Post-Operative Sensitivity and How to Avoid It
Too often, patients around the world have a tooth treated only to experience continuing discomfort or symptoms that don’t get resolved. In some cases the treatment may make the symptoms feel worse. While traditional guidance recommends that patients wait a few weeks after having dental work to see if post operative pain subsides, biomimetic restorative dentistry provides a better solution.
The Hydrodynamic Theory of Pain
In 1986 researcher Martin Brännström published “The Hydrodynamic Theory of Dentinal Pain: Sensation in Preparations, Caries and the Dentinal Crack Syndrome.” His research showed how the pain a patient feels comes from the movement of pulpal fluid (the tooth’s nerve) through the dentin inside the tooth. In order to protect areas that could be exposed to infection, the pulp sends pulpal fluid to seal dentin that has been exposed by caries (decay from bacteria) or cracks to prevent infection; this is the tooth’s natural defense. If the tooth’s nerve becomes severely infected, it will die and greatly weaken the remaining tooth (just like teeth that have had root canal therapy).
But a pulp does not know the difference between a crack or a restoration. If your tooth has been prepared for a traditional crown or filling near the pulp and the prepared dentin is not sealed, any gap between the tooth and the restoration can elicit this feeling of pain or sensitivity. If symptoms persist, traditional techniques recommend root canal therapy for that tooth. Biomimetic techniques offer a way for that pulp to heal instead.
Treating the cause of symptoms
If symptoms exist before your tooth is restored and they are not addressed, they will likely continue after. The main causes of pain or sensitivity come from caries or cracks in non-restored teeth, and in traditionally restored teeth, the symptoms could also be caused by a gap under your restoration. In cases of severe caries or cracks, pain could mean your pulp is inflamed or already infected.
If caught early, these pathologies can be treated to eliminate symptoms and protect the pulp. At the Alleman Center we use high magnification and precise measurements to safely remove cracks and caries in your tooth. Leaving these pathologies in your tooth where we are trying to bond a restoration can lead to continued symptoms or debonded restorations, so creating this bonding surface is a crucial step for an asymptomatic restoration.
Restoring teeth with asymptomatic results
Once any pathologies have been treated, the next step in a biomimetic restoration is immediate dentin sealing. For this step, an adhesive seals your tooth, including the pulp, at a strength that mimics how a natural tooth is bonded to itself. This means there are no gaps for bacteria to enter, and the tooth is supported, making it resilient to future pathologies. Under this seal, the pulp is given a chance to heal, reducing your risk of needing endodontic treatment.
Mimicking natural occlusion
The final step in a biomimetic restoration is to check your occlusion, or how your teeth come together when you bite and chew. During your appointment, Dr. Alleman will check your occlusion to make sure your teeth are coming together like your jaw is naturally designed to do and make any necessary adjustments to help the teeth fit together well. Due to numbing from treatment, sometimes your chewing patterns will change over the next day or two, so if you feel any pain after a biomimetic restoration, the occlusion can be adjusted again with a quick visit and without numbing.
At the Alleman Center, we only offer biomimetic dentistry because of the predictability it offers our patients. When Dr. David Alleman Sr. started researching better dentistry for his patients in 1995, it was to address post-operative sensitivity and future problems with the treated tooth. He was frustrated that traditional practices offered no answers to his patients’ problems. As he researched advancements in dentistry and organized these techniques into treatments he could offer in his office, the results were exactly what he had hoped for. With every case he knew he was treating the cause of symptoms and creating a restoration that would stay bonded and symptom-free.
We’re happy to talk about the work we do any time. Reach out at office@allemancenter.com or (801) 717-9860 any time, or ask Dr. Alleman at your next appointment.