examination and x-rays.

If left untreated, the decay may continue to progress until it reaches deep inside the tooth, risking the need for much more aggressive treatment, such as extraction or root canal therapy.

The treatment: composite fillings

When a significant amount of healthy tooth structure remains, we most commonly treat a cavity by cleaning out the soft, infected tissue and restoring the tooth with a filling made of dental composite (a tooth-coloured material mostly consisting of resins and filler particles). We build this directly onto the tooth surface by hand, and it may or may not require a local anaesthetic injection to reduce discomfort as much as possible.

A filling is a medical procedure, not a generic product

How do we ensure that the fillings we place are of the highest possible quality for our patients?

  • Good isolation: composite is extremely sensitive to moisture, whether from a patient's own body or from the dentist's equipment. Isolating the working field, usually with a rubber dam, ensures that we minimise contamination as much as possible.
  • Premium materials: we only use composite from reputable premium brands, all of which demonstrate strict manufacturing standards and a large evidence-base for their efficacy. The brands that we most commonly use are manufactured in Japan, Germany and the USA.
  • Taking our time: composite exhibits a small percentage of shrinkage when cured (hardened with a strong blue light), requiring great care in its placement to prevent excessive stresses and adhesive failures. This usually involves building a filling in many small increments, which can take a long time. A small, simple filling may take 30 minutes to an hour, and a large filling may take well over an hour.
  • Magnification: we usually place our fillings under magnification, whether using dental loupes (magnifying glasses worn by the dentist) or an operating microscope. This allows us to see as much detail as possible when working.
  • Understanding the limits of the material: composite is not a one-size-fits-all material, and we have to be conscious of its limits and suitability depending on each individual situation. If good isolation is not possible or insufficient tooth structure remains, we will advise a more appropriate course of treatment, using other materials.

Feeling sensitivity or pain, or think you may have a cavity? Book an appointment: the earlier decay is caught, the simpler and more conservative the treatment.