A common Question we often hear from new patients is the following: “I had some new fillings done a while ago by another dental office and they are still sensitive. Is there anything Biomimetic dentistry can do for these sensitive teeth?
Any filling or dental restoration that is still sensitive to cold or slightly painful to bite on after a few days generally has some sort of problem that should be addressed.
Most commonly a filling may be too “high” or hitting prematurely with the opposing tooth. This causes prolonged sensitivity to cold and usually slight pain when chewing down on something.
A simple “bite” adjustment and re-polishing the filling may be all that is needed.
There are, however, two additional fairly common problems that can also be involved in this sort of pain that requires more diligent and comprehensive assessment and treatment.
The first one is an internal dentin fracture. This is where a fracture inside the tooth was not noticed during the placement of the filling.
When biting down on this type of fracture, it will cause immediate pain on downward bite pressure. If it was noticed, most dentists will tell you that you need a crown to fix it. If you weren’t told that, then they likely didn’t see the fracture at all.
Biomimetic restoration techniques are always done under magnification with high power loupes or microscope.
Strict protocols are followed to look for internal fractures by staining and micro-etching the tooth prior to a filling being placed.
Any fractures are addressed immediately by dissecting out the fracture lines, and placing Kevlar ribbon over the damaged area and bonding the Kevlar into place before the filling is placed.
This “Ribbon” layer prevents the fracture from expanding. These can be fixed without a crown in a high percentage of the cases through the placement of the Kevlar ribbon and proper incremental bonding of the composite resin layers, thus mimicking natural tooth structure in form and function.
The second category of chewing pain is a tooth that hurts when you open up after biting down on it.
The pain occurs when opening, not on the downward pressure. This pain is almost always caused by improper or incomplete bonding before and during the placement of the filling.
Unfortunately, it is common for dental supply companies to sell simplicity and time savings to dentists through “single bottle” bonding systems. These single bottle systems are inferior materials to multi-bottle systems. Research shows conclusively that two-step Prime and Bond systems have greater bond strengths and are less likely to become “de-bonded”.
In Biomimetic treatment, we assure the critically essential step that the dentist apply the primer for a minimum of 20 to 30 seconds by massaging the primer into the dentin of the teeth. We never simply place the Primer on the tooth and air dry it immediately. That shortcut can lead to inferior bond strength and separation of the bond from the dentin. Additionally, in Biomimetic dental care, a flow-able layer of composite is placed over the bond layer and between or prior in the actual filling layers being placed.
Scientific research at two major Universities shows that the bond is severed in a very high percentage of cases as soon as the dentist shines the light on the tooth to complete the hardening of the materials if that layer is not placed.
Biomimetic Dental care has exacting standards and protocols which we have to follow to be called Biomimetic Dentists. These methods include obtaining superior bond strengths, then a layer by layer approach of highly specialized and specific materials to mimic the properties of natural teeth.
Both of the above situations where sensitivity occurs in the placement of fillings are quite common in Non-Biomimetic dental offices. They lead to “sensitivity” or pain in your bite. Biomimetic Dentistry can be used effectively to treat these symptoms.
