Restorative Dentistry · Last reviewed May 2026
Dental Fillings That Last
Decades.
Picasso Dental places tooth-coloured composite dental fillings in Vietnam across small, moderate, large and cervical/Class V cases, plus IAOMT-protocol safe amalgam removal, cosmetic Class IV composite and tooth-gap closure. For larger restorations we offer Emax porcelain inlays and onlays. No mercury amalgam used in our routine work.
What is a Dental Filling?
A dental filling restores a tooth damaged by decay or fracture by removing the diseased tissue and rebuilding the missing portion with a tooth-coloured composite resin or glass ionomer (GIC). Modern fillings bond directly to the tooth, preserve healthy structure, and are virtually invisible. Picasso uses no mercury amalgam in routine work and offers IAOMT-protocol safe removal of existing amalgam fillings.
Why Picasso for Fillings
Composite-First Approach
No mercury amalgam in our routine restorative work. Tooth-coloured composite bonds to the tooth, preserves healthy structure, and is virtually invisible. The aesthetic and biological choice for most modern fillings.
IAOMT Safe Amalgam Removal
For patients replacing existing amalgam fillings, we follow the International Academy of Oral Medicine and Toxicology safe-removal protocol, rubber dam isolation, high-volume suction, copious water cooling, external oxygen supply, mucosal rinse.
Cosmetic Composite for Front Teeth
Class IV chips, fractured corners and tooth-gap closure performed by our cosmetic dentistry team. Shade-matched in layers for natural translucency.
Step-Up to Porcelain Inlays
Where a cavity is too big for a reliable composite, typically more than half the cusp width, we step up to an Emax porcelain inlay or onlay. Stronger, more durable, with a 5-year warranty.
Tooth Gap Closure
A single small diastema between front teeth can be closed in one visit with direct composite bonding. For larger gaps or full smile redesigns, we discuss porcelain veneers or Invisalign honestly first.
Sub-30-Micron Bite Adjustment
Every filling is bite-checked with articulating paper before you leave, composite restorations sitting even slightly high cause biting pain. We adjust to fine tolerance so your bite feels natural the moment the anaesthetic wears off.
Itemised Filling Pricing
Difficulty is decided after clinical exam and X-ray; quoted in writing before treatment. For published rate cards across composite (small, moderate, large, cervical), GIC/FUJI, cosmetic Class IV, tooth-gap closure, IAOMT-protocol amalgam removal, and Emax porcelain inlays / onlays / overlays, see the dedicated cost guide.
Decay too deep? See root canal treatment. Tooth too broken-down? See dental crowns.
Filling Types Explained
Six common scenarios. The right material depends on cavity size, location, biting forces, aesthetic priority and patient caries risk, decided by the dentist after exam, not from a catalogue.
Composite: Small
A pinpoint or shallow cavity, typically a single surface. Composite layered, cured and polished in one visit. The bread-and-butter modern filling.
Composite: Moderate
Two-surface cavity (e.g. occlusal plus interproximal) where contact with the neighbouring tooth must be rebuilt. Layered carefully to restore anatomy and contacts.
Composite: Large
Three-surface cavity or extensive decay needing significant reconstruction. Composite is still the right tool here in most cases; very large cavities step up to inlay or onlay.
Cosmetic Class IV
A chipped or fractured front-tooth corner restored with shade-layered composite. Done by our cosmetic team for natural translucency at the incisal edge.
GIC / FUJI
Glass ionomer cement releases fluoride and is well suited to paediatric work, root-surface caries and patients at high caries risk. Less aesthetic than composite, used where the biological case justifies it.
Porcelain Inlay / Onlay
For very large cavities where a giant composite would not be reliable, an Emax porcelain inlay (intracoronal) or onlay (covering one or more cusps) is fabricated indirectly and bonded. Stronger, more wear-resistant, 5-year warranty.
How a Filling is Placed
Four steps from examination to polished restoration. Most fillings complete in a single 30–60 minute visit.
Examination + Diagnosis
Clinical exam, decay assessment, X-ray where indicated. Material and approach decided after seeing the cavity in person.
Visit · 10 minAnaesthetic + Decay Removal
Local anaesthetic. Decay removed conservatively under magnification with rubber dam isolation where appropriate.
Visit · 15 minBonding + Composite Layering
Cavity etched, primed and bonded. Composite layered in 1–2mm increments and light-cured for predictable polymerisation.
Visit · 15–20 minShape, Polish, Bite Check
Final shaping with diamond burs, articulating paper bite check, polishing to high lustre. You confirm the feel before leaving.
Visit · 10 minWho Is, and Isn't, a Good Candidate?
A composite filling suits the great majority of cavities. A few situations call for a different tool, root canal, inlay, crown, or extraction. Here's the honest version.
A Filling Is The Right Tool If
You have small to moderate decay or a fracture in an otherwise healthy tooth.
The pulp (nerve) is healthy and the cavity has not reached it.
Sufficient tooth structure remains for reliable bonding and to support the filling.
The bite is stable and the tooth is not under severe occlusal stress.
You want to replace a failing or aesthetically unacceptable amalgam filling.
You have a small front-tooth chip or a single small gap to close cosmetically.
A Filling May Not Be The Right Tool If
Decay has reached the pulp, root canal treatment is needed first.
More than around half a cusp has been lost, a porcelain inlay, onlay or full crown is more reliable than a giant composite.
The tooth has fractured below the gumline, extraction or surgical treatment may be required.
You are a heavy bruxer (grinder) with no protection, composite fractures and an inlay or crown is more durable.
The tooth has a hopeless prognosis, extraction plus implant is the better long-term answer.
You want long-term stain resistance for a front-tooth shape change, porcelain veneers outperform composite for that purpose.
Risks & Honest Tradeoffs
Composite fillings are among the most evidence-based restorations in dentistry. Here's what the literature reports, what can go wrong, and how Picasso minimises every avoidable risk.
Documented Lifespan
Demarco et al. (2012) systematically reviewed 12 long-term studies of posterior composite restorations and reported median annual failure rates of 1–3%. A well-placed composite filling in a healthy mouth commonly serves 7–15 years; longevity is more strongly tied to the patient's caries risk and bite forces than to the material itself.
What Can Go Wrong
Post-operative sensitivity for 1–2 weeks, usually self-resolving. Marginal stain over years at the bond line. Secondary decay if plaque control is poor. Fracture in heavy bruxers. Debonding rare with current adhesives but possible.
The Bonding Tradeoff
Modern composite bonds chemically and micromechanically to enamel and dentine, preserving more healthy tooth structure than amalgam, which relied on mechanical retention via undercuts. The tradeoff: composite is technique-sensitive and demands strict moisture control, which is why we use rubber dam isolation on larger cases.
Mercury Amalgam: Why We Avoid It
Picasso does not place mercury amalgam in routine restorative work. Composite is aesthetically superior, bonds to the tooth rather than relying on undercuts, and avoids the patient communication and biological concerns that drive many patients to seek replacement. Sound existing amalgam, however, does not need to be replaced unless failing.
IAOMT Protocol Explained
For patients choosing to replace existing amalgam, the IAOMT safe-removal protocol uses rubber dam isolation, high-volume suction, copious water cooling, external oxygen supply for the patient, and a final mucosal rinse, designed to minimise mercury vapour exposure during the removal procedure. Applied on every amalgam removal at Picasso.
What We Will Tell You No To
A composite filling when an inlay, onlay or crown is the right tool, giant composites in heavy bite zones fail predictably. Replacing sound, well-sealed amalgam restorations purely for the sake of replacement, this removes additional healthy tooth and creates exposure risk. Front-tooth shape changes that veneers or Invisalign would deliver more reliably than composite.
Common Questions
Composite or amalgam, which?
Picasso uses no mercury amalgam for routine restorations. Tooth-coloured composite resin is the modern standard, it bonds to the tooth, is virtually invisible, and preserves more healthy tooth structure. Amalgam is mechanically retentive and longer-lasting in some studies, but the aesthetic and biological tradeoffs make composite the preferred choice for most patients today.
Does it hurt?
Local anaesthetic is profound, you feel pressure, not pain, during decay removal and the filling itself. Mild post-operative sensitivity to cold or biting is common for a few days and resolves on its own. Persistent sensitivity beyond two weeks should be reviewed.
How long does a composite filling last?
Demarco et al. (2012) reviewed 12 long-term studies of posterior composite restorations and reported median annual failure rates of 1–3%, with most failures driven by secondary decay or fracture rather than material breakdown. In practical terms: a well-placed composite filling in a healthy mouth commonly lasts 7–15 years, with longevity strongly tied to the patient's caries risk and bite forces.
Will my filling stain?
Composite picks up surface stain over years from coffee, tea, red wine and tobacco, far slower than natural tooth enamel does. Polishing at hygiene visits restores most of the original colour. The bond margin between the filling and the tooth can pick up colour over many years; if it becomes visible, the filling is replaced rather than re-stained.
Can I eat right after my filling?
Yes, composite is fully cured the moment the curing light is removed. Wait until the local anaesthetic wears off (1–3 hours) so you do not bite your cheek or tongue. Avoid very hard or sticky foods on a freshly placed filling for the first 24 hours.
Why does my filling hurt after a few days?
Mild thermal sensitivity for 1–2 weeks is normal and self-resolving. Persistent throbbing pain, biting pain or pain that wakes you at night suggests the cavity may have been deeper than it appeared, or the bite needs a small adjustment. We see you back at no charge to investigate.
Should I replace my old amalgam fillings?
Not unless they are failing. Sound, well-sealed amalgam restorations do not need replacement; replacing them removes additional healthy tooth structure and creates exposure during removal. Where amalgam is failing, fractured, or aesthetically unacceptable, we replace with composite using IAOMT-protocol safe removal.
Cost difference small versus large filling?
The fee depends on cavity size (small, moderate, large), surface count, and whether a cosmetic Class IV or tooth-gap closure is involved. Very large cavities step up to an Emax porcelain inlay or onlay, more durable than a giant composite. After your free consultation we provide a written quote. For published rates, see the full pricing index. See also our dental crowns page for full-coverage options.
What is IAOMT protocol for amalgam removal?
IAOMT (International Academy of Oral Medicine and Toxicology) safe amalgam removal protocol uses rubber dam isolation, high-volume suction, copious water cooling, an external oxygen supply for the patient, and a final mucosal rinse, designed to minimise mercury vapour exposure during removal. Picasso applies this protocol on every amalgam removal.
Do you fill front-tooth gaps with composite?
Yes, direct composite bonding closes a single small gap (diastema) in one visit. For larger gaps, multiple gaps, or cases where overall shape change is wanted, porcelain veneers or Invisalign produce a more stable, longer-lasting result.
Start Here
Fix the Cavity,
Save the Tooth.
Book a free consultation. We will examine the tooth, take any X-ray needed, and recommend the right restoration, composite, GIC, inlay or otherwise, quoted in writing before any drilling begins.