Sensitivity after a white composite filling

N

Natural_

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I had some 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.

I had small holes in the buccal surface of my 2nd molar on both sides and on my left side (where the smaller of the two holes was). That tooth is now extremely sensitive with some lingering sensitivity to hot/cold (never had this in that tooth AT ALL before the procedure) and is pretty much constantly throbbing a bit with some pain/discomfort. The fillings were composite.

I've made my finger cold with ice and explored a bit and it seems to just be the buccal side of the tooth that is sore/experiencing sensitivity. When I was biting into my dinner last night the heat was also really painful, which from my time here I have taken as a bad sign.

My plan was to avoid googling and looking around but since I can't get in I tried to find something here via searching that could ease my mind but it's looking more and more like I am going to end up with a root canal.

Is what I am experiencing normal? I've seen some sensitivity being normal but in all of the threads, I found it seemed like RCT 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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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

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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.

Lord it would be lovely if that's all that it is. I've got some big events coming up with work and hosting my wife's family and the timing of this is a nightmare.

Is there something in my description that leads you to believe this is the case and not something more sinister? There is some pain and discomfort even without hot/cold stimulus and it's hard to keep my mind off of it. The pain from the sensitivity is also pretty severe and lingers for a bit. The cold is almost unbearable.
 
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Additionally, I'm not feeling any discomfort really when chewing or putting pressure on the tooth (I'm a big gum chewer) so I suppose that must be a good sign?
 
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I froze a couple of damp cotton swabs last night and have been testing the area and it seems as though the only painful sensitivity on any of the filled teeth is just on the one and only on the one side. I can press the cold on the other side of the tooth and it just feels "normal" but if I put it on the buccal side where the composite filling is it hurts really bad and lingers.
 
Gordon

Gordon

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All this points to a bonding failure really, if it was heading for endo then you'd not have any cold sensitivity and it would be becoming tender to bite on.
 
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Went back to the dentist on wednesday, they seemed to think that the filling on the buccal side on the left 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 got sleep.

Pretty disappointed, the soreness gets worse as the day goes on and it is just uncomfortable.

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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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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