Only a trained dentist can properly diagnose and treat dental problems. In regards to tooth fillings, they are almost always a first-line treatment if you are experiencing: nerve (pulpal) pain; severe discomfort (like from a jagged tooth edge); functional problems (such as trouble chewing); or severe aesthetic issues. How to Get Rid of Tooth Pain offers some good tips on temporary and at-home remedies, but note that none of these can replace a proper dental evaluation.
Waiting until you have tooth pain before going to the dentist will almost always result in a tooth filling or other necessary procedure. Going before there is pain is more likely to give you treatment options in dealing with potential or emerging cavities. There is also some debate regarding the value of professional tooth cleaning, but this is almost always a standard component of a dental examination. Talk to your dentist if you have questions or concerns about the value of regular scaling and polishing procedures. Prevention is always less expensive and healthier than treatment; make regular dental appointments!
When your dentist recommends a filling, never be afraid to ask if there are other, less drastic options that can be tried first. While some dentists are quick to recommend filling cavities that are not yet fully-formed, others are more open to recommending risk-management approaches. These usually involve regular observation, proper cleaning, and treatments that focus on neutralizing acid, killing mouth bacteria, and strengthening tooth enamel. Resin sealants can also sometimes be used to stop cavities on the biting surfaces of teeth from developing further. [9] X Research source
A tooth filling involves drilling out the dental caries (cavity) and often surrounding tooth material, in order to create a pocket that can be filled. Local anesthesia is often administered. The filling itself is meant to seal off the inner tooth material and replace the damaged and removed dentin and enamel. Fillings can be made of gold, metal alloys, ceramic, or various composite materials, and should last for several years at least. [11] X Research source
Alongside this aggressive “drill and fill” approach, other dentists have taken things in the opposite direction, using increased information regarding the development of cavities to formulate a “watchful waiting” approach. It basically comes down to deciding whether it is best to nip a potential cavity in the bud or wait to see if it becomes an actual problem first. Some dentists now use lasers to treat cavities, as it is minimally invasive.
Many if not most “drill and fill” dentists genuinely believe in the health value of being proactive with fillings, however. If your dentist advocates an aggressive approach, you have every right to ask for a clear explanation as to why he or she believes this is the best way to go. In the end, you have to decide whether to trust his or her opinion.
Modern evidence indicates that cavities typically develop more slowly than often assumed, taking on average around four to eight years to fully form. Therefore, if you are visiting your dentist every six months, you should theoretically have ample time to catch a developing cavity before it becomes a serious problem that might lead to a root canal or tooth extraction. You should also ask for an intra-oral camera check to make sure that the lesion has penetrated your enamel and can turn into a problem. It is your mouth and your choice, of course. Don’t let a dentist scare you into taking action, but also accept that he or she has the expertise and experience in the field. Inform yourself, ask questions, and be ready to weigh the risks versus benefits of waiting.
If your dentist seems angry or offended that you want a second opinion, it is probably for the best that you seek out a new dentist anyway.
