What type of FILLING should I have?

How to choose the best option for you

How to choose the best option for you

It is good to know a bit about your dental fillings. It is more than likely that you have one or two yourself… and they will need replacing at some stage.

When your dentist discovers you need a new filling or that you need an old one replacing, a joint decision between the two of you has to be made on which type of filling to have ….and there are quite a few options.

There is no perfect 100% guaranteed solution. All types of fillings have “pros” and “cons”. The trick is to chose the option that keeps the “pros” to the maximum and the “cons” to a minimum!

Getting your heads together

There will be some things your dentist will be weighing up…such as how big the filling is going to be, how strong it will have to be, will the nerve of the tooth be affected, what are the chances of a successful outcome?

Other things you, the patient, will be weighing up….how much is this going to cost me, will it hurt, how long is this going to take, what will it look like?

The best decisions are made when both parties communicate and understand each other. It is up to the dentist to listen to your concerns and expectations so that information can be given clearly and accurately.

But it is also helpful if you understand a little about the materials and processes involved so that an informed decision can be made between you both.

“Silver” fillings

These are the metal fillings that most people have and have been used by dentists for 150 years. (They don’t contain very much silver though).

The metal that they are made from is called “amalgam” which is an alloy of mercury plus a number of other metals. When these are combined in the dental surgery, they make a paste that can be plugged into the hole in your tooth.

After the dentist has played around with it for a few seconds to make it the right shape, the amalgam sets hard…very hard!

This makes them potentially very durable (although not all amalgam fillings last the same time). They are also safe…read more about the safety of amalgam fillings.

Amalgam fillings are cost effective and quick to place, making them a popular choice for with patients.

Good for:

  • Small- to medium-sized fillings.
  • Back teeth where chewing forces are very high.
  • Patients who want a convenient, one-visit and cost-effective option.

Not so good for:

  • Teeth with very big holes or teeth that are actually “broken down” i.e. there is very little tooth left.
  • Teeth towards the front of the mouth…a metal filling may be unsightly.

“White fillings”

Known as “composite” fillings, these are also quick and convenient for patients.

They are often used at the front of the mouth as they can match the shade of the natural tooth. Made of acrylic resin, they are placed on the tooth as a paste. Once the dentist has shaped it, the filling is set hard by shining a blue light onto it.

In recent years composite fillings have been used for back teeth also as an alternative to amalgam fillings ( see above). They may need replacing more regularly than amalgam fillings as they are not generally as durable.

Good for:

  • Small- to medium-sized holes or fractures in front teeth
  • Small- to medium-sized holes in back teeth

Not so good for:

  • Badly broken down back teeth
  • Very deep holes as they can cause damage to the nerve of the tooth
  • Very large breakages of front teeth : the fillings tend to break frequently

Gold and porcelain inlays

An inlay is a type of filling that is made in a dental laboratory. It’s a more time-consuming and complicated technique ( and therefore more expensive too) but it may be a good option in certain types of situation.

Here’s how it works : your dentist takes an impression of the hole in your tooth and send it to the dental lab. A temporary filling will be placed in the meantime to keep your tooth safe.

In the lab, the technician will make a model of your teeth…which will include the tooth in question. The gold or porcelain inlay will be made in the lab and then sent back to your dentist.

At your second visit your dentist will remove your temporary filling and cement in your new inlay.

Good for:

  • Large holes or broken down teeth where amalgam or composite fillings would not be suitable
  • For porcelain inlays, as a more cosmetic alternative to amalgam fillings

Not so good for:

  • Patients who want a less expensive and more convenient option
  • Severely broken down teeth


If teeth are badly broken down or have very large fillings that are at risk of breaking, a crown may be an option. These are “caps” that are fitted around the tooth and are made usually with a similar technique to the inlays as above.

They are not without risk, however, as this procedure can cause the nerve of the tooth to be damaged. Your dentist will discuss the likelihood of this happening and what would need to be done.


Some dental practices offer a one-visit Cerec™ procedure for porcelain inlays and crowns. This involves taking a digital photograph of the tooth which is then transferred to a Cerec machine in the practice.

Using CAD-CAM technology, your new crown or inlay can be made while you wait! This is more convenient than a two-visit procedure.

About Cleveland Orthodontics

Our specialist-led practice has been established since 1996 and provides brace treatment to people of all ages from across the North East, including Middlesbrough, Yarm, Stockton-on-Tees, Billingham and Redcar.

We offer NHS orthodontic treatment for children and a range of modern white and “invisible” braces for adults of all ages such as Invisalign. FREE consultations are available… you can either telephone for an appointment on 01642 243 020 or book through our website.