Recently I visited a new dentist for a regular cleaning & exam. After his temp hygienist noted “excellent overall oral hygiene” in my case, the doctor came in and pointed out some things which he identified as defects in my silver amalgam fillings, using a TV camera intra-orally. X-rays were taken but not discussed. He said one black mark was a crack, a black spot was a place where the edge of the filling had rolled away from the tooth surface and might lead to caries, etc. So the next day on his advice all three of them were drilled out and replaced with a whitish resin compound called bond. They look fine, and felt fine too before this visit.
The question is, is it normal for there to still be tenderness on chewing with them? (All three are on the left side.) They never hurt or ache when not in use, and they are occasionally sensitive to cold. It’s been just under four weeks since the procedure, and I still have to chew on the opposite side, although the intensity of tenderness with pressure on the fillings seems to be gradually lessening. I did go back two days afterward and have some “flash” (resin slopped over the edges) removed which was preventing flossing in one area. Another $5 copay for the office visit.
All told, fairly normal scenario & just wait it out, or cause for concern?
You should not have tenderness 4 weeks after a filling. The most likely cause is one or more of the fillings is too high. Amalgams are not fully cured when freshly placed and can be “bitten” into occlusion. Not so with composites. A fraction of a millimeter too much can be just enough to keep the tooth aggravated. Have your dentist check the bite and adjust as necessary. This will only take about 5 minutes. Then give it a week to see if things are improving. If not, go back and have it checked again.
Cold sensitivity can be, unfortunately, common with composites. Factors contributing include: depth of cavity, resin used, method and speed of curing, overfill. A base and liner in deep cavities can lessen the chances, as can slow cure of thin layers of composite. The good news is it generally diminishes with time.
Request a refund of the $5 co-pay for removal of the flash. As the insurance companies say, “This is considered a part of the primary procedure and is not billable as a separate procedure.” Yes, it was another visit, but patients should be able to floss after a filling is replaced.
slight hijack: i had my silver fillings replaced becase my dentist said they were posionous or somesuch, and that the new kind was better for you. is this true?
and on topic: i had the same problem and what peri said worked for me, i had to have a little bit shaved off and it was fine after that. i’m pretty sure the dentist did it for free too and it dident take long at all.
The mercury filling=poison argument has been discussed by Cecil. I wouldn’t be surprised if it was also in Great Debates (I never go there, so I don’t know). The majority of the dental community seems to think that though amalgam does contain mercury, which is in fact toxic, there is no reliable evidence that mercury leaches out and poisons the patient. There are some dissenters to this position, but as far as I’m aware the reputable studies that have been done tend to support the majority.
Interestingly, if the mercury WAS poisoning people, it would be a boon for dentists because they’d make big money replacing everybody’s fillings. That’s why I don’t understand the claims by some that the dental association is engaged in a massive cover-up about the danger. If amalgams are replaced, they’re usually replaced with a composite, and composites don’t last nearly as long and have to be periodically replaced, whereas amalgams usually last longer than the patient. Alternatively, you could use gold. That’s why amalgams are so popular; they’re both cheaper and longer-lasting than the alternatives.
Thanks for the responses. You can imagine my joy at learning my former fillings might have outlived me, but now I get to go in periodically for replacement of the composite. I should have let sleeping teeth lie. They weren’t bothering me, but the dentist convinced me they would. Damned if you do, damned if you don’t.
I suppose this filing down of the filling which is too high will be counted as a separate procedure, or is it also part of the primary one?
Answered my own question by calling the ins. co. They said the $5 copay is OK for every visit, regardless, it’s beween me and the dentist, and they don’t see it as out of line.
Gawd, are you kidding? Have you ever heard of class action suits? Of judgments for punitive damages in the tens of millions of dollars? Do you have an idea of how litigious Americans are? Review the history of certain industries (from asbestos to silicone breast implants) and you should understand why the ADA isn’t exactly on the forefront of the investigative process. For cutting-edge research, rely on the Europeans.
My dental professional uses a resin bonded ceramic powder for replacing amalgam. He does NOT remove amalgam unless it is defective and has to be replaced to maintain good tooth integrity. The mere fact that it contains a bit of mercury amalmagated with silver is not a hazard. Like asbestos removal is more of a problem than leaving it undisturbed.
Ask questions, be sure you understand what is to be done ond why!