I have some concerns about the quality of work of some recent composite
fillings. My dentist replaced most of the old amalgam fillings in one
quadrant of my mouth.
All the fillings feel significantly rougher than the old amalgams and
the tooth enamel, and one feels higher than it used to - like the
occusal surface is filled with stuck food. It also has a sharp ridge of
material along one of the cusps that I can feel with both my tongue and
a fingernail.
My back molar had a broad, sharp overhang of filling material near the
gum line. In flossing over the last few days, I have snapped off off
several significant (3-4 mm wide, 1-2 mm thick) chips of this
overhanging composite. The back of the tooth is now smooth again, but I
don't know if the chips were critical pieces of the filling or
untrimmed excess.
I have scheduled an appointment to have these fillings reexamined and
treated.
Are these normal problems with composite fillings? I never had these
issues with my amalgam fillings. I'm supposed to have the dentist (a
recent graduate of a well-regarded school) work on other quadrants
soon, and I'm now leery of continuing with him.
Mark & Steven Bornfeld - 19 Nov 2005 19:43 GMT
> I have some concerns about the quality of work of some recent composite
> fillings. My dentist replaced most of the old amalgam fillings in one
[quoted text clipped - 20 lines]
> recent graduate of a well-regarded school) work on other quadrants
> soon, and I'm now leery of continuing with him.
Tough to say specifically without looking. Using good lightand a sharp
explorer it should be possible to remove most flash past the cavity
preparations, though since the resin should match the tooth color pretty
closely it is possible to miss some. But chunks as big as you're
reporting don't sound like flash.
There may be minor bite discrepencies that can be missed, and I find
that a patient that is numb from anesthesia doesn't always bite in
exactly the same way, so this bite problem should be addressed.
It's tough to say based on a couple of fillings that the dentist is
substandard. But if you see a pattern developing over time I'd trust my
gut on this one.
Steve

Signature
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
Mr. Someone - 21 Nov 2005 19:08 GMT
Another issue I'm noticing is new temperature sensitivity in the
quadrant that hadn't been there before - ice cream and hot coffee on
the area cause a lingering ache.
I know the drilling could have irritated the nerves in the treated
teeth. Is it also possible that the chunks that came off the
rough/unfinished back edge may have exposed some dentin that would
cause this sensitivity?
> > I have some concerns about the quality of work of some recent composite
> > fillings. My dentist replaced most of the old amalgam fillings in one
[quoted text clipped - 34 lines]
>
> Steve
W_B - 21 Nov 2005 19:29 GMT
>Another issue I'm noticing is new temperature sensitivity in the
>quadrant that hadn't been there before - ice cream and hot coffee on
>the area cause a lingering ache.
Not a good sign.
If it hasn't eased in a week or two, get it checked.
>I know the drilling could have irritated the nerves in the treated
>teeth. Is it also possible that the chunks that came off the
>rough/unfinished back edge may have exposed some dentin that would
>cause this sensitivity?
Doubtful.
--
W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Mark & Steven Bornfeld - 21 Nov 2005 19:36 GMT
> Another issue I'm noticing is new temperature sensitivity in the
> quadrant that hadn't been there before - ice cream and hot coffee on
[quoted text clipped - 4 lines]
> rough/unfinished back edge may have exposed some dentin that would
> cause this sensitivity?
Possible. Also possibly the sensitivity is related to excessive heat
buildup when drilling, or ineffective bonding technique. Any and all of
these can cause sensitivity. Overall, postop sensitivity incidence is
greater with resin than with amalgam (though careful technique can
minimize this difference).
Steve

Signature
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
Mr. Someone - 26 Nov 2005 06:38 GMT
I had a follow-up with my dentist, who said that the chips were only
excess material on the back molar, and nothing to worry about. He
smoothed the surfaces out a bit - said that he would rather place too
much resin than too little, and these ridges of built-up excess
material do happen.
The pain is coming from a premolar that had the deepest filling, and I
ws told that it might take 2 weeks for the sensations to subside. He
also told me that a fluoride-based resin was placed in the bottom layer
of the replacement filling of that tooth.
The dentist did address my roughness concerns on all the teeth, and all
the new fillings are now smooth.
If dull pain (easily controlled with ibuprofen, naproxen, or
acetaminophen) is normal when replacing old, deep fillings, then I'm
not so worried about having my other fillings replaced.
Thanks Dr. Steve, for your input! If I ever move to Brooklyn (which
could happen), I'll know who to contact for my dental needs!