Dental Fillings

Common reasons

• A hole caused by decay. Decay may not cause any symptoms at first¹. It is often found at a check-up, or on an X-ray, before it hurts.
• A broken, chipped or worn tooth. A small break can often be rebuilt with a filling. A cracked or damaged tooth, or a loose or broken filling³, can cause toothache.
• An old filling that has failed. A filling that has broken, come loose or has new decay at its edge may be repaired or replaced. See "How long do fillings last?" below.

When a filling may not be needed yet

In its early stages, decay can be reversed⁴. If it goes on, the tooth surface breaks down and a cavity forms. For early decay, a dentist can prescribe fluoride treatments like mouthwash or varnish¹. A review of 44 trials compared treatments that aim to stop decay without drilling, such as sealants with fluoride varnish, or high-fluoride toothpaste. It ranked these treatments for different kinds of decay, but its pooled results do not say how often decay stopped⁵ with each one. Whether early decay can be watched or needs a filling is decided at an examination.

When a filling may not be enough

• Deep decay close to the nerve. In very deep decay, the risk of exposing the nerve (the pulp, the soft tissue inside the tooth) is high. A 2026 European guideline on deep decay says this risk should be anticipated⁶. Whether the nerve needs treatment is sometimes clear only while the decay is being removed. If the nerve is exposed, the guideline suggests removing only part of the nerve (pulpotomy)⁶ for some teeth; the certainty of the evidence is low. The guideline also expects that not all dentists will be able to perform pulpotomies⁶ in adult teeth. Ask whether it is an option for your tooth. If the nerve cannot recover, root canal treatment or having the tooth out is discussed.
• A large part of the tooth lost. When the walls or cusps of a back tooth are weakened, cracked or broken, a filling may not be enough. An inlay, an onlay or a crown may be considered, depending on how much sound tooth is left and whether the cusps are weakened. Only an onlay or a crown covers the cusps, the raised points on the biting surface. See "When a filling is not enough" below.

Decay is diagnosed at an examination. The dentist looks at the teeth and the old fillings, and takes X-rays where needed. Tell your dentist about any medical conditions, the medicines you take and any allergies. Say too if you are pregnant or breastfeeding.

Even a dentist's eye does not always get early decay right. A Cochrane review looked at how well a visual examination finds early decay in enamel, the tooth's outer layer. In its worked example, 28 in every 100 tooth surfaces have early decay. Of every 1,000 surfaces examined, about 40 decayed surfaces would be missed and about 163 sound surfaces would be wrongly called decayed⁷. The certainty of the evidence is low, and 48 of the 67 studies were laboratory studies.

A photograph alone cannot show whether a tooth needs a filling: that needs an examination, with X-rays where needed. If you are told you need several fillings and you are unsure, ask to see the X-rays, or ask another dentist for an opinion.

Deep cavities

How deep a cavity goes is sometimes clear only once the dentist is working on it. For deep decay in a tooth with no symptoms, or only brief sensitivity, the European guideline suggests removing the decay selectively or in two stages⁶. In these approaches, some softened decay next to the nerve is left in place. This is a weak recommendation, and the certainty of the evidence is very low.

If the decay is removed in two stages, the second stage is at a later appointment. Ask before treatment when that would be, and whether it would be done in Antalya or by your own dentist at home.

The material depends on where the tooth is, how big the cavity is, your bite, your health and your preferences. Your dentist should explain the options for each tooth.

• White (tooth-coloured) composite. Composite is placed in layers, shaped to the tooth and hardened with a special light. It is bonded to the tooth, and its shade can be matched to the tooth. For how composite is shaped and colour-matched on front teeth, see composite bonding.
• Silver-coloured amalgam. Amalgam contains mercury⁸. It is not tooth-coloured and does not bond to the tooth. It is retained in the tooth by mechanical means⁸, such as the shape of the cavity. This page does not set out the rules on amalgam in Turkey. Ask whether the clinic places amalgam fillings, and for whom.
• Gold and porcelain. These fillings are usually made in a dental laboratory to fit your tooth, and usually need 2 appointments². Gold is sometimes used for molars. Laboratory-made fillings are usually called inlays or onlays; see inlays and onlays.
• Other materials. If another material is proposed, such as glass ionomer, ask why it suits that tooth and how long it is expected to last.

Composite or amalgam?

A 2021 Cochrane review included eight trials. Its main analysis combined two of them, in children with fillings in back teeth. It found that composite fillings may have almost double the failure rate⁹ of amalgam. Composite had a much higher risk of new decay at the edge, but was not more likely to fracture. The certainty of this evidence is low, and composites have improved since those trials. The review found no consistent or clinically important harms⁹ from either material, but that evidence was of very low certainty. These findings come from published studies, not from our own records.

In 2015 a scientific committee of the European Commission (SCENIHR) concluded that current evidence does not preclude the use of either amalgam or alternative materials⁸. It advised basing the choice of material on the patient. Examples it gave were baby or adult teeth, pregnancy, an allergy to mercury or other filling components, and reduced kidney function⁸. The 2021 Cochrane review adds that the global phase-down of dental amalgam under the Minamata Convention on Mercury⁹ is an important consideration. It says the choice depends on a shared decision between dentist and patient, and on local rules and protocols⁹. Ask for the plan to name the material for each tooth, and why it was chosen.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, tell your dentist before any filling is planned. In its 2015 opinion, SCENIHR advised that caution should be exercised when considering the placement of any dental restorative material in pregnant women⁸. Of resin-based filling materials such as composite, it wrote that, as with amalgam, their use in pregnant women is discouraged⁸. The American College of Obstetricians and Gynecologists is a US professional body. It considers dental treatment safe¹⁰ in pregnancy, including examinations, dental X-rays and local anaesthetic. It says that dental treatment which cannot wait, such as a filling, may be managed at any time during pregnancy¹⁰. It adds that delaying treatment may result in more complex problems¹⁰. Ask your dentist which treatment is urgent and which can wait until after the birth.

No cavity size has been identified at which a filling stops being enough. The choice depends on how much of the walls and cusps remains. Cusps are the raised points on the biting surface of a back tooth.

• A large filling made in the mouth. Many large cavities can still be filled directly with composite. Two reviews, published in 2023 and 2024, compared such fillings with laboratory-made composite inlays and onlays in large back-tooth cavities. They reached different conclusions¹¹. One found no significant difference; the other reported fewer failures with direct fillings¹². Both rated the certainty of their evidence as very low, and neither covers ceramic.
• Inlay or onlay. An inlay fills the space between the cusps; an onlay also covers one or more cusps. Both are usually made in a laboratory and then bonded to the tooth.
• Crown. A crown covers the whole visible part of the tooth. It may be recommended for a tooth that is badly damaged or broken, weakened by a large filling, root-filled, worn down or cracked¹³. A laboratory study on plastic model back teeth measured how much tooth each preparation removes. Full crown preparations removed about two thirds to three quarters¹⁴ of the visible part of the tooth. For inlays and small bonded preparations, the figure was about 5 to 27 per cent. These are laboratory values and give only a sense of scale. How much is removed from a real tooth depends on the existing damage and old fillings. See dental crowns.
• After root canal treatment. A root-filled back tooth can be restored with a filling, an onlay or a crown. A Cochrane review updated in 2015 found only one small study comparing a crown with a filling. It did not find any study¹⁵ comparing an inlay or onlay with a crown. So the evidence does not favour one option for every tooth; the decision rests on how much sound tooth is left.

The steps below are for a filling made directly in the mouth. Your dentist will advise whether a local anaesthetic is needed, depending on the extent of the work. If you would like one, or feel anxious about treatment, tell your dentist.

Preparing a tooth for a filling may remove some tooth, and the removed enamel and dentine do not grow back. So before any tooth is drilled, make sure you understand why the filling is needed. You can ask for changes, and you can say no, or ask to stop, at any stage. Once treatment has started, ask what would happen to the tooth if it stopped at that point.

Benefits

• Fillings repair holes caused by decay¹⁶ and restore the shape of the tooth, so you can chew on it again.
• A filling made in the mouth needs no laboratory stage.
• A white filling can be matched to the colour of the tooth.

Limitations

• It cannot be undone. Tooth removed for a filling does not grow back. From then on, that part of the tooth depends on a restoration.
• No filling lasts forever. Fillings can become chipped or worn or change colour over time².
• A filling does not protect the tooth from decay. New decay can start at the edge where the filling meets the tooth.
• Whitening does not lighten fillings. It will not work on fillings¹⁷, crowns or veneers. Next to whitened teeth, a filling can look darker, and it may need to be polished or replaced¹⁸. A 2011 review suggests avoiding whitening on ceramic (porcelain) restorations¹⁸, especially on front teeth, because their surface may become rougher. If you are thinking about teeth whitening, raise it before the plan is made.

Risks and complications

• Sensitivity. After a filling, the tooth may be sensitive to hot and cold for a while. See "Aftercare and sensitivity" below.
• A high bite. If the filling is slightly high, biting can hurt. Your dentist can adjust it.
• The nerve of the tooth. In a deep cavity, the nerve may be exposed while the decay is removed. For some teeth, part of the nerve can be removed (pulpotomy); if the nerve cannot recover, root canal treatment or extraction is discussed. After a deep filling, ask your dentist which signs to watch for.
• Failure over time. New decay at the edge and fracture are the main reasons fillings fail (see "How long do fillings last?").

If you had a local anaesthetic, it can take a few hours to wear off. Do not eat until the numbness has gone, and take care not to bite your cheek, lip or tongue. If your bite feels high in the first few days, tell your dentist; it can be adjusted.

Sensitivity after a filling

After a filling, the tooth may be sensitive to hot and cold for a while. Tell your dentist if it does not settle or keeps getting worse. Pain that starts on its own, lingers after something hot or cold, or wakes you at night is more than simple sensitivity: see a dentist. The same applies to toothache that lasts more than 2 days³, or toothache that painkillers do not ease.

Once you are home, see your own dentist about sensitivity that does not settle. You can also write to the clinic and send photographs.

Daily care

• UK prevention guidance for dental teams advises all adults to brush at least twice a day with a fluoride toothpaste of 1,350 to 1,500 ppm¹⁹. One of these times is last thing at night. Spit out the toothpaste rather than rinsing. Your own dentist can tell you which toothpaste suits you.
• The same guidance advises keeping sugary food and drinks to a minimum, and avoiding them at bedtime¹⁹.
• Clean between your teeth every day with floss or interdental brushes.
• Do not bite hard objects such as ice, pens or your nails.
• If you clench or grind your teeth, tell your dentist.
• Keep to your regular check-ups.

Studies show how groups of fillings fare over time. They cannot tell you how many years your own filling will last, and no filling lasts forever². The figures below come from published studies, not from our own records.

A 2014 analysis pooled data on 2,816 composite fillings in back teeth, from 12 studies that followed them for at least 5 years. During follow-up, 569 of these fillings failed, mainly because of new decay or fracture²⁰. Failure was more common²⁰ in people at high risk of decay and in fillings that covered more surfaces of the tooth. This figure is not a failure rate over a set number of years, and it does not predict the outcome for any one filling.

Repair or replacement

An old filling that is still sound does not need replacing just because it is old. A filling with a defect can sometimes be repaired instead of being replaced in full. Studies comparing the repair of defective fillings with their replacement found no significant difference²¹ in the risk of failure. Only 3 studies were included; the risk of bias was high and the certainty of the evidence very low. Ask your dentist whether a repair is possible, and if not, why not.

If a filling keeps failing, or the tooth around it is weakened or cracked, an onlay or a crown may be discussed instead. See "When a filling is not enough" above.

Contact a dentist if any of the following happens. While you are in Antalya, that is the clinic; once you are home, it is usually your own dentist or a dentist near your home.

• Sensitivity that does not settle, or keeps getting worse
• Pain that starts on its own, lingers after something hot or cold, or wakes you at night
• Toothache that lasts more than 2 days³, or that does not go away when you take painkillers
• Pain when you bite, or a bite that feels high
• Toothache with a high temperature, red gums or a bad taste in your mouth³, or a swollen cheek or jaw
• A filling that cracks, breaks, feels rough or falls out, including a temporary filling
• Food catching at the edge of a filling, or a dark line or new hole at its edge

If you think you have a dental abscess, do not wait. An abscess does not go away on its own and needs urgent treatment by a dentist²². Ask for an urgent appointment with a dentist where you are.

Emergencies. The following need urgent medical help²². Do not wait for a dental appointment or for the clinic's reply. Go to the nearest emergency department or call the emergency number where you are (112 if you are in Turkey).

• Swelling that makes it hard to breathe, speak or swallow
• Swelling around your eye or in your neck³
• A painful eye, or sudden problems with your sight
• A lot of swelling inside your mouth
• Difficulty opening your mouth

Before you fly home

Make sure every planned filling has been placed, and your bite checked. If a tooth still has a temporary filling, know who will finish the treatment, where and when. Make sure, too, that you have written care instructions, a written record of your treatment and a way to reach the clinic.

Once you are home

If a problem comes up that is not urgent, write to the clinic and send photographs. See your own dentist or a dentist near your home as well. In the emergencies above, do not wait for a reply.

Your treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists.

In Turkey, a dentist does not need a specialty certificate to place fillings. The law authorises every dentist²³ to diagnose and treat the teeth, the gums and the tissues of the mouth and jaw. Restorative dentistry is one of the nine dental specialties set by law in Turkey²³. Only a dentist who holds a certificate in that specialty²³, issued and registered by the Ministry of Health²⁴, may use its title.

Ask who will examine your teeth and place your fillings. Ask what their title is and where they qualified, and ask for the answers in writing. On this page, "your own dentist" means the dentist you see at home.

Is it worth having fillings in Antalya?

For one or two fillings, usually not. A dentist near your home can place them. Fillings also need check-ups and, over time, repair or replacement, and these are usually with your own dentist. Fillings in Antalya make sense mainly as part of a wider plan you are already having there, such as crowns, onlays or root canal treatment. In that case, decay in the teeth involved is usually treated within the same plan.

How the appointments fit a trip

A filling made in the mouth needs no laboratory stage. Gold and porcelain fillings (inlays and onlays) usually need 2 appointments², with laboratory time between them. How many days you need depends on how many teeth are treated. It also depends on whether any tooth needs root canal treatment, an onlay or a crown, and on other treatment in the same trip. Whether a deep cavity needs nerve treatment is sometimes clear only while the decay is being removed. Root canal treatment can add visits, so ask what would change for your trip if a tooth needs it.

What to agree in writing before you start

Before you book, you receive a written preliminary plan based on the photographs and any X-rays you send. It sets out the appointments and how many days they need. It is not a diagnosis or a final treatment plan: a photograph alone cannot show whether a tooth needs a filling. A qualified dentist should examine you before your treatment plan and its cost are confirmed. For fillings, that examination is in Antalya, with X-rays where needed. It confirms or changes the preliminary plan, and with it the days and the cost. If it changes, you receive the revised plan in writing before treatment starts. You can take time to decide. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone. You can also have the assessment, and any fillings, with a dentist near your home.

Ask for the plan to answer these questions:

1. Which teeth need a filling, and which might need root canal treatment, an onlay or a crown?
2. Which material is planned for each tooth, and why?
3. Will every filling be finished before you fly home?
4. If a tooth turns out to need more, what changes in the appointments, the days and the cost?
5. Which records will you take home for your own dentist?

Flying. A 2023 narrative review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment²⁵, and longer after surgical procedures. These times assume there is no pain, swelling or bleeding where you were treated. The authors note that the research is limited and comes mainly from military aviation. Treat it as a starting point for your dentist's advice, not as a rule.

Your own dentist

Talk to your own dentist before you go. They need to know the plan in case problems come up later. If you do not have a dentist near your home, it helps to find one before you travel. Fillings need check-ups for as long as they are in the tooth, and over time they may need repair or replacement. These visits are usually with your own dentist. The UK's NICE guideline on dental recall says check-up intervals should be set for each person according to their risk²⁶ and discussed with them. Agree yours with your dentist at home.

Your records

Ask the clinic for a written record of the treatment to take back to your own dentist. For each tooth, it should say:

• which tooth was filled, and which surfaces
• the material and, for a white filling, the shade
• whether the decay was deep, and whether the nerve was treated
• anything that still needs to be done, and by when

Ask for copies of any X-rays, in a form your own dentist can open. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging²⁷.

Health service and insurance where you live

What a health service or an insurer covers after treatment abroad differs from country to country. Before you travel, ask the health service or your insurer where you live what they would cover. Ask in particular about repairing or replacing a filling placed abroad, and about any complication. Ask any dentist about the cost before they repair or replace a filling. Tell your travel insurer about your plans too.

These are the questions we suggest you ask before treatment abroad, with what this page can answer today and what to ask for in writing.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. Ask for the name of the dentist who will place your fillings. Ask where they qualified and what their title is (see "Who carries out the treatment?").
2. Will the dentist speak English, or will there be a translator? Ask before you book who will explain the plan, the consent form and the aftercare instructions to you.
3. Are you regulated by a professional body and registered with it? In Turkey, a health facility needs an authorisation certificate²⁷ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes²⁸, so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. A dentist in private practice in Turkey must also register with the provincial or regional dental chamber²⁹ within a month of starting. Ask for the treating dentist's own registration details as well. More is on our page about dental treatment abroad.
4. How many times have you carried out this treatment, what are your rates of success and complications, and can you give references? The figures on this page come from published studies, not from our own records. We publish no figures of our own yet, and this page carries no patient reviews. Ask for the clinic's figures in writing, and how they were collected.
5. Is the work guaranteed, are the terms in writing, and for how long do they apply? This page makes no guarantee. Ask for the clinic's written terms for a filling that breaks, comes out or needs replacing, and read them before you commit. Check whether they cover a repair after you are home.
6. What aftercare do you provide, and who can I contact after the treatment? For a problem that is not urgent, you write to the clinic and send photographs. Check-ups, and problems that need someone to look at the tooth, are usually with your own dentist near your home. Ask which channel to use, in which language, and how quickly you can expect a reply.
7. If there are complications, or I am unhappy with the result, who pays for further treatment, extra flights and the hotel? Is further treatment included in the cost? Ask for the answer in writing before you commit. Ask too who pays if a tooth needs root canal treatment or a crown during the trip.
8. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre²⁷. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.
9. Do you have a complaints system, and can I see a copy? Ask for it before treatment. A complaint goes to the clinic first. If it is not resolved there, you can apply to the provincial health directorate's Patient Rights Board³⁰, which does not assess allegations of medical error. The dental chamber can also open disciplinary proceedings²⁹ against a dentist. Turkey's health tourism regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided²⁷.
10. What happens if the examination shows that a tooth needs more than a filling, or none at all? Ask before you book what you pay for the examination and X-rays, and how the plan, the days and the cost would change.

Think twice before booking any treatment abroad if you see any of these signs. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare. Apply them to this clinic too.

This page does not show prices. Your treatment plan and its cost are confirmed after an examination. The main factors that shape them are:

• How many teeth need a filling, and how large each cavity is
• The material for each tooth
• Whether a tooth needs more: root canal treatment, an inlay or onlay, or a crown
• Whether the examination and any X-rays are included
• Repair or replacement that may be needed over time

Ask for the plan in writing, including what is covered and how, and where, a filling that fails later would be repaired. Ask too who pays for further treatment and extra travel if there is a complication. If you are comparing with a quote from a practice near your home, compare what each one includes, item by item.