Dr. Hall, I recently had a small composite filling done on tooth 14 [upper left first molar] and am experiencing the exact symptoms you describe as:
“With composite fillings, there is an unusual kind of sensitivity that sometimes occurs. With this sensitivity, the tooth is not sensitive when you clench your teeth together but will experience a sharp pain when food is chewed. . . . Curiously, it tends to occur most often in smaller fillings. When it occurs, replacing the filling with another composite filling can eliminate the sensitivity.”
My question is, can you point me towards any documentation or research concerning this unusual sensitivity? My dentist has checked for a cracked tooth, adjusted my bite twice and yet my extreme sharp sensitivity to chewing food still exists. He states he sees 5 or 6 patients a year with this type of sensitivity (all in small fillings he claims) but still insists that my bite is off and is suggesting a crown/root canal if the pain does not go away. I have searched the internet for more information about this unusual sensitivity but have not found much other than your website. When I suggested he redo the filling, he stated composite material bonds excellent and that could not be the cause. Can you help provide me with more information or a piece of your own knowledge regarding this?
Thanks for you time.
Matthew from Arkansas
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Do a root canal and a crown? You have to be kidding me! When all you need is a small composite filling?
You’re asking me about documentation for this. I’m guessing that what you want to do is take that documentation to your dentist and convince him that replacing the filling is the way to solve this. The problem is I have never seen this approach work where the patient tries to become the teacher. Plus, you already have documentation on this sensitivity—my web page you reference that explains tooth sensitivity after a composite filling. The page should have pretty good credibility with you and your dentist because it nails your problem exactly—small composite filling, pain when you chew, no pain when you bite, the bite adjustment didn’t solve it, checking for a cracked tooth doesn’t turn up anything. What more does your dentist need? Look up my CV and check my credentials. Not only have I heard other lecturers talk about this, I had a fair amount of experience with this. Replacing the filling does work, as I did that every time I saw this sensitivity and it worked every time.
The problem may actually be that your dentist doesn’t WANT to replace the filling. What he appears to want is to do a root canal and a crown. The crown and root canal will likely be near $2000, but he’d have to replace the filling for free. He’s leaving me wondering if that isn’t what he’s really concerned about.
No, I don’t think you’re going to persuade your dentist, no matter what you do. I think you need to get a little assertive with him. Here’s what I recommend doing: Take a printed copy of my web page (assuming he hasn’t seen it yet), and maybe a copy of my CV (you can find that on our infinitydentalweb.com website). Show that to him and then tell him you and he can fix this one of two ways. Either he can replace the filling himself, putting in a glass ionomer base that completely covers the dentin before the tooth is etched (that’s the best guarantee for eliminating the sensitivity). Or, if he won’t do that, you’ll go to another dentist to have that done, which will solve the problem and prove him wrong. And then you will demand that he pay for it or you will report him to the dental board and take your complaint public on Yelp or Google reviews.
And I’d love to know how this turns out.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.