Does my composite filling hurt because my dentist did a cheap job?

I have a young enthusiastic dentist whose treatment is really affordable. I’ve been a patient for almost 3 years and have been pleased with her gentle care and treatment. In mid-September, I had 3 small fillings filled with flowable resin-based composites. These fillings have been a problem ever since I received them. Whenever I chew hard crunchy food, like dark chocolate covered toffee, which I love, I get sharp pains. It doesn’t last long, but toffee takes some time to chew, so the pain repeats itself. It happens with other hard crunchy food, too.

Of course, I have mentioned the issue to my dentist. In late October, at no cost to me, she replaced the fillings with the same composites, but I still have pain that is pretty much at the same level as the first fillings. This pain does not occur when I clench my teeth together – only with hard crunchy food.

I’ve read a few dental articles online about this issue with small fillings and learned that before placing the flowable composite, self-etching primers or a glass ionomer base might help. Does my dentist not know this because she is young, or might she be skipping the step to make this dental procedure affordable? Does using this base sound reasonable, and is it a no-no for me to ask my dentist about her technique? Thanks. Sunni

Sunni – The sensitivity that commonly occurs with flowable resin-based composites in small fillings, as opposed to larger ones, seems to be related to bonding the filling to the dentin of the tooth.

We won’t suggest that your dentist isn’t using the base just to make dental care affordable. It is possible that she is unaware of the benefits of using self-etching primers or a glass ionomer base. Or, she might typically have success without using a base under flowable fillings.

What’s Next?

Below are two options to consider.

Vertical before-and-after composite filling photos. The top photo shows three lower molar teeth with silver fillings, and in the bottom photo, they are replaced with composite.
Properly bonded composite fillings look and feel great
  • Schedule an appointment with your dentist to have the fillings replaced again. Before she starts the work, insist on a glass ionomer base to protect the dentin. The composite will be bonded to the base, not the dentin, and you should have relief when you chew hard crunchy foods. If your dentist refuses to apply the base, you can refuse further treatment.
  • Find an experienced cosmetic dentist to replace the fillings. He or she will know how to prepare your tooth to ensure flowable composite doesn’t cause any discomfort when you chew. And keep in mind that regardless of which type of composite a skilled cosmetic dentist uses, the results will function well and look natural. No critical steps will be skipped to keep costs down.

This post is sponsored by Plano, TX female cosmetic dentist Dr. Miranda Lacy. Dr. Lacy doesn’t take shortcuts to make dental care affordable. She provides high-quality care and offers payment options to help you get the care you need.

Four Factors to Consider Before Taking Your Child to a Sedation Dentist

I’m really struggling with how much I am to blame for not taking my son, Chase, to a sedation dentist. He’s six years old and is a bit fidgety. 3 weeks ago, after an exam, the dentist said Chase had a cavity that needed to be filled.

The dentist offered to do the filling immediately, and I saw no reason to object. Chase seemed a little apprehensive but not overwhelmingly. The dentist asked me to leave the room saying sometimes it helps kids relax when their parents aren’t there. About 15 minutes later, I heard Chase screaming and the dentist began yelling at him. I ran into the room and saw Chase on the floor crying with the dentist standing over him and telling him to get off the floor.

I immediately jumped between the dentist and Chase, took Chase by the arm, and prepared to leave. I didn’t know what had happened, but what I saw and heard didn’t look right. The dentist left without saying anything. Chase was hysterical, so I sat down with him for a moment in the treatment room. One of the assistants came in and explained that Chase had bitten down while the dentist was drilling, his tooth cracked, and now he needs a crown. She gave me a referral to a pediatric dentist and then left. The lady at the checkout desk was pleasant but said nothing about the incident.

I still haven’t taken Chase to a dentist to see if he really needs a crown. He has not complained about the tooth, but he has said that he doesn’t want to return to our dentist. Neither do I.

Although my son hasn’t directly said that he is afraid of going to another dental appointment, I’m now wondering if he should start seeing a sedation dentist Is it possible that I missed signs that Chase has some dental anxiety?  Kyla

Kyla,

Outdoors close-up photo of a mother and children smiling and lying on grass. The dark-haired mother is in the middle, her daughter is pictured left, and her son is on the right; for information on sedation dentistry for children.
Family and pediatric dentists make visits fun for children

Please don’t blame yourself for what happened. If Chase handled dental appointments well in the past, you had no way of knowing how he would react during the most recent appointment.

Normally, kids who have trouble during a dental appointment get quite fidgety long before there is an issue. Ultimately, it was the dentist’s responsibility to assess the situation, and it sounds like he failed and was very unprofessional in handling Chase’s anxiety.

Should  You Take Your Child to a Sedation Dentist?

Below are four considerations:

  1. Results of delaying treatment – Your son should have his tooth examined. Don’t wait until he is in pain, because it could lead to anxiety about going to any dental office. Even routine dental exams should not be delayed due to a child’s anxiety or fear. Delays in treatment can contribute to a buildup of plaque and decay, and treating those issues makes dental appointments even longer.
  2. One step at a time – You may need to gradually help your child get comfortable again, perhaps by taking him for an office tour or consultation the first visit and then an exam on the second visit.
  3. Does the dentist regularly treat children? – Your child might be a good candidate for dental sedation, but if you decide to try it, visit an office, such as a family dentist, that regularly treats children, or visit one that specializes in dental care for children.
  4. There are levels of sedation – The mildest form of sedation, nitrous oxide (laughing gas), might be sufficient to help your child relax. The gas is breathed in during the procedure, and it is quickly reversed with pure oxygen. An experienced sedation dentist can determine which option is best for your child.

This blog is sponsored by Dr. Miranda Lacy, a Plano sedation dentist.