On The Go Dental Group

General Dentistry

General Dentistry

White Fillings

Fillings (restorations) are used to repair decayed, cracked or broken teeth and teeth that have been worn down due to harmful habits (such as nail-biting or tooth grinding). To treat a cavity the dentist will remove the decayed portion of the tooth and then “fill” the area with restorative material.


First, the dentist will use local anesthetic to numb the tooth and the surrounding area. Next, she will clean out the caries with hand and/or electric instruments. The choice of instrument depends on the location and extent of the decay. If the cavity is deep, a layer of protective liner may be used. This is followed by conditioning the cavity, applying a bonding agent (adhesive), placement of the final composite restoration, finishing and polishing.

  • Aesthetics-the shade/color of the composite fillings can be closely matched to the color of existing teeth.
  • Versatility-in addition to use as a restorative material for decay, composite fillings can also be utilized to repair chipped, broken, or worn teeth.
  • Tooth-sparing preparation-most of the time less tooth structure needs to be removed when preparing teeth for composite restorations as compared with amalgam (silver colored) restorations.
  • Inherent chemical bonding to tooth structure.
  • Good aesthetics.
  • Moisture-tolerant can be used for teeth which are difficult to isolate and keep dry during treatment.
  • Fluoride releasing great option for patients at high risk for caries (geriatric, medically complex, special needs, and pediatric patients) to minimize caries recurrence.

Tooth sensitivity following placement of a filling is fairly common. A tooth may be sensitive to pressure, air, sweet foods, or temperature. Usually, the sensitivity resolves on its own within a few weeks. During this time, avoid things that trigger the sensitivity. Schedule an appointment if sensitivity does not subside within two to four weeks or if it is becoming progressively worse. The dentist may recommend a desensitizing toothpaste, apply a desensitizing agent to the tooth, or investigate further.


If the decay was very deep or close to the nerve tissue, you may experience a “toothache- type” pain. This response may indicate the nerve is inflamed or infected and the tooth may require root canal therapy.


There is some discomfort that is expected to arise after receiving dental treatment. Gum tenderness after receiving the anesthetic injection and jaw soreness from keeping the mouth open during the procedure may occur.


Sometimes patients experience what is known as referred pain — pain or sensitivity in other teeth besides the one that received the filling. With this particular pain, there is likely nothing wrong with the teeth. The filled tooth is simply passing along “pain signals” it’s receiving to other teeth. If this is the case then the pain should decrease on its own over 1 to 2 weeks.

To prolong the longevity of your fillings, it is imperative to follow good oral hygiene and have a healthy diet low in added sugars. Visit the dentist regularly for cleanings and exams, brush twice daily with fluoride toothpaste, and floss at least once daily. Using an antibacterial mouthwash or fluoride rinse may also help.

Pressure from chewing, grinding, and clenching can cause dental fillings to wear away, chip, and crack. A diet rich in acidic and sugary foods can shorten the lifespan of dental restorations by contributing to recurrent decay and weakening the enamel.


If the seal between the tooth and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling and cause recurrent caries. Decay that is left untreated can enlarge and progress to reach the nerve of the tooth, which may result in a dental infection.


If the restoration is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In such a case, the defective filling may need to be replaced with a crown.

Simple Extractions

Reasons for Extracting Teeth

  • Non-restorable tooth-if a tooth is so severely damaged by decay or trauma that not enough sound tooth structure remains in order to successfully restore it, it will need to be extracted.
  • Infection-if tooth decay or damage extends to the pulp, the center of the tooth containing nerves and blood vessels, bacteria can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT). However, if the infection is so severe that antibiotics and RCT cannot cure it, extraction may be needed to prevent the spread of infection and systemic health complications.
  • High risk of infection-if your immune system is very compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may be reason enough to remove the tooth prior to commencing the medical treatment.
  • Periodontal (gum) disease-if severe periodontal disease (infection of the tissues and bones that support the teeth) is present and causing considerable mobility of one or more teeth (due to loss of supporting bone structure), it may be necessary to extract them.
  • A crowded mouth-sometimes dentists take out teeth to prepare the mouth for orthodontic treatment (braces). This is usually done only in cases of severe crowding and malocclusion.

What to Expect With Tooth Extractions

First the dentist will discuss the risks and benefits of taking the tooth out with you so that you can make an informed decision about proceeding with the recommended treatment.


Next, you will have topical anesthetic gel applied to the gum to lessen the discomfort of local anesthesia injection. The injection will be administered to numb the appropriate tooth. Special instruments will be used to slowly loosen the tooth and then remove it.


Sometimes, a badly broken down tooth that is difficult to take out must be removed in pieces. Once the tooth has been extracted a blood clot fills the socket. If needed, the dentist will place a few self-dissolving sutures to close the gum edges over the extraction site.


At the conclusion of the procedure you will be asked to bite down on gauze to help stop the bleeding.


Sometimes, in the early days after the extraction, the blood clot is displaced from the socket, exposing the bone underneath. This painful condition is called dry socket. It is more common in patients who smoke. If this happens, your dentist will place a sedative dressing for a few days to alleviate the discomfort and aid in the healing process. In order to try to prevent it, don’t use a straw, spit, drink alcohol or carbonated beverages, or smoke for at least 3 days after the procedure.

What to Tell The Dentist Before You Have a Tooth Pulled

If you have a medical condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction or take other precautions. Before having a tooth pulled, let the dentist know your complete medical history, the medications and supplements you take, and if you have or had one of the following (note that this list is not complete):


  • Damaged or man-made heart valves
  • Congenital heart defect
  • Impaired immune system
  • Liver disease (cirrhosis)
  • Artificial joint, such as a hip replacement
  • History of bacterial endocarditis
  • Uncontrolled Diabetes
  • Organ transplant
  • Bleeding problems
  • Chemotherapy
  • Radiation therapy
  • Have ever taken Bisphosphonates for osteoporosis or other conditions

After You've Had a Tooth Pulled

Recovery after extraction typically takes a few days. Following the instructions below can help minimize discomfort, reduce the risk of infection, and aid in the healing process.


You may have some bleeding for the first day or so after surgery. Bite firmly but gently on gauze to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads after they become saturated with blood or every 30-60 minutes. Note that blood mixing with saliva may give an impression of bleeding being more severe than it actually is. Over use of the gauze or talking with gauze may promote bleeding.


When the surgical site(s) are not visually/actively bleeding, remove the gauze.


Your face might swell or have bruises. This is normal. Apply ice packs for a minimum of 24 hours (may be wrapped in cloth for comfort) to the outside of your face to keep down swelling and help dull the pain. Pain may peak around 48-72 hours after procedure. If you still experience soreness in your jaw muscles after 72 hours, apply warm compresses to the area.


Relax for at least 24 hours after the extraction. Limit activity for the next day or two. Don’t bend or lift anything heavy. Avoid vigorous rinsing or spitting for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.


After 24 hours, you may begin to gently rinse your mouth with a solution made of 1/2 teaspoon salt and a cup of warm water a few times a day (after meals and before bedtime, in addition to rushing and flossing).


Do not drink from a straw for the first 24 hours.


Do not smoke, which can inhibit healing.


Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.


When lying down, prop your head with pillows. Lying flat may prolong bleeding.

Continue to brush and floss your teeth, and scrape your tongue, but be sure to avoid the extraction site. Keeping your mouth clean can help prevent infection.

When to Call

It is normal to feel some pain after the anesthesia wears off. For one or two days after having a tooth removed, you may also expect some swelling, bruising and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is extracted, please let us know.


Please call if you experience any of the following:


  • Signs of infection, including fever and chills.
  • Redness, swelling, or excessive discharge from the affected area.
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting.

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Over time, having a missing tooth (or teeth) can cause other teeth to shift and bone in the area to resorb, affecting your bite and making it difficult to chew. For that reason it is advisable to replace the missing tooth or teeth with an implant, fixed bridge, or removable partial denture.