Sensitive Composite Fillings
Sensitive composite fillings were thought to be normal. It used to be said that there were two choices, mercury fillings that were ugly but didn’t hurt or tooth colored (composite) fillings that took time to get used to due to nerve adaptation. Years ago, dentists didn’t really understand dental anatomy or histology and treated fillings the same, no matter what material was used.
Mercury Fillings are not the same as Composite Fillings
Dentists that were trained in the ‘70’s were taught in a drastically different way than younger dentists. A patient may feel that an experienced dentist is a better choice, but that is only true if that dentist has kept up with the changes (and many have not). Mercury (amalgam) fillings are cheaper, quicker and relatively easier to place than composites. They are also much more aggressive to the teeth, as the metal filling needs a minimum thickness or else the filling will break. They also do not bond to the tooth, so undercuts in the teeth are created so that after the material is hardened or set, the filling won’t fall out. In the short term this is fine, but over time this leads to tooth fracture.
Proper Technique Means Less Sensitive Composite Fillings
A well done composite filling, when all steps are properly performed, leads to very few sensitive composite fillings. This is key. Proper tooth isolation, for moisture control, is the first step. This is with a rubber dam or Isolite/Isodry (bite block attached to suction) or similar process gives the proper working area. Tooth conditioning, usually with a mild acid, should be done but not OVER done (acid on the tooth too long can be damaging). Bonding agent properly primed and placed and correct layering of the composite material all contribute to less risk of a sensitive composite filling.
Sensitivity May Mean More
If all steps were properly followed and pain or sensitivity remains, it is possible more was initially needed. This doesn’t mean something was done wrong or poorly, but may mean something like a nerve was needing treatment. This is like if a band-aid was placed over a knife wound, it simply wasn’t enough. Proper diagnosis is often difficult, but one would normally want a dentist to try a cheaper and less invasive treatment before the more expensive and challenging one. Root canal therapy and a crown may be the more proper treatment instead of a filling.
