Dr. Jay Goldstein's Blog

I also had tooth pain after a white filling on my molar. The pain did not go away for several months and eventually the filling was removed.

It seems that many older dentists, say, in practice for 10-20 years, did not have the ability to do white filling job. If so, should I look for young dentists, e.g., those who just finish school for 1 or 2 years? That these dentists would know more about cosmetic denistry.

Thank you very much,
- Mike from Ontario

Mike,
No, I wouldn’t look for a younger dentist if you want white fillings, as opposed to an older dentist, because most dental schools are STILL clinging to the dental amalgam as the filling of choice. Here’s a way to tell if a dentist knows how to do white fillings properly:

Just call the office and ask which type of filling the dentist prefers to do on BACK TEETH: amalgam or composite. Dentists like to do what works well for them. And if a dentist has had good success with white fillings, with few patient complaints, and feels confident placing them, he or she will prefer doing those.

Many young dentists out of school one or two years have no clue as to the proper technique for doing white composite fillings on back teeth because they were never taught. But they may be willing to try, and that’s where there is potential trouble.

Links:
Cleveland cosmetic dentist

I am 50 years old and have only had 3 small cavities in my liftime. I recently relocated and went to a new dentist. It had been 8 months since my last cleaning. She found 2 new cavities and filled them about 6 weeks ago. I immediately had some pain issues and went back for a bite adjustment. It didn’t get better and I had an intense pain reaction to both cold and heat. She removed the new composite filling and an older amalgam filling in the adjacent tooth and refilled both. The intense pain is gone but it still hurts to floss a month later and is sensitive to cold. They keep telling me to wait it out a little longer and try Sensodyne. Reading the blogs here about infections has me worried. Should I try a new dentist or just relax and don’t worry if the pain isn’t extreme? I’m not sure what “normal” is as I’ve never had any reaction to a filling at all.
- Alice from New Hampshire

Alice,
It sounds like your dentist certainly had some trouble with these fillings! I don’t know if this is the case or not, but I just wanted to mention that many dentists have trouble with white fillings on back teeth. The technique often isn’t taught in dental school, and they assume it’s the same as for white fillings on front teeth. But it actually requires specialized training to place these properly. And many times what happens is that there is a great deal of sensitivity afterwards.

White fillings should have zero or very little post-operative sensitivity if they’re done right. But at this point, it may not be wise to work on these teeth again. If the teeth are slowly getting better, then I would leave the situation alone. That’s your key. If they’re getting worse at all, then you want to be looked at. But if they’re getting better, even if the progress is slow, I’d leave it alone.

Related links:
Cleveland cosmetic dentist
Cleveland dental implants
Cost of lumineers

I have a very very small cavity in my second last molar (bottom left side) that was first filled with a white filling by my usual dentist in Johannesburg. He has done this twice now as it always comes out after about 20 months (he told me this would happen).

Today I went to have it done again by another dentist (in Cape Town) and he has practically covered the whole tooth whereas the first dentist just filled in the little dot of the cavity. I am a bit nervous of this as I don’t think it was done properly.

Can a white filling be put over a larger area of the tooth or should it just fill the cavity?

Kind regards,
Sandra in South Africa

Sandra,
It’s hard to tell without seeing your tooth, but maybe we can be a little helpful.

First, if a white filling comes out, it probably wasn’t done properly. White fillings should be bonded to the teeth, and therefore there shouldn’t be any tendency to come out.

As far as what the second dentist did, I am guessing that it was probably done properly. Often, when doing a small white filling, we will seal over a larger area of the tooth–filling in some of the deep grooves, to help keep them from later developing cavities. It’s possible that this is what was done. It’s also possible that the dentist made the filling too large–it’s hard to tell without seeing it. If your bite feels normal, though, it is probably okay.

Other information:
Cleveland cosmetic dentist

I have a dentist I’ve been going to for years, and last month I needed two old fillings replaced, so I asked him to put in the white fillings. Now, whenever I eat and I hit those fillings, I get a sharp pain. I went back to him and he said the bite looked fine, but he adjusted it anyway. What’s going on?
- Dave in Denver

Dave,
When your dentist doesn’t offer white fillings as an option, it’s generally not a good idea to ask them to do white, because these fillings require special training. One thing that happens is that if they aren’t bonded on correctly, you can get this strange sensitivity where they only hurt when you chew. In our office we use special techniques including self-etching primers that eliminate this sensitivity. When they are done properly, white fillings are very gentle, usually with zero post-operative sensitivity, unlike amalgam fillings which can be sensitive to cold for weeks afterward.

I’d ask your dentist to re-do the fillings and this time to cover the floor of the cavity with a glass ionomer base before he does any etching or bonding procedures. That should take care of the problem.

Related information:
Dr. Goldstein’s cosmetic dentistry credentials.
Bonded all-porcelain crowns also require specialized procedures to do them properly.