 | Bonded dentistry, depending on how deep the filling is, can cause a reversible pulpitis with the nerve of the tooth. This pulpitis which is reversible by nature, causes the tooth to be over-responsive to temperature and this normally goes away on its own within 24-36 hours. Another cause of this problem can be that the tooth may be high in the bite, which would be causing occlusal trauma and similar pain. Once the bite is adjusted the pain will go away within 2-4 days. |
Dental procedures are not without risk, and more so in cases where the tooth being worked on, had previously been heavily restored. Prior to undertaking a restoration on a tooth, we are able to get an indication as to whether the tooth is alive or dead (vital or non-vital) but beyond that we have no idea as to what extent the nerve has been damaged by previous decay and subsequent restoration work. Thus we are unable to measure the health of the nerve of the tooth. A tooth with a badly damaged nerve can still give a false positive or indicate to us a normal response to testing, even though in reality some part of the nerve is already dead. A root canal treatment in such a tooth is inevitable, as the nerve is dying, and working on such a tooth may tip the balance and accelerate the need for the root canal.
Even teeth that do not have large restorations can develop irreversible problems due to fracture lines caused by old silver (amalgam) fillings over time, allowing bacteria to get into the nerve. The silver fillings do so by acting as a wedge, pushing the cusps of the tooth apart, causing micro fractures that propagate towards the nerve with chewing. (Much like a crack in a windscreen propagates as one goes over bumps in the road.)
Is there any way we can predict when this will happen in teeth that respond 'normally' prior to filling? - the answer is no, and this is something patients need to be aware of prior to undertaking such a procedure.
