New tooth-colored fillings sensitive? They should not be!

When most people think of “bonding,” they are thinking of tooth-colored dental fillings, or composite fillings.  To be completely technical for a moment (I try to avoid that as much as possible to not bore you 😉 ), “bonding” is actually the series of steps and the products we dentists use to make the tooth-colored fillings actually STICK to the teeth.  OK – technical moment is over.  Whew, aren’t you glad of that?

An issue that many patients have experienced in the past, is that their new tooth-colored fillings seem to be mildly or even extremely sensitive to cold, and sometimes hot, foods and drinks, even just to tapping your teeth together.  Naturally, it’s not a fun experience, and one that all conscientious dentists try to avoid for their patients, but even in 2009, when one would imagine there is a solution, many patients still run into this problem.  Here’s the thing, though……..THERE IS A SOLUTION!

OK, you’re probably asking, if there’s a solution, why is it still a problem?  Well, it’s simply a matter of technique, really, and getting the technique for bonding is actually more difficult than it might seem to be.  In addition, just as in the rest of the world, there are MANY bonding products that dentists can use when doing tooth-colored fillings, but just because the companies that produce them supposedly have research behind these products, they’re not all they’re always promised to be.  Some work better than others in strength, sensitivity, durability…..and it can honestly be rather tough to sort through all the stuff that companies throw at us, just like for physicians with all the stuff pharmaceutical companies throw at them.  So it is CRITICAL that dentists really stay up on the latest research, but here’s the thing…..just because something has the “latest and greatest, newest and most improved,” labels all over it, that doesn’t mean it actually works as well as the old stuff all the time.

There’s one other REALLY CRITICAL FACTOR for long-term success of composite fillings, and that is keeping the teeth DRY while the bonding is placed and activated, then the filling material is layered into the tooth. Saliva contamination is one of the most common reasons for bonded fillings to be sensitive, and it’s also one of the most common reasons bonded composite fillings fail earlier than they should.  There are a couple techniques dentists can and SHOULD use to do this – a Rubber Dam or something like the Isolite2 Dryfield Illuminator system.  Both are pretty inexpensive for the dentist to have (we have both and use them as appropriate), both are pretty easy to use, and to tell the honest truth, they actually make it EASIER for us to complete your dental work faster and with better results.  I really don’t know why not all dentists use 1 or the other; I can’t imagine practicing without them, ’cause it’s a lot harder to get good fillings!

So there you go: 2 of the most common reasons why bonded, tooth-colored, composite fillings are often sensitive to hot and cold foods/liquids or even just tapping your teeth together.

The good news in our office?  I’m fortunate to actually know the man who basically INVENTED bonding, and I not only use the techniques he teaches, but I even use the most current materials that he himself has developed and/or recommends, and I can honestly say that ALMOST NOONE who gets tooth-colored fillings in my office ever has hot/cold sensitivity afterwards.  There are rare exceptions, ’cause I’m not going to claim perfection, but they’re quite rare indeed.

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Treating Gum Disease with a Laser – Effective, Comfortable, and No Scalpel or Stitches!

I’ve been really updating my website to reflect the exciting new technologies that we’re implementing here at Smiles by Payet Dentistry in Charlotte, NC, so I wanted to let people know about that here so they can be updated: Laser Treatment for Gum Disease in Charlotte NC.  In addition, now you can visit our website devoted strictly to Periodontal (Gum) Disease Treatment with LANAP.

Cracked teeth – Act early

One of the most common reasons that patients come to us for dental emergencies is cracked and broken teeth.  For some reason, this always seems to happen on weekends, when you’re out at dinner, or right after we’ve closed for a long weekend – go figure.  This is avoidable, though, if you act preventively.  Here’s the key, though, and this is one of the reasons we use digital photography so extensively to communicate with our patients — very often these teeth won’t hurt at all until they break.  Don’t ask me why – noone really knows.  But so often, what we’ll here is, “Doctor Payet, it never bothered me at all, and then last night I was chewing on a banana and a big chunk of the tooth just broke off!”

Many doctors still go by the philosophy of, “If it ain’t broke and it don’t hurt, leave it alone.”  The problem with that philosophy (in my humble opinion) is that when it finally does break, it will take more time, cost more money, and until it’s fixed is often pretty painful than if it had been treated before it broke.  If it’s a small crack, treat it with a nightguard and a filling.  If it’s a big crack, treat it with a nightguard and a crown.  But if it breaks, you might well need a nightguard, root canal, build-up filling, and a crown.  And all because the small crack wasn’t treated with a filling.

Research tells us that teeth with tooth-colored (composite resin) fillings crack  just as often as those with silver fillings.  My experience over 10 years, however, tells me that teeth with LARGE silver fillings crack much more frequently than with composite fillings.  But even the bonding process can’t stop a crack from forming if the stress isn’t relieved.  I’d like to show you some examples of what we often see:

It does seem that these cracks form around old fillings most of the time……..but they can even happen in teeth that have never had any work done.  All it takes is a lot of force (usually grinding and/or clenching your teeth) and enough time.  Here’s an example from a young man in his late 30’s who clenches his teeth so hard that he split this back molar completely in 1/2.  It had NEVER had any dental work, and in fact, it didn’t even have a cavity.  But he split it so far that it had to be extracted.  Obviously I recommended a nightguard to help him not do this to any other teeth!

So what’s my point?  Simply this: if you have been told that your tooth is cracked, at the VERY least, please make sure that you have a nightguard, because clenching and grinding of your teeth is the most common cause.  But also — get it treated BEFORE it breaks.  It’s less expensive and a lot less uncomfortable that way.   And you won’t have to worry about it breaking over that long weekend or holiday when we’re out of the office.