Tooth Fillings in Rawalpindi

Bacteria in plaque turn sugar into acid. That acid dissolves mineral out of the enamel, and when it has done so faster than saliva can put it back, the surface collapses into a hole. Past that point the process is one-directional - decay does not heal, it advances.

Early decay is invisible and painless, which is exactly why it gets missed. By the time a tooth is sensitive to cold or sweet things, decay has usually reached the softer dentine beneath the enamel. By the time it aches on its own at night, the nerve is involved and a filling is often no longer the answer.

Composite fillings are bonded to the tooth and matched to its shade, so a repaired tooth looks like a tooth. They need a dry, carefully prepared surface and are placed in layers, which is why a well-done composite takes longer than the silver amalgam fillings most people remember from childhood.

They also conserve more of the tooth. Amalgam needed a shaped cavity to hold it mechanically; composite bonds, so only the decay has to go. On a front tooth, composite is the only sensible option. On a heavily broken back tooth, a crown or an inlay may outlast any filling, and we will say so rather than place something we expect to fail.

There is a point where so little sound tooth remains that a filling has nothing to hold on to, and a point beyond that where decay has reached the nerve. Those are different treatments - a crown in the first case, a root canal in the second - and placing a large filling instead buys a few months at best.

A dentist who tells you a tooth needs more than a filling is not necessarily upselling you. The test is whether they can show you why on the X-ray and explain what happens if you choose the filling anyway. We will show you the image.

A deep filling sits close to the nerve, and the nerve responds to having been disturbed. Mild sensitivity to cold for a few days up to a couple of weeks is normal and settles on its own.

What is not normal is pain that increases over time, pain that lingers for minutes after something cold, or pain when biting that was not there before. Any of those means come back - usually the bite needs a small adjustment, occasionally the nerve has not recovered.