Friday, September 25, 2009

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

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