Your filling just fell out. Maybe you were eating something chewy, or maybe it simply loosened over time and came away while you were brushing your teeth. Either way, you're left with a gap where solid tooth structure used to be, and your tongue keeps finding its way to the exposed area.
The first thing most people notice is sensitivity. Cold air hitting the exposed tooth creates sharp, uncomfortable sensations. Hot drinks do the same. Even breathing through your mouth feels different because air flows directly over the unprotected tooth surface.
This sensitivity happens because the filling was protecting the inner layers of your tooth. Without that barrier, temperature changes and pressure reach the more sensitive dentin underneath the enamel. The tooth isn't damaged yet, but it's vulnerable.
What a Lost Filling Actually Costs to Fix
Emergency appointments for lost fillings run £75-150 at most private practices during normal hours. This covers examination and X-rays to assess the tooth's condition.
Temporary fillings cost £80-95 and provide immediate protection. They seal the tooth against bacteria and stop the sensitivity, though they're designed to last only a few weeks.
Permanent replacement fillings cost £175-260 depending on the size of the cavity and which tooth needs treatment. Larger back teeth with extensive decay require more material and time, pushing costs toward the upper end of that range.
At Dentozen, emergency examinations cost £65 including X-rays. White fillings are £175 for standard cavities and £260 for large restorations.
The complete cost for treating a lost filling typically runs £220-405 when you include both the emergency appointment and the permanent filling replacement.
Why Fillings Fall Out
Fillings fail for predictable reasons. New decay develops around the edges where the filling meets natural tooth structure. Bacteria find microscopic gaps between the filling material and tooth, creating infection underneath what appears to be a solid filling.
The filling material itself breaks down over time. Composite fillings last 3-10 years depending on their location and how much pressure they endure during chewing. Fillings in back teeth fail faster than front teeth because molars handle significantly more force.
Some fillings were simply too large to remain stable. When decay removes too much natural tooth structure, the remaining walls become thin and weak. The filling might stay in place for years, but eventually the surrounding tooth fractures and the filling comes loose.
Grinding teeth accelerates filling failure dramatically. The constant pressure and friction wears down both natural tooth structure and filling material. People who grind often lose fillings earlier than the typical lifespan would predict.
What Happens at the Emergency Appointment
The dentist examines the tooth to determine why the filling failed. X-rays reveal whether new decay developed underneath the old filling, whether the tooth structure around it cracked, or whether the filling simply wore out.
This examination matters because different causes require different treatments. A filling that fell out due to new decay needs more extensive work than one that simply reached the end of its lifespan.
If the tooth shows signs of deep decay approaching the nerve, you might need root canal treatment rather than just a new filling. The dentist can usually tell from the X-ray and examination whether the nerve is affected.
For immediate relief, a temporary filling seals the tooth. This material sets quickly and stops sensitivity within minutes. It's soft enough to remove easily later but hard enough to protect the tooth against bacteria and temperature changes.
The temporary filling buys time for proper treatment. Some teeth need the decay to be cleaned out more thoroughly than an emergency appointment allows. Others need root canal treatment before the permanent filling can go in. The temporary seal keeps the tooth safe while you schedule the definitive treatment.
Temporary vs Permanent Fillings
Temporary fillings use zinc oxide or glass ionomer cement. These materials bond adequately to tooth structure but aren't designed for long-term durability. They typically last 2-4 weeks before starting to break down.
The purpose of a temporary filling is protection during multi-stage treatment. Root canal cases often require several appointments, and the temporary filling seals the access hole between visits. Teeth with extensive decay sometimes need the inflammation to settle before permanent restoration.
Permanent fillings use composite resin for visible teeth or amalgam for some back teeth. Composite bonds chemically to tooth structure through an etching process, creating a seal that prevents bacteria from entering. The material comes in layers, each hardened with a special light before the next layer goes on.
The dentist shapes and polishes the permanent filling to match your natural bite. This takes more time than placing a temporary because the fit needs to be precise. An improperly shaped filling creates pressure points that cause discomfort every time you chew.
Permanent composite fillings typically last 5-10 years with proper care. Their lifespan depends on their size, location, and how much force they endure during chewing. Front teeth experience less stress and often last toward the upper end of that range.
When the Tooth Needs More Than Just a Filling
Some teeth can't support another filling. If too much natural structure is gone, the tooth needs a crown instead. Crowns cap the entire visible portion of the tooth, protecting weak walls from fracturing under normal chewing pressure.
The examination reveals whether enough tooth remains for a simple filling. As a general pattern, if more than half the tooth is filling material or cavity, a crown becomes necessary. The exact threshold depends on which tooth and how the remaining structure is distributed.
Root canal treatment becomes necessary when decay reaches the nerve chamber inside the tooth. This manifests as severe pain, prolonged sensitivity to temperature, or sometimes as a complete absence of pain because the nerve has died.
Dead nerves create their own problems. Bacteria colonize the empty nerve chamber and form abscesses at the root tip. These infections require root canal treatment to remove the dead tissue and seal the chamber against bacteria.
Root canal treated teeth need crowns to prevent fractures. The treatment removes not just the nerve but also blood supply to the tooth, making it more brittle over time. Crowns protect these weakened teeth during normal function.
The Risks of Delaying Treatment
Exposed tooth structure deteriorates quickly. Bacteria colonize the open cavity within hours. The longer the tooth stays unprotected, the deeper the decay penetrates.
Surface decay extends into deeper tooth layers at a steady pace. What starts as a small exposed area requiring a simple filling can become a large cavity needing extensive restoration within weeks.
The exposed nerve becomes increasingly sensitive as infection approaches. Temperature sensitivity evolves into constant throbbing pain as bacteria reach the nerve chamber. This progression from mild discomfort to severe pain typically takes 2-4 weeks depending on how deep the original cavity was.
Once infection reaches the nerve, root canal treatment becomes unavoidable. The cost jumps from £175 for a simple filling to £499-599 for root canal plus £499+ for the crown needed afterward. That's £998-1,098+ instead of £220 total cost, purely because of delayed treatment.
Infected teeth can develop abscesses. The infection spreads from the nerve chamber through the root tip into surrounding bone. This creates swelling, severe pain, and sometimes fever as your body fights the infection.
What People Do While Waiting for Treatment
Sugar-free gum sometimes provides temporary relief by covering the exposed area. The gum creates a physical barrier against temperature changes and prevents food from packing into the cavity. This isn't a solution, but it helps manage discomfort for a few hours.
Cold sensitivity decreases if you avoid cold foods and drinks. Room temperature or slightly warm beverages don't trigger the same sharp sensation. This adaptation works short-term but doesn't address the underlying vulnerability.
Some people use over-the-counter dental cement from pharmacies. These products create a temporary seal similar to what a dentist would place. They work adequately for a few days but don't bond to tooth structure the way professional materials do.
The issue with pharmacy cement is removal. These materials sometimes bond well enough that removing them damages tooth structure. Dentists often spend extra time cleaning out pharmacy cement, which wouldn't have been necessary if the tooth had stayed empty.
Pain relief comes from standard painkillers. Ibuprofen helps more than paracetamol because it addresses inflammation alongside pain. The combination of both medications provides better relief than either alone when pain becomes significant.
How Long Temporary Fillings Actually Last
Temporary fillings typically survive 2-4 weeks of normal use. They're designed to be soft enough for easy removal but hard enough to protect the tooth between appointments.
Chewing on the temporary filling accelerates its breakdown. People who eat primarily on the affected side or who grind their teeth often lose temporary fillings within days rather than weeks.
The material gradually erodes from chewing forces and chemical breakdown. Small pieces chip away each time you eat. Eventually enough material is lost that bacteria can enter around the edges.
Lost temporary fillings require replacement before the permanent treatment appointment. The tooth can't stay exposed for extended periods without developing new decay. This means an additional emergency visit to place another temporary if the first one fails early.
The Permanent Filling Appointment
The dentist removes all remaining decay and any pieces of the old filling. This cleaning process often removes more tooth structure than the original cavity because decay spreads underneath fillings over time.
The tooth gets shaped to receive the new filling. Sharp internal corners are rounded to prevent stress concentration. Undercuts are created so the filling locks mechanically into the tooth alongside chemical bonding.
Composite fillings go in layers. Each thin layer gets hardened with a UV light before the next layer is added. This layering technique prevents shrinkage that can occur if thick composite is placed all at once.
The final shaping determines how the tooth feels when you bite. The dentist checks your bite repeatedly, adjusting high spots until pressure distributes evenly. This takes several rounds of checking and adjusting because the tooth is numb and you can't feel the bite accurately.
Polish brings the filling to a smooth finish that matches surrounding enamel. Rough fillings collect bacteria and stain quickly. Proper polishing extends the filling's lifespan and keeps it looking natural.
When to Book That Permanent Filling
Most temporary fillings should be replaced within 2-3 weeks. Waiting longer risks the temporary breaking down and exposing the tooth again.
Some situations require faster scheduling. If the temporary filling feels loose or you notice sensitivity returning, bacteria have probably breached the seal. This means new decay is developing underneath.
Root canal cases often need longer between temporary and permanent fillings. The tooth needs time for inflammation to resolve after nerve removal. Rushing the permanent filling can trap bacteria inside, leading to reinfection.
Large cavities sometimes require staged treatment. The dentist might place a temporary, let the tooth settle for a few weeks, then place another temporary before the final permanent restoration. This stepped approach gives heavily decayed teeth the best chance of survival.
Prevention After Replacement
New fillings fail for the same reasons old ones did. If the original filling fell out due to grinding, the replacement will eventually fail unless the grinding is addressed. Night guards protect both natural teeth and fillings from grinding damage.
Decay around filling edges happens when bacteria colonize the microscopic gap between filling and tooth. This gap is inevitable over time as the filling material and tooth structure expand and contract at different rates with temperature changes.
Regular cleaning appointments catch early decay around fillings. Professional cleaning removes bacterial buildup before it penetrates underneath. The dentist can also monitor filling margins for early signs of breakdown.
Some filling materials last longer than others in specific locations. Composite works excellently in front teeth but can wear faster in back teeth that handle heavy chewing forces. The material choice affects how long the filling survives in that particular tooth.
The Bottom Line
Lost fillings cost £220-405 to treat completely, including emergency examination and permanent replacement. Temporary fillings provide immediate relief for £80-95 but need replacement with permanent restoration within 2-4 weeks.
The exposed tooth deteriorates quickly without protection. Decay spreads deeper into tooth structure, potentially requiring root canal treatment if left untreated beyond a few weeks.
Book an emergency appointment at Dentozen if you've lost a filling. Emergency examinations cost £65 and can be arranged quickly to protect the tooth before decay develops.