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Mercury Gone but Teeth Hurt? Take a Poll
Video: Amalgam Removal and Replacement
Video: Composite Resin Bonding Shrinkage Problems
Amalgam Replacements Treatment Failure
Question:
Tooth pain after amalgam removal: I had several amalgams replaced to get rid of mercury about 4 months ago.
My molars on the upper right have remained sensitive to especially cold and pressure since then. The pain became worse, so I visited my dentist (not the one who replaced the fillings) last week and he x-rayed the teeth on top and bottom (right) and found nothing.
We were able to determine the most sensitive tooth though and he adjusted the new fillings. I am taking antibiotics now (as I have in the last few months for unrelated problems) and each time with some relief of tooth sensitivity and pain.
What should I do now? My dentist has suggested a root canal procedure. What is used to fill the canal? ...Visitor from AR
Answer:
Were the old mercury fillings filled with composite or porcelain overlays?
In my practice if the old restoration is 2/3 the width of the tooth or bigger then I always recommend a crown or porcealin overlay. If the old mercury filling is relatively small then it can be replaced with composite resin.
There can be many causes of sensitivity when replacing old restorations. First if the previous restoration is deep then every time you remove the old restoration the preparation is extended into the tooth more.
However, if bonding protocols are followed properly, you should not have long term sensitivity issues. There may have been moisture contamination or too much drying of the tooth when bonding.
The old restoration may have been too large to just use a composite resin restoration when replacing.
Composite resins have shrinkage and flexing that occurs which may cause sensitivity.
It is difficult to say without a thorough examination or xrays, but based on your description it sounds like you do in fact need a root canal. If that is the case make sure to have a crown covering and protecting that tooth.
Ara Nazarian, D.D.S.
Michigan Reconstructive Implant Dentistry
1857 East Big Beaver Road
Troy, Michigan MI 48083
(248) 457-0500
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