In brief: Class V fillings repair decay or wear at the gum line, on the cheek-side or tongue-side of a tooth. Class VI fillings repair worn, chipped or fractured cusp tips and biting edges. Both are usually done with tooth-coloured composite or glass ionomer, and the filling only lasts if the cause (decay, hard brushing, acid or grinding) is also dealt with.
What Is a Class 5 Filling?
A Class 5 filling (Class V in the G.V. Black system) repairs a cavity or worn notch in the third of the tooth next to the gum, on the cheek, lip or tongue side. It can be needed on front or back teeth. At Dazzle it is done in tooth-coloured composite or glass ionomer, because we place mercury-free fillings only.
What Class V and Class VI Mean
Dentists still use the G.V. Black classification to describe where a cavity sits. Class V covers the gingival third of a tooth: the strip next to the gum line on the outer (cheek or lip) or inner (tongue or palate) surface. It can affect front teeth and back teeth alike.
Class VI was added later for damage on the cusp tips of back teeth and the incisal (biting) edges of front teeth. These are the highest points of the tooth, where enamel takes direct chewing load and wears first.
Why Teeth Break Down at the Gum Line (Class V)
Enamel tapers to its thinnest point at the neck of the tooth, where the crown meets the root. Once gums recede, the root surface is exposed. It is covered by a thin layer of cementum over dentine, both softer than enamel, so it decays and wears faster. The common causes are:
- Root caries: plaque left along the gum line produces acid that decays the exposed root. Risk rises with age, gum recession, dry mouth (from medicines, diabetes or mouth breathing) and frequent sugary snacks.
- Abrasion: brushing hard, sideways, with a hard-bristled brush or an abrasive powder wears a notch into the tooth near the gum.
- Erosion: frequent acidic drinks and foods (colas, citrus, vinegar, sour pickles) or acid reflux soften enamel and dentine chemically.
- Abfraction: heavy biting or grinding flexes the tooth, and the stress is thought to concentrate at the neck, helping to form wedge-shaped notches.
- Plaque traps: an old filling or crown with a rough or open edge near the gum collects plaque and starts new decay.
Decay or wear: telling them apart
Dentists split gum-line lesions into carious (decay) and non-carious (wear) types. Brushing notches are usually smooth, hard and shiny. Erosion tends to be broad and shallow. Decay is usually brown or chalky and feels soft when the dentist checks it with a probe.
The difference changes the plan. Decay needs plaque, sugar and saliva problems addressed, often with fluoride. Wear needs a softer brush and better technique, less acid, or a nightguard.
Why Cusp Tips and Biting Edges Wear Down (Class VI)
Class VI damage is mostly mechanical. Attrition is tooth-on-tooth wear from grinding or clenching (bruxism), often at night and often unnoticed. It flattens canines, shortens front teeth and leaves shiny flat facets on the molars at the back.
Erosion makes this worse: acid-softened enamel wears much faster under the same bite. A typical sign is "cupping", small craters on the cusp tips where the enamel has worn through to the softer dentine underneath. Once dentine is exposed, wear speeds up.
Abrasion from habits also wears edges in specific spots: nail-biting, holding pins or hair clips in the teeth, biting thread, or chewing ice and nut shells.
Cusps and edges damaged by trauma
A fall, a sports injury or biting unexpectedly on something hard can snap off a cusp tip or the corner of a front tooth. The dentist checks the tooth clinically and with an X-ray first. A chip limited to enamel and outer dentine can usually be rebuilt with composite. A fracture that reaches close to the nerve may need a root canal treatment assessment before it is restored.
Signs to Look For
- Sharp sensitivity to cold, sweet, air or brushing at the gum line.
- A notch, groove or rough step you can feel with a fingernail near the gum.
- Brown, black or chalky white areas at the neck of the tooth.
- Front teeth that look shorter, thin or see-through at the edges, or canines that have lost their point.
- Small craters on molar cusps, chipped edges, or a bite that feels different.
Not every notch needs a filling straight away. Small, non-sensitive wear lesions may simply be monitored at each dental check-up while the cause is corrected. Treatment is usually advised when there is sensitivity, decay, a cusp at risk of breaking, or a change in the bite or appearance that bothers you.
Materials Used for Class V and VI Fillings
Dazzle places mercury-free fillings only. We do not place amalgam (silver) fillings.
Composite resin
Tooth-coloured composite bonds to enamel and dentine and can be shade-matched and polished to a high shine. It is the usual choice for visible front-tooth notches and for rebuilding worn edges and cusp tips, because it resists wear better than glass ionomer. A flowable composite is often used as the first layer at the gum edge because it adapts well to narrow notches.
Glass ionomer and resin-modified glass ionomer (RMGI)
Glass ionomer bonds chemically to the tooth and releases fluoride, which helps protect the margin from new decay. It tolerates the moist conditions near the gum better than composite. That makes it a common choice for root caries, patients with a high decay rate or dry mouth, and areas below the gum line. RMGI adds some strength and a better finish. Glass ionomers are weaker than composite and less suited to chewing surfaces.
Some dentists use a "sandwich": glass ionomer against the root surface with composite over it for appearance.
Ceramic onlays for larger cusp loss
When damage runs down the sides of a cusp or involves several cusps, a large composite build-up is weak and wears quickly. A ceramic onlay (lithium disilicate or zirconia) made from a digital scan covers the cusps and spreads the bite load. See fillings vs cuspal restorations for how that choice is made.
How the Filling Is Done
- Assessment: the dentist checks whether the lesion is decay, wear or both, and looks for the cause (brushing, diet, grinding, gum disease). X-rays may be taken.
- Numbing if needed: wear lesions often need little or no drilling. Decayed or deep areas are treated with local anaesthetic.
- Preparation: decay is removed; non-decayed notches and worn edges are just cleaned and lightly roughened so the material bonds.
- Isolation: the gum is kept dry with a retraction cord or rubber dam, because saliva and gum fluid weaken the bond.
- Placement: composite is built up in thin layers, each hardened with a curing light, or glass ionomer is placed and set.
- Finishing: the edges are smoothed flush with the root so plaque cannot collect, and the bite is checked with marking paper so a Class VI filling does not take a high spot.
Most single Class V or VI fillings are finished in one visit. Mild sensitivity for a few days afterwards is common. Our tooth-coloured fillings page covers the visit in more detail.
When a Filling Alone Is Not Enough
If the cause is grinding, new fillings on edges and at the gum line can chip or debond under the same forces. A hard acrylic nightguard worn while sleeping protects both natural teeth and restorations, and is usually advised once attrition is visible.
- Gum recession: where the gum has receded a lot, gum grafting can cover the root and may be combined with or replace a filling.
- Erosion: diet changes, reflux treatment and fluoride are needed, or wear will continue around the filling.
- Heavy wear across many teeth: when teeth have lost significant height, onlays, crowns or a planned full-mouth rehabilitation may be needed to rebuild the bite.
FAQs
Will the filling show?
On front teeth and premolars, shade-matched composite is usually hard to spot in normal conversation, and the gum often covers part of it. On back molars, glass ionomer may be chosen for its fluoride and moisture tolerance, where appearance matters less.
Why did my old gum-line filling fall out?
The usual reasons are saliva or gum fluid contaminating the bond during placement, ongoing brushing or grinding forces, and a cause that was never corrected. The dentist looks at why it failed before replacing it. Old fillings can often be repaired or replaced without removing more tooth.
Can a chipped front edge be fixed in one visit?
Usually, yes. Small and moderate chips are rebuilt with layered composite bonding in a single appointment. Larger breaks may need a veneer or crown.
How do I make these fillings last?
Brush gently with a soft brush and fluoride toothpaste, and skip abrasive tooth powders. Keep acidic drinks to mealtimes, rinse with water and wait about 30 minutes before brushing. Wear your nightguard if one was made, and have the edges checked at routine visits.
Noticing notches at the gum line or worn edges? Book a Consult at our Bandra West or Kemps Corner clinic.
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