Composite Fillings in San Jose, CA

What Is a Composite Filling?

A filling repairs a tooth damaged by decay. The decayed structure is removed, and the cleaned space is filled with a restorative material that seals the tooth and returns it to normal shape and function.

Tooth-colored fillings use composite resin — an acrylic resin base combined with fine glass or quartz-like filler particles. The material arrives in a moldable form, is placed directly into the prepared tooth in small increments, and is hardened with a curing light before being shaped and polished. Because composite comes in many shades and levels of translucency, the shade can be selected or blended to coordinate with the enamel around it.

They are used on front teeth for obvious reasons, and on many back teeth as well. But a tooth-colored filling is not only a cosmetic treatment. It is a functional restoration that seals the space left after decay is removed, smooths rough or sharp areas, and restores comfortable chewing. It is also one of the most common treatments in cosmetic dentistry.

In the past, amalgam (mercury and silver) and gold were the materials used to treat cavities. Newer cosmetic materials, advanced bonding techniques and more durable fillings have come into wide use mostly in the past 30 years.

What Composite Fillings Can Repair

During your examination we look at how much tooth structure is damaged, the health of the tooth and surrounding gums, your bite, and where the problem sits before recommending a restoration. Composite fillings are commonly used to:

• Treat small or moderate cavities caused by decay
• Repair minor chips, cracks and worn edges
• Restore a tooth damaged by biting something hard
• Replace an old filling that is worn, leaking, cracked or noticeably discolored
• Improve the appearance of a visible existing restoration
• Close a very small gap or refine tooth contours in selected cosmetic cases
• Rebuild an area where a small piece of enamel has broken away

Not every damaged tooth is best treated with a filling. When decay is extensive, the tooth is badly cracked, or so much structure is missing that a filling would have little to hold onto, an inlay, onlay or crown protects the tooth better. We will tell you which option we are recommending and why — including what it would cost to do it the other way.

How Do I Know If I Have a Cavity?

Some cavities announce themselves and some develop silently, which is why examinations matter even when nothing hurts. Possible signs of decay include:

• Sensitivity to cold, heat or sweets
• Discomfort when biting, or a persistent toothache
• Food repeatedly trapping in one spot
• A visible dark spot, hole or defect
• A rough edge that catches your tongue
• Floss tearing or catching between two teeth
• A loose or missing filling, or an unpleasant taste

These symptoms do not always mean a cavity, and feeling nothing does not mean a tooth is healthy. An examination — often with digital X-rays, since decay between teeth is invisible from the outside — is what identifies the cause.

What Happens During the Appointment

Placing a composite filling is a routine procedure. Doing it well depends on comfort, keeping the tooth dry, and getting the shape, bite and shade right.

1. 1. Examination and diagnosis.

   We evaluate the tooth and determine how deep and extensive the damage is, using digital X-rays or photographs when the area cannot be assessed visually.

2. 2. Comfort.

   Local anesthetic is used to numb the tooth and surrounding tissue, particularly when decay is present or the tooth is already sensitive. For very small or shallow restorations it is not always necessary.

3. 3. Removing the decay.

   The decayed or weakened structure is removed conservatively, preserving the healthy tooth around it.

4. 4. Preparing the tooth.

   The area is cleaned and conditioned so the composite bonds securely. The tooth has to be kept clean and dry through this step — the American Dental Association notes that this need for moisture control is one reason composite takes longer to place than metal.

5. 5. Shade selection and placement.

   For visible teeth a shade is selected to complement the neighboring enamel, and more than one shade or level of translucency may be layered to avoid a flat, obvious repair. The composite is placed in small increments, each hardened with a curing light before the next is added.

6. 6. Shaping, polishing and bite adjustment.

   The filling is shaped to follow the tooth's natural contours, polished smooth, and checked against your bite.

A finished filling should not feel bulky, sharp, rough or high when you close. If it does once the numbness wears off, tell us — a small adjustment protects both the tooth and the restoration from taking more force than they should.

What to Expect Afterward

Numbness lasts a while if anesthetic was used; wait until it has fully worn off before chewing so you do not bite your cheek, lip or tongue. Mild short-term sensitivity to cold, heat, sweets or pressure is common as the tooth settles, particularly when the cavity was deep, and it generally improves.

Contact us promptly if you notice any of the following:

• Severe, persistent or worsening pain, or pain that wakes you at night
• Pain that lingers long after hot or cold exposure
• Pain on biting that does not improve
• A filling that feels high or has changed your bite
• A rough, sharp, chipped or broken filling, or one that falls out
• Swelling, fever or other signs of infection

These do not necessarily mean the filling has failed, but they should be looked at rather than waited out.

Composite and Amalgam Compared

Amalgam — the silver-colored filling — has been used for generations, particularly in back teeth. Composite is a separate, tooth-colored option. Both have real strengths, and the right choice depends on the size and location of the cavity, how well the area can be kept dry, your bite forces, how much healthy tooth remains, and what you want the result to look like.

Sources: NIDCR · FDA

Should Old Silver Fillings Be Replaced?

Not automatically. An existing amalgam filling should not be removed simply because it is old or because tooth-colored materials exist. If it is intact, sealing properly and surrounded by healthy tooth structure, replacing it may offer no dental benefit — and every replacement removes a little more natural tooth.

Replacement is worth considering when a filling:

• Is cracked, broken or loose
• Has decay around or beneath it
• No longer seals the tooth
• Traps food
• Is associated with a fractured tooth or cusp
• Interferes with the bite
• Has become a significant cosmetic concern to you
• Has to come out as part of another necessary treatment

We will evaluate the restoration, the tooth around it and your own concerns before recommending anything. The decision belongs to the condition of the tooth, not to a blanket policy about metal.

When a Crown Is the Better Choice

A filling replaces a damaged portion of a tooth. A crown covers and protects what is left of it. A crown is usually the better answer when the cavity is very large, when much of the tooth is already filling material, when the tooth is cracked or a cusp has fractured, after root canal treatment, or when heavy bite forces make another filling unpredictable. Placing an oversized filling in a badly weakened tooth often postpones the real solution rather than providing it. Our dental crowns page explains what that treatment involves.

Composite Fillings and Cosmetic Bonding

The two use similar composite materials for different purposes. A filling restores a tooth affected by decay or damage. Cosmetic tooth bonding makes an appearance change — repairing a small chip, closing a minor gap, reshaping an uneven edge. Sometimes one procedure accomplishes both.

How Long Do Composite Fillings Last?

No filling lasts forever. Lifespan depends on the size and location of the restoration, the forces on it, daily hygiene, diet and habits such as grinding or chewing ice. A small filling surrounded by strong enamel behaves very differently from a large one on a molar. Composite can wear, chip, fracture, stain or begin to leak at the edges, and any filling may eventually need repair or replacement.

You can protect yours by:

• Brushing twice daily with fluoride toothpaste
• Cleaning between your teeth every day
• Limiting frequent sugary snacks and drinks
• Keeping recommended examinations and professional cleanings
• Not chewing ice, pens or fingernails
• Wearing a nightguard if you grind or clench, and a mouthguard for contact sports
• Reporting sensitivity, food trapping, a rough edge or a bite change promptly

Will the Filling Match My Tooth?

That is the goal, and for visible teeth it often takes more than one shade or level of translucency to get there, because natural enamel is not a single flat color.

One thing worth knowing in advance: whitening products lighten natural enamel but do not change the color of composite. If you are considering professional whitening and also need a filling in a visible area, the sequence matters — whiten first, then match the restoration to the new shade. It is a short conversation that prevents a mismatched front tooth. Our teeth whitening page explains the options.

Why Patients Choose Dr. Douglas R. Maxson for Restorative Care

Fillings are the most common treatment in dentistry, which is exactly why the details separate a restoration that lasts from one that gets redone. Dr. Maxson brings 40+ years of clinical experience to that work, and he evaluates the whole mouth — the bite, the neighboring teeth and the existing dentistry — before deciding how a tooth should be restored.

• Conservative preparation that keeps as much natural tooth as the situation allows
• An honest recommendation when a filling is not the right answer, including what a crown or onlay would involve
• Shade selection and layering for restorations in the visible smile zone
• Sedation available for patients who are anxious, have a strong gag reflex or want several teeth treated in one longer visit
• A calm, nonjudgmental approach for patients returning after years away from the dentist
• Costs and alternatives discussed before treatment begins, not after — we'll review your specific benefits

Dr. Maxson prefers to evaluate the location of the filling, the size of the filling, the amount of potential wear and tear on that tooth, and the patient's history of caries prior to suggesting any specific type of restoration material.

Composite Filling FAQs