The short answer
A filling (Füllung) that has come out is almost never an emergency, but it is not something to leave for months either. The tooth underneath is now open: the cavity it was sealing is exposed to bacteria, food and temperature, and decay progresses faster in an open tooth than in a sealed one. Rinse with lukewarm water, keep the area clean, chew on the other side, and book an appointment — within a few days if the tooth is sensitive or has a sharp edge, within a week or two if it feels fine. Do not try to glue anything back in. If the tooth throbs, hurts on biting, or the gum or cheek swells, that is a same-day matter, because the problem is then no longer the filling but what is happening under it.
What to do in the first hour
Rinse gently with lukewarm water. Not hot, not ice cold; a little salt is fine. The aim is to clear food debris out of the cavity.
Look, or feel with your tongue. Is the crater smooth-edged or is there a sharp ridge? Did a piece of the tooth break away with the filling? Both details are useful when you call the practice.
Keep the fragment, but do not expect it to go back. A filling is shaped and bonded inside the cavity and cannot be refitted like a lost crown. Bring it anyway if part of the tooth came with it.
Keep the cavity clean and chew on the other side. Brush gently and rinse after meals, because food left in an open cavity is what turns a manageable situation into a painful one. A tooth that has lost a large filling also has thin, unsupported walls, and biting hard on it is the classic way to turn a straightforward refill into a broken cusp that needs a crown.
Cover a sharp edge if it is cutting your tongue. Temporary filling material from a pharmacy (Apotheke), sold without prescription as provisorisches Füllmaterial, will do for a couple of days. Treat it as a plaster, not a repair — it does not seal the tooth and does not stop decay.
What not to do
Never use superglue or any household adhesive. They are not made for the mouth, they are toxic to the pulp, and they make the eventual repair harder. The same goes for a lost crown.
Do not put an aspirin tablet on the gum, and do not poke at the cavity with anything metal. The first can cause a chemical burn; the second damages the exposed dentine and pushes debris deeper.
Do not rely on temporary material for weeks. It is designed to hold for days; people who stretch it to a month usually arrive with decay that has grown underneath.
Do not wait for pain to make the decision. The absence of pain is not evidence that the tooth is fine — decay reaches surprising depth before the nerve says anything: Does tooth decay hurt? When it does and when it does not.
How quickly do you need to be seen?
| Your situation | How soon |
|---|---|
| No pain, small cavity, smooth edges | Within one to two weeks |
| Cold or sweet things now cause sharp twinges | Within a few days |
| A sharp edge is cutting your tongue or cheek | Within a few days |
| A piece of the tooth broke off with the filling | Within a few days |
| A front tooth, where it shows | Within a few days |
| Pain on biting, or throbbing of its own accord | The same day, or the next |
| Swelling of gum, cheek or jaw, or fever | The same day — out-of-hours service if needed |
| A temporary filling or temporary crown came off mid-treatment | Call the practice the same day |
The middle rows are the ones people underestimate. A tooth that has become sensitive to cold since the filling came out is telling you dentine is now exposed — not dangerous in itself, but the clock is running.
Why fillings fall out
Fillings are repairs sitting in a warm, wet environment under a chewing load of several hundred newtons, thousands of times a day, so most eventually need replacing. The common reasons for a sudden loss:
New decay at the margin. By far the most frequent. Bacteria find the microscopic gap where filling meets tooth, work underneath and hollow out the support. The filling then comes out in one piece, often while eating something sticky, and the cavity underneath is bigger than the one originally filled.
Age and fatigue. Older fillings wear and develop fine cracks. There is no fixed expiry date — position, chewing load and oral hygiene matter far more than the year it was placed.
A large filling in a small remnant of tooth. The less original tooth remains, the less there is to hold the repair — which is why an inlay (Inlay) or a crown (Krone) enters the conversation when a filling has to be replaced for the second or third time.
Grinding and clenching. Bruxism (Bruxismus) applies forces the repair was never designed to absorb. If your filling failed and your jaw is tight in the mornings, the two facts are probably connected, and a night guard (Knirscherschiene) belongs in the discussion. Biting on ice, olive stones or crusty bread is usually the last straw rather than the cause.
What happens at the appointment
Expect the visit to answer one question first: how much tooth is left, and is the nerve involved. We clean out the cavity and remove the decay that has developed underneath — often more than the X-ray suggested, because decay spreads sideways along the junction between enamel and dentine — then test whether the nerve still responds normally.
From there, three routes are usual. With enough sound tooth left, you get a new tooth-coloured filling, generally in one appointment. If too much has gone for a direct filling to be stable, we discuss a partial crown, an inlay or a crown — this is where digital impressions with Primescan and our in-house master dental laboratory (Meisterlabor) come in. If the nerve is already inflamed or infected, a root canal treatment (Wurzelbehandlung) comes first. Which route applies is not something anyone can tell you over the phone, but you will be told before treatment begins.
What it costs and who pays
For statutorily insured patients the essentials are simple: treating decay and restoring the tooth with a tooth-coloured filling is standard care (Regelversorgung), and the fund covers it — in front teeth and back teeth alike. Since dental amalgam was banned across the EU on 1 January 2025, the covered material at the back is a self-adhesive tooth-coloured material — in exceptional cases a bulk-fill composite — so the fund no longer pays only for a grey filling there. A conventionally bonded composite in a back tooth remains an upgrade you agree to in writing beforehand.
Extra costs arise only if you choose something beyond that standard — a more elaborate layering technique or a laboratory-made inlay. Then you sign a written additional cost agreement (Mehrkostenvereinbarung) in advance and pay the difference: What a dental filling costs in Germany.
If your filling failed unusually early, one point is worth knowing: § 136a Abs. 4 SGB V gives you a two-year guarantee (Gewährleistung) on fillings — and, in the same provision, on dentures including crowns. Within those two years an identical or partial redo of the filling is not charged to you again. Defined exceptions exist, agreed between the dentists’ national association and the funds, so it is worth asking at the appointment rather than assuming it either way.
What is normal — and when to contact us
Swelling and fever override everything else here: an infection has spread beyond the tooth and needs treating the same day, if necessary through the dental out-of-hours service (Notdienst).
Special situations
It happened on a Friday evening or a public holiday. With no pain and no swelling, wait for the regular working week — an open cavity is not an out-of-hours case. With throbbing pain, swelling or bleeding, the out-of-hours service covers evenings, weekends and holidays; the duty practice for your area can be found online or through the nationwide patient service number 116 117.
A temporary crown (Provisorium) came off, not a filling. More urgent than it looks. The prepared tooth underneath is unprotected and neighbouring teeth can shift within days, which makes the finished crown fit worse. Call the practice looking after you the same day, and do not glue it back yourself.
Children. A filling lost from a milk tooth still needs looking at. Milk teeth hold the space for the permanent teeth behind them, and decay in one is not something to ride out until the tooth falls out by itself.
You are new to Germany. You need no referral and no prior registration — call any dental surgery directly. When you book, say that a filling has come out and whether the tooth hurts; that determines how quickly you are seen. We treat patients in English, and English-Speaking Dentist in NRW explains insurance, cards and appointments for people who have recently arrived.
No. Fillings are bonded or condensed into a prepared cavity and cannot be refitted. Household glues do not belong in the mouth, harm the nerve and complicate the repair. Temporary filling material from a pharmacy is fine as a cover for a few days, but it is a dressing, not a fix.
Days rather than weeks. An open cavity has exposed dentine and rough walls that trap plaque, so decay progresses faster than on a sealed surface. A week or two is usually manageable if the tooth is not sensitive; months is how a simple refill becomes a crown or a root canal treatment.
Yes. Pain is a late signal in dentistry, not an early one — decay can reach the deep dentine before the nerve reacts. A painless open cavity is the easiest situation to treat, which makes it the best moment to be seen rather than a reason to postpone.
Yes. A tooth-coloured filling as standard care is covered in both front and back teeth, and you pay nothing for it. You would only pay extra by choosing a more elaborate technique or a laboratory-made inlay, and that is agreed in writing beforehand.
Losing a filling is common, fixable and rarely dramatic. Treat it as a short deadline rather than an emergency: keep the tooth clean, chew elsewhere, resist the urge to repair it yourself, and get it seen within days if it is sensitive or sharp, within a week or two if it is not. And remember that the absence of pain says nothing about what is happening inside the tooth.
Zahnarztpraxis Tsypin · Wuppertal. This article was medically reviewed and is provided for information; it does not replace an examination. Updated August 2026.
