Aim: Aim of this study was to evaluate the long-term performance of teeth after direct restorations in general dental practices. Methods: Claims data from a national health insurance company was used to trace re-interventions after direct restorations on a day-count basis. All teeth with direct restorations placed from 2010 till 2024 entered the analysis. A Kaplan-Meier-Survival-Analysis evaluated the time without re-intervention. A new direct restoration affecting the respective tooth (1), a crown or partial crown on the same tooth (2) or the extraction of the respective tooth (3) counted as target events. Differences in survival rates between different restoration sizes were tested for significance using the Log-Rank-test. Results: A number of 47.379.138 direct restorations placed within 8.668.014 patients were observed. At five years, 68 % of the related teeth showed no re-intervention while at ten years, more than 50 % were free of any re-interventions. About 40% of the respective teeth required no re-intervention after 15 years. At 10 years, two-surface restorations showed the highest survival rates when compared with one-surface, three-surface, and four-or-more-surface restorations. The differences were statistically significant (P<0.0001). A new filling on the respective tooth was by far the most prevalent re-intervention. Conclusions: Direct restorations showed an acceptable performance for up to 15 years. Teeth with very large restorations tend to have a significant shorter time without re-intervention.