Filling problem

oliveoyl

In May I had a broken amalgam filling in a molar replaced with a white one... ever since then I haven't been able to eat properly with it (can chew soft foods but anything hard is painful) and it is super sensitive to cold (even a sharp intake of breath can make me wince a bit). I went back to see the dentist after 2 weeks and she told me that white fillings can sometimes take a while to settle down... well it didn't settle down so I went back a couple of months later... she then told me that the white fillings can sometimes be very sensitive... she painted something called Duraphat on the tooth telling me that it should help but didn't offer any further advice. The Duraphat did seem to calm it down a bit but didn't last very long.

Has anybody had anything similar? I'm thinking about going back and asking for them to replace it with amalgam unless anyone has any better suggestions.

Toothsmith

White fillings are very 'technique sensitive'. If they're not done with time and care, they can easily give problems afterwards.

It's very very difficult to do bigger white fillings well.

I think you need to keep going back until it's either better or replaced.

oliveoyl

It just took the same amount of time as a normal filling... a few minutes. I'll give them a ring tomorrow and make another appointment.

Thanks for your reply.

melanie_frontage

Toothsmith wrote: »

White fillings are very 'technique sensitive'. If they're not done with time and care, they can easily give problems afterwards.

It's very very difficult to do bigger white fillings well.

I'm interested to know the reason for this, could you explain further please?

jugglebug

melanie_frontage wrote: »

I'm interested to know the reason for this, could you explain further please?

Lots of reasons.
The bonding resins used to seal the filling to the tooth are very sensitive to contamination by saliva whilst they are setting. Even a moments contamination will ruin the bond
The bond strength to enamel is far stronger than to dentine so if the tooth has lost all its enamel on one or more borders then a weak link exists
The filling materials shrink as they are placed, so need to be placed in small increments to reduce this effect. Essentially bit placed, set, shrinks, new bit placed and repeat
The filling materials are light activated and so if placed too thickly the deeper portions wont set as well as the light doesn't penetrate fully
If the the stresses caused by the shrinking can cause the walls of the cavity to be pulled inwards, or the bond to fail on one wall. A failed bond is on the microscopic level so invisible to the dentist at the time. The cuspal flexure similarly so. The flexure can possibly relax over time so the symptoms go away the bond wont suddenly reseal though.

This is why it bugs me when anti amalgam articles in the media present it as a simple "get your fillings changed for white ones" as they are not like for like. Whole different material that needs to be handled differently.
Amalgam is not as sensitive to moisture, doesnt rely on a bond (but can be bonded)
2 Different animals entirely

melanie_frontage

jugglebug wrote: »

Lots of reasons.
The bonding resins used to seal the filling to the tooth are very sensitive to contamination by saliva whilst they are setting. Even a moments contamination will ruin the bond
The bond strength to enamel is far stronger than to dentine so if the tooth has lost all its enamel on one or more borders then a weak link exists
The filling materials shrink as they are placed, so need to be placed in small increments to reduce this effect. Essentially bit placed, set, shrinks, new bit placed and repeat
The filling materials are light activated and so if placed too thickly the deeper portions wont set as well as the light doesn't penetrate fully
If the the stresses caused by the shrinking can cause the walls of the cavity to be pulled inwards, or the bond to fail on one wall. A failed bond is on the microscopic level so invisible to the dentist at the time. The cuspal flexure similarly so. The flexure can possibly relax over time so the symptoms go away the bond wont suddenly reseal though.

This is why it bugs me when anti amalgam articles in the media present it as a simple "get your fillings changed for white ones" as they are not like for like. Whole different material that needs to be handled differently.
Amalgam is not as sensitive to moisture, doesnt rely on a bond (but can be bonded)
2 Different animals entirely

That's very interesting. I have recently had some teeth splinted to stabilise them after laser gum treatment and there is one very tiny area of sensitivity which is not really bothering me much but would appear to be explained by your post. I don't know what the material was that was used, it wasn't ordinary filling material but a light was used to set it.

Toothsmith

That's a completely different thing to white fillings.

Many things in dentistry are light cured now.

If you've had gum surgery, then the sensitivity is likely to be from newly exposed bits of root caused by the gum shrinking back a bit as it heals and tightens.