How Many Years Can a Composite Filling Last? How Should Materials Be Chosen?

How Many Years Can a Composite Filling Last? How Should Materials Be Chosen?

Direct answer in 60 words

The literature reports population survival, not an individual lifespan: an umbrella review found conventional composite survival above 90% at five years [F1]. Secondary caries and fracture are the main failure modes, and the size of the defect and patient risk matter more than the material alone [F2][F3].

Scope: This guide is specific to Taiwan's healthcare system (National Health Insurance and Taiwan's Medical Care Act). Restoration survival and material comparisons are based on international literature; system matters such as coverage, ways to verify charges, and disclosure duties apply only in Taiwan.

What this card covers (division of work within the card family)

Whether caries needs a restoration and how it is restored is addressed in another card; so is eating and brushing after a filling [F25]. This card deals only with two questions: how long restorations last in the literature, and the principles for material selection. For overlap with related cards, including caries removal and management of postoperative sensitivity, it cites the conclusion rather than restating it; see the internal links at the end [F25].

Why “how many years will it last?” has no single number

Clinical studies do not answer “this material lasts X years.” They report survival rate (the proportion of restorations not classified as failures at a stated follow-up point) and annual failure rate (AFR, the average proportion classified as failures each year) [F2][F11][F25]. Both are population statistics, not predictions for one tooth [F25].

• A 2026 umbrella review included 16 systematic reviews and meta-analyses published from 2012 to 2025, covering more than 15,000 restorations with follow-up from 6 to 120 months. In the included study populations, conventional composites had five-year survival above 90%, especially when multi-step adhesives were used. This is a study-population statistic, not an individual outcome [F1].
• The same review reported similar short- to medium-term performance for bulk-fill composites (failure rates below 7%), while long-term data remain limited. Ormocer-based composites had a clearly higher failure rate (12.1%), mainly from marginal degradation [F1].
• A review of 34 clinical studies from 1996–2011 with at least 5 years of follow-up found that 90% of the studies reported annual failure rates of 1% to 3% for Class I and II posterior composites; the observed value depended on tooth location, operator, socioeconomic circumstances, behavior, and other factors [F2].

Three conversions that cannot be made (this site’s reading framework, not a literature conclusion) [F25]:

1. A five-year survival rate cannot be multiplied or divided into “it will definitely fail after so many years.” A study follows people only to its stated endpoint.
2. Numbers from different studies cannot simply be compared: their definitions of failure, populations, and follow-up periods differ [F1][F2].
3. A research setting cannot be assumed to be the same as the clinic you attend. A 2026 Cochrane overview found that only about one tenth of the primary studies were conducted in general practice [F5]; a systematic review of anterior composites likewise identified treatment setting and number of operators as performance factors [F18].

Factors that affect longevity matter more than the material alone

This is the main point to take away: research has observed different outcomes for the same composite in different mouths [F3][F4].

• An individual-participant-data meta-analysis of 12 longitudinal studies with at least 5 years of follow-up included 2,816 posterior composite restorations (2,585 Class II and 231 Class I), of which 569 failed during observation. The main reasons were caries and fracture [F3]. Its regression analysis found a significantly higher risk of failure for people at high caries risk and for restorations involving more surfaces [F3].
• A practice-based retrospective study followed 306 posterior composite restorations in 44 adults for 10 to 18 years. Thirty percent failed, and 82% of failures occurred in patients with 1 or 2 risk factors; secondary caries was the main failure reason in the caries-risk group [F4]. Sex and age were not significant predictors, whereas risk status (p < .001), tooth type (p < .001), arch (p = .013), and pulpal vitality (p = .003) were all significantly associated with survival [F4].
• A 2012 review stated directly that material properties have a minor effect on longevity. The principal long-term failure mechanisms were secondary caries related to individual caries risk, and fracture related to the liner, material strength, and patient factors such as bruxism [F2].

So asking only “which material is more durable?” omits the other conditions repeatedly identified in the literature. Your caries risk, number of involved tooth surfaces, night-time grinding or clenching, and pulp status are all associated with survival outcomes in these studies [F2][F3][F4].

Choosing a material: start with the indication, not a durability ranking

Clinical guidelines do not rank materials. They match materials to clinical situations. The American Dental Association (ADA) 2023 restorative-treatment guideline issued 16 recommendations and good-practice statements; 12 address direct restorative materials by tooth location and involved surfaces. The panel made conditional recommendations for all included direct materials while prioritizing some in specified clinical situations [F10].

Composite resin (commonly called a white filling)

• The German S3 clinical-practice guideline states that composite is a viable option for direct restoration of Class I–V cavities and may also be used for cusp replacement and tooth-shape correction. In posterior teeth, it prefers direct composite over indirect composite inlays. For Class V cavities near the cervical area, use requires adequate contamination control and adhesive technique [F8]. This is wording from a German professional-society guideline in its own scope, not a treatment instruction for an individual tooth; a dentist must still assess your clinical circumstances [F8][F10].
• For bulk-fill versus layered composites, the 2026 Cochrane overview found moderate-certainty evidence that restoration-failure risk may not differ and was below 5% in both groups (RD 0.00, 95% CI −0.03 to 0.03; 7 studies, 511 restorations, 1–10 years) [F5].
• Composite performance is tied to how it is placed. Part 2 of the S3 guideline addresses isolation, adhesive systems, light polymerization, anatomically contoured sectional matrices, phosphoric-acid etching, and polishing [F9]. This is one reason the same material can have different outcomes in different conditions [F1][F9].
• On disadvantages, the literature records failure modes rather than something that must happen: secondary caries and fracture are the main modes [F2][F3]; in pediatric randomized trials, composite had a higher secondary-caries risk than amalgam [F6]; and ormocer materials primarily failed through marginal degradation [F1].

Dental amalgam (commonly called a silver filling)

• The current 2021 update of a Cochrane systematic review, searched through 2021-02-16, included 8 randomized trials. Its main meta-analysis combined two parallel-group trials: 1,645 composite and 1,365 amalgam restorations in 921 children [F6]. Low-certainty evidence in that pediatric population found composite failure risk nearly twice that of amalgam (RR 1.89, 95% CI 1.52 to 2.35) and a higher secondary-caries risk (RR 2.14, 95% CI 1.67 to 2.74), while restoration-fracture risk did not differ significantly (RR 0.87, 95% CI 0.46 to 1.64) [F6].
• Those figures need two qualifications. First, the main analysis was in children [F6]. Second, the 2026 Cochrane overview notes that the underlying studies began recruitment in the late 1990s, limiting transferability to current practice; their composite failure rate was almost 15%, higher than the approximately 5% in other contemporary composite reviews [F5]. The Cochrane review authors also noted important improvements in composite materials since those trials [F6].
• For larger defects, evidence is less clear. A 2025 systematic review and meta-analysis of complex direct restorations involving more than two surfaces included 15 randomized trials, but only 2 directly compared amalgam and composite. The pooled data showed a trend toward higher failure of multisurface composite restorations, but this was not statistically significant (p = 0.06); the authors judged the evidence low-quality and insufficient to establish superiority of either material [F7].
• In policy terms, the Minamata Convention recommends a phase-down of dental amalgam, and mercury-free direct materials are available [F5][F6]. The Cochrane review frames material choice as shared clinical decision-making subject to local directives and protocols [F6].

Glass ionomer and resin-modified glass ionomer (GIC/RMGIC)

• In the 2026 Cochrane overview, composite versus GIC may have little or no difference in failure risk (RD −0.07, 95% CI −0.17 to 0.04; 1 study, 60 restorations, 10 years). This is low-certainty evidence from a small sample, mostly Class I non-load-bearing occlusal restorations [F5].
• In the same overview, RMGIC may reduce failure risk more than conventional GIC for Class I (RD −0.19; 1 study, 50 restorations) and Class II (RD −0.71; 1 study, 38 restorations) restorations. Both results were low-certainty evidence from very small samples with 2 years of follow-up [F5].
• The umbrella review found lower survival for GIC materials, while retaining a role in high-caries-risk or moisture-challenged situations [F1].
• Atraumatic restorative treatment (ART), which principally uses glass ionomer, has separate statistics: survival for single-surface ART restorations in permanent posterior teeth was 87.1% (standard error ±3.2) over the first 3 years, and for multiple-surface restorations was 77% (±9.0) over the first 5 years. For primary posterior teeth, the corresponding figures were 94.3% (±1.5) for single-surface restorations over 2 years and 65.4% (±3.9) for multiple-surface restorations [F14]. Another meta-analysis found ART feasible in both field settings and conventional dental offices [F15]. These figures apply to ART and its research settings, not directly to the lifespan of an ordinary in-clinic GIC filling (this site’s reading note) [F25].

When a defect is larger: direct filling, inlay, or cusp-coverage restoration?

• A 2024 systematic review and meta-analysis included 5 randomized trials, 279 patients aged 28–81, and 627 restorations (323 direct and 304 indirect). Annual failure rates ranged from 0% to 15.5% for indirect restorations and from 0% to 5.4% for direct restorations. Meta-analysis found lower failure risk for direct restorations (RR 0.61, 95% CI 0.47 to 0.79), but evidence was very low certainty and every included study had high risk of bias [F11]. Very-low-certainty evidence is not enough to establish a general advantage for either approach. The authors themselves concluded that both direct and indirect composite restorations can be recommended for single-tooth restoration of large Class II posterior cavities with cusp coverage [F11].
• For indirect restorations, materials also differ. A 2023 systematic review and meta-analysis of 12 studies and 946 restorations followed for 1–7 years found that indirect composite inlays had an 18% higher failure rate than gold inlays over 5–7 years (risk difference −0.18, 95% CI −0.27 to −0.09; the source describes this as 18% higher). Lithium disilicate and indirect composite had comparable short-term survival in medium-quality data. The authors also noted short observation, few eligible papers, and low sample sizes [F12].
• Should a root-canal-treated tooth receive a crown? The current Cochrane review, searched through 2015-03-26, included only 1 trial of 117 participants comparing a full crown with direct adhesive composite restoration. At 3 years, non-catastrophic failure did not clearly differ (1/54 versus 3/53; RR 0.33, 95% CI 0.04 to 3.05), with very-low-certainty evidence. The review concluded that evidence is insufficient and that decisions must consider individual circumstances and patient preferences [F13]. The retrospective study above also found pulpal vitality significantly associated with restoration survival (p = .003), reinforcing the need for an individual assessment [F4].

If the filling has a problem, should it be replaced or repaired?

• A 2022 systematic review and meta-analysis of 3 studies found no difference in failure risk between repair and replacement (RR 1.21, 95% CI 0.51–2.83; composite p = 0.97, amalgam p = 0.51), but risk of bias was high and certainty very low [F16]. The authors place repair within minimal-intervention practice and state that more studies are needed before firm conclusions can be drawn [F16].
• Why ask about this? A study of 1,337 decisions to replace existing restorations found that 70% of the recommendations increased the number of restored surfaces; the authors therefore suggested avoiding premature rerestoration [F17]. The 2012 review also identifies repair as a viable alternative that can extend restoration lifetime [F2].
• In plain language: in that study, most recommendations to replace a restoration increased the number of restored surfaces [F17]. Repair versus replacement is a clinical judgment; this card provides no self-assessment rule [F25].

Risk factors (conditions associated with shorter restoration life)

• Higher caries risk: Failure risk was significantly higher in high-caries-risk individuals [F3], and secondary caries was the main failure cause in a caries-risk population [F4].
• More involved tooth surfaces: More restored surfaces were associated with significantly higher failure risk [F3]; evidence for complex multisurface restorations is itself thinner [F7].
• Occlusal load (grinding or clenching): Fracture is associated with the liner, material strength, and patient factors such as bruxism [F2].
• Pulp status and tooth location: Pulpal vitality, tooth type, and arch significantly affected survival [F4]. Evidence on restoration after root-canal treatment is insufficient and needs individual assessment [F13].
• Sites where moisture and contamination control are difficult: Class V cavities require adequate contamination control and adhesive technique for composite [F8]; GIC materials retain a role in moisture-challenged situations [F1].
• Adhesion and placement procedures: Adhesive protocol is an important prognostic factor across materials [F1]; isolation, light polymerization, matrix use, and polishing are all part of guideline recommendations [F9].

Risk disclosure: Dental restoration and the various filling and prosthetic materials have their own indications, limitations, and possible adverse effects. The literature records postoperative pain and discomfort (about 5% in both composite and amalgam groups in one review, rated very-low-certainty evidence) [F5], secondary caries [F3][F6], chipping and fracture of the restoration or tooth [F7][F11], and marginal degradation [F1]. Whether any of these applies to you must be assessed by a dentist; treatment and outcomes vary between individuals [F10][F13].

Charges and system information: no prices here, only how to check (Taiwan)

• Under Article 51 of Taiwan’s National Health Insurance Act, dentures, artificial eyes, spectacles, hearing aids, wheelchairs, crutches, and other non-actively therapeutic devices are excluded from insurance benefits [F19]. Whether a particular material or procedure is covered depends on current National Health Insurance Administration notices and the provider’s claim item; this card makes no coverage determination.
• There are two ways to verify self-pay items: the medical-fee standards approved by the health authority in each city or county (for example, the government open-data dataset “Taipei City Medical Fee Standards,” provided by the Taipei City Department of Health) [F22], and a written itemized charge statement from the provider that identifies the material, scope, and possible additional items. Under Article 22 of Taiwan’s Medical Care Act, a medical institution must issue a receipt stating charged items and amounts and may not violate fee standards, overcharge, or create unauthorized charge items [F26].
• One common misleading route should be excluded: dental self-pay items cannot be found through the National Health Insurance Administration’s Medical Device Price Comparison Website, because neither of its two category tracks includes dentistry [F23]. Content presenting that site as a dental price-checking channel can be disregarded.
• If the plan extends to an inlay, cusp-coverage restoration, or crown, the cost structure differs from that of a direct filling. A separate card explains how to read those estimates; see the internal links below [F25].

Before your appointment: 7 questions to ask

1. How large is the defect in this tooth, and how many surfaces are involved? How does that affect your material choice? [F3][F10]
2. Do you assess me as being at high caries risk? Are there signs of grinding or clenching? [F2][F3][F4]
3. Which material do you plan to use, and why is it appropriate for this tooth location? [F8][F10]
4. Has this tooth had root-canal treatment? Is enough tooth structure left to support a direct filling? [F4][F13]
5. If both direct filling and indirect restoration (inlay or cusp coverage) are feasible, what are the possible failure modes of each? [F11][F12]
6. If the margin has a problem later, would you repair it first or replace it completely, and what is the basis for that judgment? [F16][F17]
7. How are the charges calculated, what is included, and can you provide a receipt stating charged items and amounts? [F26] In addition, Article 81 of Taiwan’s Medical Care Act requires a medical institution to inform the patient or relevant representative about the condition, treatment plan, procedures, medication, prognosis, and possible adverse effects [F20].

How to find a clinic that provides this service

This site lists no clinics and does not recommend, rate or compare any medical institution.

To find a clinic that provides this service, use the following official lookup channels yourself —

they are maintained by the competent authorities and are more current than any list:

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- The Ministry of Health and Welfare's medical-institution lookup: search by city or county,

township and specialty (dentistry) for institutions that have completed practice registration.

The results show the institution's name, address and registered specialty. This is the first place

to confirm whether a clinic is lawfully registered.

- The National Health Insurance Administration's contracted-institution lookup: check whether a

clinic is under contract with National Health Insurance. This determines which items are covered

and which are self-paid, and therefore what kind of fee explanation you will be given.

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Both systems are on the respective authorities' official websites; searching for the

medical-institution lookup or the contracted-institution lookup will find them. This site does not

reproduce the URLs, because they change; use whichever entry point the authority currently publishes.

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In an emergency, do not spend time looking up lists. If your breathing, swallowing or speech is

affected, or swelling is spreading, go to the nearest emergency department.

Chinese labels to look for on the official pages

These official systems, datasets and files are published in Chinese only. The English names above are this site's renderings; on the page itself you will see the following strings, so search for these:

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- 「醫事機構查詢」

- 「特約醫事機構查詢」

- 「特約院所查詢」

Compliance note

This is health-education information. Under Article 87 of Taiwan’s Medical Care Act, publication of medical knowledge or research reports and patient health education that does not solicit medical business is not medical advertising [F21]. This is not medical advertising and does not recommend any provider. Dental restoration and filling/prosthetic materials have risks and contraindications; treatment and outcomes vary between individuals and require a dentist’s assessment. The survival rates, annual failure rates, and risk ratios cited here are statistics for study populations; they cannot estimate the lifespan of any individual restoration or replace clinical diagnosis. This card recommends no brand, product, or clinic and gives no price.

Every clinical statement in this article is mapped line by line to its cited source (see the sources and evidence chain below). It has not been clinically reviewed by a licensed practitioner. This is health information, not individual advice; assessment by a clinician is required.