Dental Fillings St. John's: A Complete Patient Guide
- 1 day ago
- 10 min read
Most people discover they need a filling and immediately wonder what exactly is going into their tooth. It is a fair question. If you are searching for dental fillings in St. John's, understanding your material options before you sit in the chair will help you make a confident, informed decision. Composite and amalgam are the two names you will hear most often, but they are not the only choices. This guide breaks down exactly what each filling material is made of, how it performs over time, and which situations call for which option.
Table of Contents
Quick Takeaways
Key Insight
Explanation
Composite resin matches your tooth colour
Composite fillings are made of a tooth-coloured resin and glass mixture, making them ideal for visible front teeth and cosmetically sensitive areas.
Amalgam is the most durable option for back teeth
Silver amalgam has been used for over 150 years and consistently outperforms other materials in high-chewing-pressure areas like molars.
Canada is phasing down amalgam use
Health Canada updated its guidance in 2023 recommending reduced use of dental amalgam, particularly for children, pregnant patients, and those with kidney conditions.
Ceramic and gold fillings are premium alternatives
Ceramic (porcelain) and gold inlays offer excellent durability and aesthetics but come at a higher cost and require more preparation appointments.
The filling procedure typically takes one appointment
For composite and amalgam fillings, most patients are in and out in under an hour, with the tooth numbed using local anaesthetic.
Composite fillings bond directly to tooth structure
Unlike amalgam, composite resin chemically bonds to the tooth, which means less healthy tooth structure needs to be removed during the procedure.
Canadian Dental Care Plan may cover your filling
Stavanger Dental accepts the Canadian Dental Care Plan, which can offset the cost of restorative procedures including fillings for eligible patients.
What Are Dental Fillings and Why Do You Need One?
A dental filling is a restorative material used to repair a tooth that has been damaged by decay, a crack, or wear. Once your dentist removes the decayed or compromised portion of the tooth, the empty space needs to be filled to restore function and prevent bacteria from re-entering the cavity.
Fillings are among the most common dental procedures performed across Canada. According to the Canadian Dental Association, the majority of Canadians will require at least one filling in their lifetime, and many will need several across different teeth over the years. Leaving a cavity unfilled is not a neutral choice. Decay spreads, infections develop, and what could have been a simple filling becomes a root canal or an extraction.
At Stavanger Dental in St. John's, we see patients at every stage of this process, from early-stage cavities caught during a routine cleaning to larger restorations on teeth that were left untreated. The earlier a filling is placed, the smaller it is, and the more natural tooth structure you preserve.
Types of Dental Filling Materials Explained
Not all fillings are created equal, and the material your dentist recommends depends on where the cavity is, how large it is, your medical history, and your personal preferences. Here is a straight breakdown of the main materials in use today.
Composite Resin
Composite resin is a mixture of plastic (acrylic) and fine glass particles. It is tooth-coloured and can be closely matched to the natural shade of your existing teeth. Composite is placed directly into the cavity in layers, and each layer is hardened using a blue curing light. The result bonds directly to the tooth surface.
Composite fillings are the standard choice for front teeth and any visible areas. They require slightly more preparation time than amalgam, and in very high-pressure areas they can wear faster. Most last between 7 and 10 years with good oral hygiene, though many last considerably longer.
Dental Amalgam
Dental amalgam is composed of a mixture of metals including silver, tin, copper, and mercury. The mercury content has raised concerns among some patients over the years, but Health Canada and the World Health Organization both confirm that amalgam is safe for most adults, as the mercury in the alloy is chemically bound and behaves differently from elemental mercury. The exception is specific vulnerable groups, which is why Health Canada now recommends limiting amalgam use in children, pregnant patients, and individuals with kidney conditions.
Amalgam is highly durable, relatively inexpensive, and has a long clinical track record. It is still used in some back-tooth restorations where strength is the primary concern, though many practices, including ours, now favour composite for most restorations.
Ceramic and Porcelain Fillings
Ceramic fillings, often referred to as inlays or onlays, are made from dental porcelain and fabricated in a lab before being cemented into place. They are tooth-coloured, highly stain-resistant, and very durable. The trade-off is cost. Ceramic restorations typically require two appointments and are more expensive than composite. For patients who want a long-lasting, aesthetic restoration on a back tooth, ceramic is a strong option.
Gold Alloy Fillings
Gold fillings are cast in a dental lab and cemented into the prepared tooth. They are exceptionally durable, sometimes lasting 20 or more years, and they are well tolerated by gum tissue. They are also the most expensive filling option and are obviously not tooth-coloured. Gold restorations are less common now but remain a viable choice for patients who prioritize longevity above all else.
Glass Ionomer Fillings
Glass ionomer is a tooth-coloured material that releases fluoride into the surrounding tooth, which provides some additional decay protection. It is less durable than composite and not suitable for high-chewing-load areas. It is commonly used for fillings in children, for root surface cavities, or as a temporary measure. Think of it as a niche tool rather than an all-purpose solution.
Pro tip: If you are unsure what material was used in an existing filling, check with your dentist at your next visit. Older silver-coloured fillings are almost certainly amalgam, and many patients choose to replace them with composite when those fillings eventually need to be redone.
Composite vs Amalgam Fillings: The Real Differences
The composite vs amalgam fillings debate comes up in virtually every restorative consultation. Both materials work. The question is which one works better for your specific tooth, your budget, and your expectations.
In practice, composite resin has become the dominant filling material in most general dental offices across Canada, including Stavanger Dental. Patients prefer the aesthetics. Dentists prefer the ability to bond to tooth structure and remove less healthy enamel. But amalgam did not survive for 150 years by accident. It holds up under pressure in a way that no other filling material matches at the same price point.
"Amalgam's longevity in posterior teeth remains clinically significant. Composite resins have improved dramatically, but their performance in large, load-bearing restorations still warrants careful case selection." - American Dental Association, Dental Materials Research
Aesthetics
Composite wins outright on aesthetics. It is matched to your tooth colour and becomes nearly invisible. Amalgam is silver-grey and very noticeable, especially in visible areas. For front teeth, composite is the only practical choice. For molars that no one will ever see, aesthetics matter far less.
Durability and Lifespan
Amalgam fillings in back teeth can last 15 to 20 years. Composite fillings typically last 7 to 10 years in the same location, though advances in composite chemistry have narrowed this gap significantly. For small to medium cavities in any location, composite performs very well. For very large restorations in high-chew-force areas, amalgam or a ceramic inlay is often a better long-term investment.
Procedure Requirements
Composite requires a dry field during placement and takes more time to apply and cure in layers. Amalgam is more forgiving in a wet environment and faster to place. This is one reason amalgam remains practical in certain clinical situations, particularly in patients with high salivary flow or when working in difficult-to-access areas.
Cost
Amalgam fillings are generally less expensive than composite fillings of the same size. However, many dental insurance plans and the Canadian Dental Care Plan cover composite at the amalgam rate for posterior teeth, meaning you may pay a co-payment for the aesthetic upgrade. Always confirm your coverage before the procedure.
What to Expect During the Tooth Filling Procedure
A lot of patients feel anxious about fillings because they are uncertain about what the procedure actually involves. The tooth filling procedure is straightforward. The discomfort most people remember from childhood dentistry is largely a product of older techniques and less effective local anaesthetics.
Step 1: Examination and X-Rays
Your dentist will examine the affected tooth and take digital X-rays to assess how deep the decay extends. If the cavity is close to the nerve, additional steps may be needed, but for standard cavities, the X-ray is simply a map for the procedure ahead.
Step 2: Local Anaesthetic
The area around the tooth is numbed with a local anaesthetic injection. Most patients feel pressure during the procedure but no sharp pain. At Stavanger Dental, we offer sedation options for patients with dental anxiety, which makes even restorative appointments comfortable for those who need additional support.
Step 3: Decay Removal
The dentist uses a dental drill or, in some cases, a laser or air abrasion tool to remove the decayed tooth material. Only the damaged portion is removed. The amount of healthy structure removed depends on the filling material chosen. Composite requires less removal than amalgam because it bonds to the tooth rather than relying on mechanical retention.
Step 4: Filling Placement
For composite, the tooth is etched, a bonding agent is applied, and then the resin is placed in layers and cured with a blue light after each layer. For amalgam, the prepared cavity is packed with the mixed material. The filling is then shaped and polished to match your bite and tooth contour.
Step 5: Bite Check and Adjustment
You will be asked to bite down on articulating paper to check for any high spots. Any adjustments are made immediately. A filling that sits too high will cause bite discomfort and jaw soreness, so it is worth mentioning if anything feels off even after the numbness wears off.
Pro tip: Sensitivity after a filling is normal and usually resolves within a few weeks. If sensitivity is severe, lasts more than 4 weeks, or is accompanied by throbbing pain, contact your dentist. This can occasionally signal that the decay was closer to the nerve than expected.
How to Choose the Right Filling for Your Tooth
Your dentist will make a clinical recommendation, but knowing the factors they weigh helps you participate in that decision rather than just accepting whatever is suggested.
Location matters most. Front teeth and any tooth visible when you smile should receive composite or ceramic. No one should be walking around with a visible silver filling in 2024 unless it is their clear preference. For back molars, where appearance is not a factor but chewing forces are high, your dentist will assess the size of the cavity. Small to medium cavities in molars do very well with modern composite. Large cavities in molars benefit from ceramic inlays or, in some cases, amalgam for patients who want the most cost-effective durable option.
Your health history matters too. If you are pregnant, a child, or have a kidney condition, Health Canada's updated 2023 guidance recommends avoiding amalgam. Stavanger Dental reviews patient health histories before recommending any restorative material.
Budget and insurance coverage are practical realities. If your plan covers the amalgam rate for a posterior composite, you will have a small out-of-pocket cost for the upgrade. For patients on the Canadian Dental Care Plan, our team will walk you through what is covered before treatment begins so there are no surprises.
Filling Materials Comparison Table
The table below compares the three most commonly used filling materials to help you understand where each one fits and where it does not.
Filling Material
Best Use Case
Average Lifespan
Composite Resin
Front teeth, small to medium cavities anywhere, patients who prioritize aesthetics
7 to 10 years (often longer with good hygiene)
Dental Amalgam
Large cavities in back molars, cost-sensitive cases, high-chewing-pressure areas
15 to 20 years
Ceramic / Porcelain Inlay
Large cavities in visible or posterior teeth where aesthetics and durability both matter
15 to 20+ years
Frequently Asked Questions
How long do dental fillings last?
It depends on the material and location. Amalgam fillings in back teeth typically last 15 to 20 years. Composite resin fillings average 7 to 10 years, though many last longer with good oral hygiene and regular dental visits. Ceramic inlays can last 15 to 20 or more years. No filling lasts forever, but proper care significantly extends their lifespan.
Are amalgam fillings safe?
For most adults, yes. Health Canada and the World Health Organization confirm that dental amalgam is safe for the general adult population because the mercury in the alloy is chemically bound and does not behave like free elemental mercury. However, Health Canada updated its guidance in 2023 to recommend against amalgam use in children under 18, pregnant patients, people planning to become pregnant, women who are breastfeeding, and individuals with kidney disease. If you fall into one of those groups, discuss composite or ceramic alternatives with your dentist.
Does getting a dental filling hurt?
The procedure itself should not be painful. Local anaesthetic is applied before any drilling begins, and most patients describe feeling pressure and vibration rather than pain. Post-procedure sensitivity is common and usually resolves within two to four weeks. If pain persists or worsens after that window, book a follow-up appointment so your dentist can assess whether the nerve has been affected.
Can I replace my old amalgam fillings with composite?
Yes, and many patients choose to do this when existing amalgam fillings wear out or crack. Replacing a functional amalgam filling purely for cosmetic reasons is a personal choice, not a clinical requirement. Removing a sound amalgam filling does temporarily expose you to mercury vapour during the removal process, which is why most dentists recommend waiting until the filling actually needs to be replaced. When the time comes, composite is the standard replacement material for most posterior teeth.
How much do dental fillings cost in St. John's?
Costs vary based on the size and location of the cavity and the material used. A small composite filling is generally less expensive than a ceramic inlay covering the same tooth. Dental insurance and the Canadian Dental Care Plan can offset a significant portion of the cost for eligible patients. At Stavanger Dental, we review your coverage and provide a treatment estimate before any procedure so you know what to expect before committing to treatment.
How do I know if I need a filling?
Sometimes you will feel it. A toothache, sensitivity to hot or cold, pain when biting, or a visible hole in the tooth are all signs that warrant an immediate appointment. But many cavities produce no symptoms at all in their early stages, which is exactly why regular dental checkups matter. Digital X-rays allow us to catch cavities when they are small and easy to treat, well before they cause pain or require more extensive work.
If you have a question about your own filling options or want to share what your experience with dental restorations has been like, we would genuinely like to hear it.
We would love your feedback and any insights you would share with others. What perspective would you add?
References
Health Canada guidance on dental amalgam safety and recommendations for vulnerable populations
World Health Organization information on mercury in healthcare including dental amalgam
Canadian Dental Association resources on restorative dental materials and patient care standards
American Dental Association dental materials research on composite and amalgam clinical performance
National Institutes of Health research on the longevity and safety of dental filling materials
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