Introduction:

We have compiled this article on “Sensitivity Of Teeth After Placing Composite Filling?“. The reference links are at the bottom of the article.

^[1]Sensitivity is characterized as being a response given by the body to say that something is wrong, and this response may be originated by an aggressive stimulus or in a spontaneous manner. The sensory potential of the pulp makes it capable of reaction with an immediate painful response, even when the stimulus is applied at a distance from the pulp tissue, such as in the superficial layers of dentin.

Innumerable restorative procedures are performed on a day-to-day basis in dental offices, and some stages of the procedure may generate stimuli that result in pain or potentiate already existing sensitivity. Therefore, it is important to know what a resin composite restoration is not: simply removing carious tissue and inserting restorative material in small increments. Instead, it comprises various steps that must be carefully performed so that the restoration will be successful; that is, a perfectly sealed restoration that restores the shape and function of the tooth, and is comfortable for the patient .

^[2]Immediate reports of Postoperative sensitivity (POS) reported after restoring teeth with direct composite resin restoration is a baffling issue experienced by most dentists. At-least five to twenty six percent patients report POS immediately after composite resin restoration1. In the authors’ observation, sensitivity typically lasts’ for a period of few days to months and finally settling down to normalcy and in very extreme cases there is pulp involvement leading to endodontic therapy. Sensitivity is mostly elicited at the margins of the restorations and sometimes at the center of the restoration inspite of dealing with the occlusal interferences.

Composite resin based fillings are technique, instrument and material sensitive restorations as they mechanically and/ or chemically bond to the tooth structure. Composite resins are irritant to the pulp and should be bonded carefully along with additional use of liner, desensitizing agents and resin modified glass ionomers where necessary, especially in deep dentinal cavities so as to prevent postoperative sensitivity and subsequently pulp death; as total etch bonding systems may cause detrimental effects on the pulp.

Past studies have cited three most common reasons for postoperative sensitivity: polymerization shrinkage of the resin, microleakage around the margins of the restoration, and build-up of residual stress in the fabric of the tooth after placement of direct composite restoration.

At-least six percent of complaints of sensitivity after direct composite resin restorations on mastication and/ or sensation to cold and hot drinks can be attributed to increased cavity depth. This study hopes to look at some of the causes of postoperative sensitivity and plausible solutions and / or prevention to this obscure issue in order to enhance patient comfort and function after restoration of teeth with composite resin.

^[3]Causes and Solutions for Post-Operative Sensitivity

Post-operative sensitivity from composite restorations is a complication most clinicians would like to avoid. Unfortunately, it happens a lot more often than most dentists and patients would like. Common causes exist for post-operative in composite restorations. Here are a few of them and how you can avoid them in your restorations.

Per Dental Update, post-operative sensitivity is more likely in complex restorative procedures, like those that require etching of enamel and dentine or that need acidic adhesive monomers. Moreover, the pain patients feel is caused by dentinal fluid movement stimulating the nerves in the tubules, which causes the mechanoreceptors near the dental pulp’s outer surface to react. The authors of the 2018 review article suggest that the remaining dentine thickness, the tubule diameters and the sealing of them, and the tooth’s overall pulp status may cause the sensitivity.

They also categorize the technique factors that contribute to post-operative sensitivity in the general areas of:

• Cavity preparation that damages dental tissues
• The type of adhesive system you use, self-etch vs. total-etch
• Not utilizing a desensitizer on the dentine surface
• Incomplete polymerization of the material because of curing
• The use of improper technique when placing materials into the cavity

Post-operative sensitivity occurs in up to 50% of composite restorations, per some studies, and is especially prevalent in posterior teeth and Class II restorations, but not limited to them. Post-operative sensitivity could have various causes. Per The International Research Journal of Dentistry (IRJD, post-operative sensitivity results from the interaction between:

• The clinician’s technique
• The health of the pulp and enamel
• The restorative material

Dentists can’t do anything about the tooth’s health (at this point, anyway) or the restorative materials’ makeup. However, clinicians can refine their technique, and this is where the most significant opportunity to prevent post-operative sensitivity lies.

Conclusion:

Thank you for reading this article, and check back frequently for other dental health articles. Should you have any questions, please contact Apple Tree Dental today!

Article compiled by Apple Tree Dental

Article reference links

1. https://www.researchgate.net/publication/235977564_Post-operative_sensitivity_on_direct_resin_composite_restorations_clinical_practice_guidelines ↑

2. https://biocoreopen.org/ijdoh/Immediate-Post-operative-Sensitivity-after-Composite-Resin-Restoration-A-Review-of-Treatment-Protocol.php ↑

3. https://www.dentalproductsreport.com/view/causes-and-solutions-for-post-operative-sensitivity ↑