Little filling can cause lots of pain

I had a patient in the office this morning that was convinced a filling I placed about a month ago had come out. The reason she felt it had come out was that the tooth was sensitive to cold and biting and she had been completely avoiding chewing on that side of her mouth. I had my assistant take an xray of the tooth which showed a very small and shallow filling on an upper second molar. The filling was completely intact and no where near the nerve of the tooth.

I had a similar experience with a filling placed in a tooth in my mouth. Sometimes the small fillings give patients the biggest trouble. The reason is that the composite materials we use today are bonded to the tooth. The composite experiences a certain amount of shrinkage after it is light cured and bonded in place. The shrinkage of material is what causes the discomfort. Since the filling is so small and completely contained by walls of tooth structure, there is lots of tooth structure to pull against.

The solution is to place a temporary sedative filling that has eugenol in it. The eugenol is very soothing for the tooth and once the nerve endings calm down, a permanent filling can be placed again. When it happened to my tooth, the tooth felt better immediately after the sedative filling was placed and I had a permanent filling placed about a month later.

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com

Dental Digital Impressions

Do you remember having ortho as a kid and having impressions taken? Or perhaps you have had a crown done recently and had some goopy material placed in your mouth that took five minutes to set? Well there is a new wave in dentistry called chairside digital imaging that is eliminating the need for a standard dental material impression.

According to Gordon Christensen, a leading dental clinical researcher, the top effective chairside systems are:
Cerec AC by Sirona Dental Systems, www.sirona.com
E4D byD4D Technologies, www.d4dtech.com
i-Tero by Cadent,Inc., www.cadentitero.com
Lava COS by 3M ESPE, www.3mespe.com

I have had the Lava COS digital impression machine in my office since February of this year and I have been quite impressed with the results. The most impressive thing about the machine is the accuracy and fit of the crowns. I have little to no adjustment with a crown that was fabricated from a Lava COS impression. Also, the marginal fit (where the crown meets the tooth) is almost impossible to discern.

I particularly like the Lava COS technology because the impression is a real time video image that lets you know right away whether or not you have an accurate and complete impression. All of the other digital systems more of a still shoot camera technology where the images are combined to give the 3D information.

My patients like the technology because they don't have to suffer through having impression material in their mouths. In addition, on the day we cement the crown, they don't have to wait for adjustments to their new crown. I highly recommend the Lava COS machine!

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com