A filling is a structural repair, not a diagnosis.
The plan matters more than the material.
An exam confirms foundation limits and long term risk. That is what protects options.
Call today vs urgent medical evaluation
- Pain is rapidly worsening
- You have biting pain that started suddenly
- You feel drainage or a bad taste with pressure
- You notice swelling starting near the tooth
- You recently had dental work and symptoms are escalating
- Swelling is spreading into the face or neck
- Fever occurs or you feel sick
- Swallowing feels difficult
- Breathing feels affected
This page helps you understand filling decisions. It does not replace an exam. If you are unsure, a calm evaluation is the right move.
Common situations and what they can mean
| Situation | Common reason | Urgency | Structural risk |
|---|---|---|---|
| A small cavity that was caught early | Decay is limited and structure reserve is still strong | Schedule evaluation | LOW |
| Replacing an old filling that is leaking | Marginal leakage, recurrent decay, or breakdown over time | Schedule evaluation | MEDIUM |
| The filling is large and close to the nerve | Deep decay or a past large restoration reduced structure reserve | Schedule evaluation | HIGH |
| Pain when biting after a filling | High bite contact, crack risk, or inflammation in the ligament | Call today | MEDIUM |
| Sensitivity to cold after a filling | Normal healing window, bonding sensitivity, or nerve irritation | Monitor | LOW |
| A filling keeps chipping or falling out | Force overload, thin remaining tooth walls, or crack progression | Schedule evaluation | HIGH |
| Food traps around the filling | Open contact, contour issues, or margin breakdown | Schedule evaluation | MEDIUM |
| Swelling or drainage near the tooth | Infection risk needs evaluation and control first | Call today | HIGH |
| You have spreading swelling or fever | Medical urgency comes before planning dentistry | Urgent medical evaluation | HIGH |
Situations guide planning. The exam confirms foundation limits. Guessing often creates repeat dentistry and higher maintenance.
Small fillings vs large fillings
Small fillings can be stable when decay is limited and the tooth still has strong structure reserve.
Do not treat a large filling like a small filling decision.
We look at remaining tooth walls, where force lands, and whether the tooth is already on a crack pathway.
Timing matters more than people think
Early care can keep dentistry small. Waiting can turn a small repair into a bigger structural compromise.
If the tooth is changing fast, do not wait for symptoms to get loud.
We evaluate progression risk, decay activity, and whether the tooth is losing options with time.
Force and bite stability
Fillings fail faster when force concentrates on thin tooth walls or on a weak zone. This is common in clenching and grinding.
If you chip fillings repeatedly, force is part of the diagnosis.
We check bite contacts, guidance, and whether protection is needed to reduce overload.
Margins, decay risk, and sealing
Many failures start at the edges. When margins are hard to keep clean, recurrent decay becomes the long term risk.
A perfect filling in a high decay environment still fails.
We evaluate margin position, hygiene access, and your personal decay risk factors.
Material is not the main decision
Material matters, but it is rarely the main reason a filling fails. The main drivers are structure reserve, force, and margin risk.
The plan matters more than the material.
We match material choice to the tooth, the load, and the margin environment so the repair fits the system.
When a crown is the more stable path
When structure reserve is thin, a filling can become a patch that repeats. A crown can protect the tooth when cracks and thin walls make a filling less predictable.
If the tooth is already breaking down, a bigger repair can be the safer choice.
We evaluate cusp support, crack risk, bite forces, and long term stability before choosing an irreversible step.
What we evaluate (Structure, Force, Time, Stability)
We do not choose fillings well by guessing. We evaluate structure reserve, force patterns, the timeline, and long term maintenance reality.
If you want the deeper decision layer, our Structural Decision Framework explains how we evaluate stability before irreversible treatment.
Why acting too fast can be harmful
Fillings seem simple. That can create false confidence.
We do not recommend irreversible treatment based on symptoms alone.
We confirm first. Then we choose the cleanest next step. That is how you avoid repeat dentistry and protect future options.
What you can do right now
If it is not urgent:
- Keep the area clean and reduce sugar frequency
- Avoid biting hard on a sensitive tooth
- Schedule a visit for evaluation
Track these details before your visit:
- What changed: cold sensitivity, biting pain, food trap, chipping
- What triggers pain: cold, sweet, pressure, or spontaneous
- Whether symptoms are getting easier to trigger over time
If pain is severe or swelling is present:
- Call us
- Do not wait for it to go away on its own
Frequently asked questions
These scenarios show how thresholds shift when structure changes over time under force.