Don't wait till it hurts!
Sensitive Teeth need to be carefully examined to make an accurate diagnosis. Causes include receding gums, decay, bite problems, clenching or grinding known as bruxing, acid erosion, aggressive bleaching, gum disease, some toothpastes, and more.
Old fillings can get sensitive with recurrent decay and processes including corrosion, acid erosion, and wear that compromise the seal provided by the filling. Don't wait for sensitivity to advance to a toothache to get an exam and diagnosis! New fillings can be sensitive for a number of reasons, including, but not limited to:
Inflammation of the pulp, which is the soft tissue inside the pulp chamber of a tooth that contains nerves, blood vessels, and other cells that nourish the tooth. Simply drilling a tooth to receive a filling can irritate the pulp, and this is rather common. We use water sprays with our drills to keep from heating the pulp up.
Removal of decay from a tooth can increase sensitivity, particularly when the decay is rather deep. Sometimes we place medicines inside a tooth where deep decay has penetrated, hoping to soothe the pulp. Sometimes we will place an indirect pulp cap, best described as a layer of medicine sealing over an area of decay that is deep enough to penetrate the pulp chamber, when we would like to give a tooth without symptoms a chance to get along without root canal treatment. Possible outcomes for this method include a tooth with sensitivity that may decline over time, a completely comfortable tooth, or a tooth that develops a toothache and needs root canal treatment anyway.
The occasional tooth where a filling is too high, because patients do not always bite in their normal position after being numb with their mouth open for a while. Always call for a post-op check if you think something feels wrong with your bite.
Metal fillings can cause a "galvanic shock syndrome" if they are placed in the proximity of fillings or crowns made with dissimilar metals. A mild electronic shock can occur as you bite together and bring upper and lower teeth into contact. This is almost always a short-lived situation, but can be somewhat uncomfortable for a couple of days. The sensation typically stops as soon as the new metal restoration develops an oxidation layer on the surface. Sometimes it is necessary to remove a new restoration and place a "sedative filling" for a few days to cool things down. A sedative filling is a temporary filling that contains a soothing medication, like eugenol.
Some practitioners feel that composite fillings are more likely to cause sensitivity, and theories include conceptual models related to minute contraction of the filling material as it sets, moisture content of the tooth structure under the filling, and different methods of sealing the tooth.
This is not an exhaustive treatise on sensitive fillings. Please contact your dentist to address any sensitivity you experience.
Sensitive gums can be caused be gingivitis, which is inflammation of the gums, more advanced breakdown of gums called periodontitis, trauma, and more unusual conditions including lichen planus, allergies and many more. Once again, an exam is necessary to provide a diagnosis and treatment recommendations.
by Keith Collins, DMD