Amalgam and Bonded Resins

You have just had one or more teeth restored (filled) with either silver amalgam or resin (tooth-colored/bonded) materials, or prepared for an inlay/onlay or crown. How quickly you adjust to the new restoration depends on the size of the restoration and the closeness to the pulp (nerve). The larger the restoration, usually, the longer it will take you to become accustomed to it.

Chewing

If you have been given a local anesthetic, please do not chew in that area until full feeling returns. When you are "numb," you cannot feel if you are biting your cheek or lip. If you have had a silver/metal filling placed, it will require a minimum of 2 hours after you leave the office before you can chew on it. If you eat before the silver filling is adequately set, the filling may break and require replacement. If you have had a resin restoration placed, the resin sets immediately, and you can eat when the effect of the anesthetic is completely gone.

Occlusion

The occlusion (bite) of the new restoration has already been adjusted. If you have been anesthetized, you may not be able to notice if the bite feels normal. Wait until the anesthesia wears off and then, if the occlusion is not comfortable, call the office to have it adjusted. We do not believe in a bite “wearing in," regardless of the material used. If you have had multiple restorations placed, please give yourself time to become adjusted to them before you call the office. This may take one or two days.

However, if the bite is off and it is not corrected, you could break the filling or the underlying tooth. We have checked your occlusion before you left our office but your tooth was still anesthetized, and you may not have been able to feel the bite well. It is often difficult to make the teeth meet as they usually meet under these circumstances. It is not uncommon for the new restoration to need a slight adjustment.

When restorations are very large, it is possible that in the future the tooth may fracture and may need a cast restoration (crown or onlay) to be properly restored. If the restoration was deep, it is possible that the nerve may die and you will need endodontic therapy (root canal treatment). This may become evident tomorrow or 10 years from now. If a very large silver amalgam or bonded restoration breaks soon after it is placed, there is a strong chance that the filling material is being called upon to replace more tooth structure than it was designed to replace. In this situation the tooth will be better restored with a cast restoration.

Exposure

The nature of the design of the preparation for the restoration or the extent of the decay has caused the nerve to be exposed on tooth #s or a near exposure on tooth #s . When the nerve was exposed, a medication was placed on the exposure site and there may be healing, but it is probable that endodontic treatment (root canal therapy) will be needed at some time in the future. If there was a near exposure, medication was also placed on the site, but there is a reduced possibility of future endodontic treatment. In either case, expect the tooth to be very sensitive to temperature changes, especially cold temperatures, for several weeks.

Sensitivity

Any time a tooth is prepared (drilled) for a filling, tooth structure is removed very quickly. The natural wear process that occurs in everyone's teeth proceeds much more slowly. The response of a vital, healthy nerve to this wear is to recede and deposit an insulation layer between the nerve and the surface of the tooth. Normally, the wear of the tooth proceeds at more or less the same pace as the nerve recedes and deposits insulation. When a tooth is drilled, tooth structure is removed much more quickly than the nerve can “defend” itself. One response of the nerve is to become sensitive to temperature changes. This will persist until the recession and insulation process can catch up to the rapid removal of the tooth structure caused by the drill. This sensitivity can last from several days to several months. Usually, the more drilling, the more and longer the sensitivity you will experience. Several other factors also contribute to postoperative temperature sensitivity, but choice of filling material ⎯silver amalgam or bonded toothcolored resin filling—is not a usual cause. When done correctly, white fillings are no more likely to be sensitive than silver fillings.

Oral Self-Care and Recare

You may (and please do!) brush and floss your teeth after the local anesthetic has worn off. There is no need to refrain from your normal, daily oral self-care routine. Continue with your oral hygiene maintenance appointments at the interval we have previously recommended. Problems that might develop around the restorations can be found at an early stage and easily repaired. If you wait too long, the entire restoration may have to be redone.