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Sensitivity after a white composite filling

N

Natural_

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Sep 26, 2021
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31
Location
Austria
I had some composite fillings done 5 days ago and things were pretty sensitive for a couple of days but everything seems to have calmed down outside of one tooth which is getting worse and worse as time passes.

That tooth is now extremely sensitive with some lingering sensitivity to hot/cold and is pretty much constantly throbbing a bit with some pain.

I've made my finger cold with ice. When I was biting into my dinner last night the heat was also really painful.

Is what I am experiencing normal? I've seen some sensitivity being normal but in all of the threads, I found it seemed like root canal treatment is the final solution. I really don't want to kill off a tooth in my early 30s when I was feeling perfectly fine before I went in.
 
Gordon

Gordon

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Oct 25, 2005
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It's more likely to be a bonding failure between the composite and the tooth, it's been mentioned on here a fair few times.
 
N

Natural_

Member
Joined
Sep 26, 2021
Messages
31
Location
Austria
Went back to the dentist on wednesday, they seemed to think that the filling just needs more time. Pretty adamant about no need for RCT or endo stuff. Gave me a special toothpaste and something to put on the tooth before I go to sleep.

I asked about the bonding and they were just like, "No it's going to hurt for a while until the outside heals."

I'm not thrilled about remaining in pain until "it just gets better". Pretty much a nightmare situation for a health anxiety sufferer.
 
Gordon

Gordon

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Oct 25, 2005
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Hmm.
Long explanation time.

The inner part of the tooth (dentine) has little tubes running through it from the pulp (the "nerve") to the join with the outer part (enamel). These little tubes carry nerve fibres. These nerves are stupid, they only carry pain receptors, not hot/cold/sweet or anything else useful, just pain. If anything stimulates them then "pain" is sent back.

Composite fillings shrink slightly as they set. This is a pain, as they can leave microscopic gaps around them or under them. To avoid this happening dentists use a variety of chemical cements to "bond" the edges and underside of the composite to the tooth structure. These cements are incredibly technique sensitive, if they aren't done almost perfectly then the bonding doesn't work 100% reliably.

In a lot of patients, due to age/anatomical differences/whatever any slight failure of the bonding process isn't important. Their little tubes aren't affected. In others the bonding failure allows either stimulant to get into the tubes via the edges of the filling or under pressure from eating/biting the filling flexes slightly, causing a pumping effect on the tubes. Thanks to the dumb nerves, the patient gets a shot of pain...

Fixes:

  1. Sometimes the composite/cement simply hasn't been zapped long enough by the blue light we use to set them, or the bulb is on the way out or the end has got a bit of cement on it which is blocking light transmission. So just zap the whole thing again for a bit longer :)
  2. If the edge of the bond has failed, redoing the bond process can sort it by filling in any micro-gaps
  3. If the underside has failed, pretty much the only thing that will work is to redo the filling
  4. Leave it alone. Eventually, the pulp gets fed up with all the abuse and literally walls itself off from the area that's doing it. This can take a while and doesn't always happen.

Sounds like your dentist has gone for option 4.
 
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