A Pressure sensitive teeth after filling is an annoying condition. Many of us have such cases.Now lets see why this occurs and how to solve it.There are many causes for it lets see it one by one and consider the treatments
NOTE- In this article we will consider the causes of sensitive teeth on biting only (Pressure Sensitive teeth ) and not for Hot and cold sensitive or continuous pain after filling.
Cause 1. Composite restoration cases- if there is a bubble entrapment at the bonding interface of composite and dentin it will cause sensitivity. This occurs because the bubble shrinks during biting and applies pressure.
Solution-Remove the restoration and replace it with corrected one,use Single bond agents which does not require separate etching and boning.
Cause2. Deep caries.Dentin is too thin to protect the underlying pulp.
Solution - After removal of caries apply a nice layer of Calcium Hydrroxide/Dycal and cover it with temporary restoration. Ask the patient not to bite heavy on the particular tooth and recall after 4 weeks. Ask about the symptoms.If not resolved then let it be there for 4 more weeks.If resolved then replace the temporary restoration with permanent one.
Cause 3. Pulp hyperemia or thermal trauma during cavity preparation.
Solution- Remove the restoration and replace it with ZOE filling ,Relieve the tooth from occlusion, Start any NSAID for three days Recall after 3 weeks ask about symptoms, if relieved then replace the ZOE with permanent restoration.
[Additional]-Check your bur and replace it if its worn out, check for water spray of your handpiece it should be directed on the bur, Don't apply pressure will tooth preparation.
Cause 4. High point on the restoration.
Solution- Take an Articulating paper,Check for the high point and clear them. Recall after 5 days. If patient still have pain relieve the tooth from occlusion and start any NSAID.
NOTE- In this article we will consider the causes of sensitive teeth on biting only (Pressure Sensitive teeth ) and not for Hot and cold sensitive or continuous pain after filling.
Solution-Remove the restoration and replace it with corrected one,use Single bond agents which does not require separate etching and boning.
Cause2. Deep caries.Dentin is too thin to protect the underlying pulp.
Solution - After removal of caries apply a nice layer of Calcium Hydrroxide/Dycal and cover it with temporary restoration. Ask the patient not to bite heavy on the particular tooth and recall after 4 weeks. Ask about the symptoms.If not resolved then let it be there for 4 more weeks.If resolved then replace the temporary restoration with permanent one.
Cause 3. Pulp hyperemia or thermal trauma during cavity preparation.
Solution- Remove the restoration and replace it with ZOE filling ,Relieve the tooth from occlusion, Start any NSAID for three days Recall after 3 weeks ask about symptoms, if relieved then replace the ZOE with permanent restoration.
[Additional]-Check your bur and replace it if its worn out, check for water spray of your handpiece it should be directed on the bur, Don't apply pressure will tooth preparation.
Cause 4. High point on the restoration.
Solution- Take an Articulating paper,Check for the high point and clear them. Recall after 5 days. If patient still have pain relieve the tooth from occlusion and start any NSAID.
ReplyDeleteThank you for sharing such helpful information. Keep up the good work guys!
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