1. Definition

A tooth-coloured filling is a restoration made of composite resin, glass ionomer cement, or other tooth-shaded materials used to restore decayed, chipped, or fractured teeth and improve aesthetics.

2. Indications

• Dental caries (especially anterior or visible teeth)

• Fractured or chipped teeth

• Diastema (gap) closure

• Worn-down teeth

• Old amalgam filling replacement (for aesthetic reasons)

• Minor reshaping or cosmetic improvements

3. Contraindications

• Large cavities where durability is more important (amalgam or crowns may be preferred)

• Patients with poor oral hygiene

• Patients with high caries risk or bruxism (unless reinforced)

4. Types of Tooth-Coloured Filling Materials

5. Advantages

• Natural tooth colour match (aesthetic)

• Bonds directly to tooth structure (minimal tooth removal)

• Mercury-free (unlike amalgam)

• Can be used for cosmetic improvements

• Versatile for front and back teeth

6. Disadvantages

• Technique-sensitive (requires a dry field)

• Can shrink slightly during curing → possible microleakage

• Less durable than amalgam for large posterior restorations

• May stain over time (especially with coffee, tea, smoking)

• Can wear down faster in high-bite-pressure areas

7. Clinical Procedure (Composite Filling)

Step 1: Shade Selection

• Choose correct shade before tooth dries out (when enamel is moist).

Step 2: Isolation

• Rubber dam or cotton rolls to keep area dry.

Step 3: Cavity Preparation

• Remove decay and shape cavity conservatively.

Step 4: Etching

• Apply phosphoric acid (35–37%) to enamel/dentin for 15–30 seconds.

Step 5: Rinsing and Drying

• Rinse off etchant and gently dry (do not desiccate dentin).

Step 6: Bonding Agent

• Apply dental adhesive and cure with light.

Step 7: Placement of Composite

• Apply composite resin in increments.

• Each layer cured with blue light (LED curing light) for ~20 seconds.

Step 8: Shaping and Finishing

• Trim excess material, shape the anatomy.

Step 9: Polishing

• Use polishing disks, cups, or paste to smooth and shine the restoration.

8. Post-Operative Instructions

• Avoid hard/sticky foods for 24 hours if deep restoration.

• Some sensitivity to hot/cold may be present initially.

• Maintain good oral hygiene.

9. Longevity

• Composite fillings typically last 5–10 years, depending on:

  • Oral hygiene

  • Size/location of filling

  • Chewing habits

  • Regular dental check-ups