Sensitive composite fillings

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Dr Mark Hassed

I was in yet another dental practice recently where sensitive composite fillings were an issue.

Patients were regularly coming back after having fillings done complaining of pain on biting or sensitivity to cold or both.

This is such a lose/lose situation. The patients are rightly annoyed with many of them saying: “It didn’t hurt before you did the filling.”

The practice loses because of the waste of time and also the bad PR that this situation creates.

In some cases the patients have developed irreversible pulpitis and will require endodontics. Disastrous!

I don’t feel that it is my place to lecture anybody about clinical dentistry but this problem has such an easy solution.

1. Use SE bond for any filling that goes onto the occlusal of a back tooth.

2. Cover the base of the cavity with flowable composite prior to placing the regular composite.

One other comment on this situation.

This practice has been putting up with this situation for years. It would be so much better to identify the problem, work out a solution and implement it.

What problems have you been tolerating for years in your practice?

2 thoughts on “Sensitive composite fillings

    DR JEREMY ROURKE said:
    February 13, 2013 at 7:33 am

    Bond is bonding agent AND solvent – like oil and water, they sperate given time. You need to have nurses give bond a good shake for fully 2 minutes every morning AND for 30 seconds before every application. Also thin layers of restorative material and avoid the “C” form packing – just try to fill against one or two surfaces but NEVER three – the ‘C” form

    Dr. Desmond Yiu said:
    February 20, 2013 at 8:03 pm

    Another precaution when using self-etching primer is not to over-dry the dentine before placing the primer, leaving it mildly damp. However, once the primer has been placed on the tooth, it is essential to fully evaporate the solvent within the primer (usually water or ethanol) before placing the bond. Modern bonding agents are very effective as long as one is mindful of the underlying chemistry!

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