Which dental filling is best for your tooth?

There is no single best filling, and any practice that tells you otherwise is selling something. The right material depends on four things: how large the defect is, which tooth it is in, how hard you load that tooth when you chew or grind, and how visible it is. For most cavities in Germany today the answer is a direct tooth-coloured composite filling (Komposit) — and since amalgam was banned across the EU in 2025, that is also what statutory health insurance covers as standard care, in back teeth just as in front teeth, with nothing for you to pay. Ceramic inlays and gold inlays are more hard-wearing and are worth considering for large defects in heavily loaded molars, but they are private services and cost you the difference. Once too little tooth is left, no filling is the right answer any more and a partial crown or crown protects better.

Patients usually arrive having researched materials. Dentists start somewhere else — with the hole.

How much tooth is missing? A small cavity on one surface and a defect that has swallowed half a chewing surface are not the same problem. Direct materials are shaped inside a tooth that still supports them. Once the walls are thin or a cusp has gone, the restoration has to hold the tooth together rather than merely fill it, and that is a job for something made outside the mouth and bonded in.

Which tooth is it? A molar carries the highest chewing forces in your mouth. An upper front tooth carries almost none, but everyone can see it. Different priorities, different answers.

How hard do you load it? People who grind or clench (Bruxismus) break restorations that would last decades in someone else. This is the factor most often left out of the conversation, and it changes the recommendation more than the brand of composite ever will.

How deep does it go, and where is the margin? A cavity whose edge sits below the gum line is difficult to keep dry, and adhesive materials need dryness. Sometimes the honest answer is that the margin has to be lifted or the design changed before any material is chosen.

Only after those four questions does the material list become useful.

How long each of these tends to serve is a subject in its own right, with more honest caveats than a table can hold: How long does a dental filling last? (EN).

If you are among the roughly 90 per cent of people in Germany with statutory health insurance (gesetzliche Krankenversicherung, GKV), this is the part that decides most of the practical choice, so here it is properly.

The GKV pays for treatment that is “sufficient, appropriate and economical”. For fillings that means: you are entitled to a technically sound restoration of the tooth as a benefit in kind (Sachleistung). You hand over your health insurance card (Gesundheitskarte/eGK), the practice bills the fund, and for a standard filling you pay nothing at the desk. There is no fixed subsidy system for fillings and no treatment and cost plan (Heil- und Kostenplan) to submit — that machinery belongs to crowns and dentures.

Tooth-coloured fillings have been standard care in the visible front teeth for many years. Nothing here has changed, and nothing is charged extra for a normal composite filling in a front tooth.

Molars and premolars used to be the amalgam teeth: amalgam was standard care, and if you wanted a white filling in a back tooth you paid the difference privately. Since the EU-wide ban on placing amalgam took effect in 2025, that arrangement is history. A tooth-coloured filling is now the standard filling in back teeth as well, and statutory health insurance covers it. In practice: a molar with a cavity gets a white filling, and as a statutory patient you pay nothing for it.

That is a genuinely better deal than the one many long-term residents remember, and it is worth knowing before you agree to anything described as an “upgrade”.

Extra costs arise when you choose something beyond standard care. The usual cases:

• a laboratory-made ceramic or gold inlay instead of a direct filling;
• an elaborate multi-layer aesthetic build-up in a visible tooth that goes beyond a normal restoration.

The mechanism is called an extra-cost agreement (Mehrkostenvereinbarung), and three points matter:

1. It must be in writing and signed before treatment. Not afterwards, not verbally. 2. The fund’s share is not lost. The insurance pays what a standard filling would have cost, and that amount is deducted; you pay the difference, not the whole thing. 3. Nobody may make it a condition of treatment. You are always entitled to the standard, covered option. If you decline the upgrade, you still get a proper filling.

The bonus booklet (Bonusheft) raises your fixed subsidy for crowns and dentures. It has no effect on what a filling costs you. Keep it stamped regardless — for future dentures it is worth real money.

The hardship provision (Härtefallregelung) likewise belongs to the denture system, where it lifts the subsidy for people on low incomes. For a standard filling it does not arise, because there is no co-payment to relieve in the first place.

If you have private health insurance (private Krankenversicherung, PKV) or supplementary dental cover (Zahnzusatzversicherung), the logic is different again: treatment is billed under the dentists’ fee schedule (GOZ) and your tariff determines the reimbursement, often in the range of 50 to 90 per cent depending on the policy. Ask your insurer before, not after — and get the practice’s cost estimate in writing.

The whole cost question, including what drives the price of private options, is covered here: What does a filling cost? (EN) and here: Does the statutory fund pay for fillings? (EN).

A rough guide, with the honest caveat that a mouth cannot be assessed through a screen:

A small to medium cavity in any tooth. Direct composite. Covered, one appointment, tooth-preserving, repairable.

A cavity in a visible front tooth. Composite, layered for shade. Where the tooth is badly broken down, a veneer or crown enters the conversation — but that is a different decision.

A large defect in a molar, walls still solid. Composite is defensible and covered. A ceramic inlay wears better and holds its colour longer; whether that is worth the private difference depends on your priorities and how heavily you load the tooth.

A large defect with a thin or missing cusp. Do not fill it. A partial crown, inlay or crown that covers the weakened cusp protects against the fracture that would otherwise turn a restorable tooth into an extraction. Where the line runs: Filling or crown? When each solution makes sense (EN).

A heavy grinder. Bruxism argues for hard-wearing materials — and, more importantly, for a night guard (Knirscherschiene). Without one, the restoration will keep losing.

A cavity at an exposed root surface. Glass ionomer or a hybrid material often serves better here than composite, because the area is hard to keep dry and the fluoride release is useful.

A tooth after root canal treatment. Back teeth in particular are prone to fracture afterwards and are usually better protected by a partial crown or crown than by a large filling.

You should not have to choose blind. In our practice that means: an examination, an X-ray where it is needed, a look under the microscope, and then a plain explanation of what we found, what is covered, what is not, and what each option would mean for that specific tooth. Anything private is quoted in writing before we start, and the covered alternative is always on the table alongside it. If you want to think it over, or get a second opinion, that is entirely reasonable — a filling that can wait a week can wait a week. Instalment payment (Ratenzahlung) is possible for larger private work, subject to a credit decision. How we work day to day: Fillings and caries treatment – service page (EN).

Children and teenagers. Baby teeth are restored with materials chosen for speed and fluoride release rather than maximum longevity — the tooth has a limited lifespan by design. Newly erupted permanent molars often benefit more from a sealant and prevention than from a filling; ask about it.

Pregnancy. Fillings can be placed during pregnancy and untreated decay is the greater risk. The second trimester is usually the easiest window. Non-urgent removal of old amalgam is generally deferred.

Allergies and material sensitivities. Documented allergy to a dental material changes the choice, and in some cases makes an otherwise private alternative medically necessary. Bring an allergy passport (Allergiepass) if you have one.

Anxious patients. If fear is what has kept you away, say so when you book. We work with local anaesthetic as standard and offer sedation and laughing gas (Lachgas), and we plan longer appointments rather than rushing.

New to Germany, or your German is limited. This is the article’s most practical point. The one document you may be asked to sign at a dental appointment — the Mehrkostenvereinbarung — is precisely the one you must understand, because it is what converts a covered treatment into a bill. Never sign it without a clear explanation of what the covered alternative would be. We explain options and costs in English before anything is signed, and our team also works in German, Russian, Turkish, Ukrainian, Arabic, Kurdish and French. If you are still searching for a practice on that basis: English-Speaking Dentist in NRW. Patients from Wuppertal, Solingen, Remscheid and the surrounding NRW towns reach us easily; for routine care, nobody should be travelling further than that.