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Beverly Hills Institute of Dental Esthetics
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Brian LeSage, DDS, FAGD, FAACD

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Sharp pain after a small composite filling

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I had a dental exam and cleaning to prepare for teeth whitening and Invisalign. My teeth are yellow, and I wanted to whiten them to make me feel better before starting orthodontic treatment. My dentist found a small cavity in a first molar tooth and filled it with composite. I feel a sharp pain in it when I chew. My dentist says the tooth is not cracked and adjusted my bite twice. He also says that sharp pain after a small composite filling is rare but not unheard of. I asked him to redo the filling, and he said that the filling was not the problem. Now he says that with sensitivity in my tooth, he doesn’t want to do teeth whitening but will proceed with Invisalign. I don’t want Invisalign moving my teeth when I am already in pain. I want the sharp pain resolved. My dentist says I might need a root canal and crown and start Invisalign. What is going on? Thanks. Marcus

Marcus,

Your dentist may prefer to do a root canal and crown for $2000 or more than replace a composite filling.

What Causes a Sharp Pain After a Small Composite Filling?

Sharp pain after a small composite filling is often due to improper technique or an issue with your bite. If your dentist prefers a root canal and crown, you probably won’t convince him to replace the filling. However, if he agrees, you can expect the steps below:

  • Remove the existing filling
  • Cover the dentin with a glass ionomer base
  • Etch the tooth
  • Replace the composite filling

If you need to switch dentists

Invisalign aligners

Invisalign clear braces

If you need to switch dentists to get a filling replacement, we recommend getting a second opinion from a skilled cosmetic dentist to redo the filling. Since you want your teeth whitened and Invisalign treatment, look for a dentist who can provide all three treatments:

  • Composite fillings
  • Teeth whitening
  • Invisalign

Don’t rush your decision, though. Research a few dentist’s websites for their post-graduate training and credentials in the treatment you need.

Beverly Hills accredited Fellow of cosmetic dentistry, Dr. Brian LeSage, sponsors this post.

Did Invisalign Cause My 3 New Cavities?

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Did Invisalign cause my three new cavities? I ask because I got Invisalign in August of last year. Before then, I had no cavities since I was 22. Now that I am 42 and wearing Invisalign, my dentist found three new cavities. I am unsure of the cause of the cavities, but the only thing that has changed is that I now wear Invisalign. My dentist insists that Invisalign is not the cause, but I want to confirm. Is Invisalign causing my cavities? – Jasmin

Jasmin,

Clear aligners, for inormation on Invisalign and avitiesThank you for contacting the Beverly Hills Institute for Dental Esthetics regarding Invisalign and cavities.

Can Invisalign Cause Cavities?

Invisalign does not cause cavities or tooth decay. A 2015 article in the European Journal of Dentistry published a study on periodontal health in patients with Invisalign versus fixed orthodontic appliances. After one month and three months, researchers observed the following in Invisalign patients:

  • Better periodontal health
  • Lower plaque levels
  • Better oral hygiene habits

What Causes Cavities?

A buildup of dental plaque causes cavities or dental caries. The progression can affect your teeth regardless of whether you wear Invisalign. Cavities develop in the following ways:

  • Natural bacteria in your converts sugars and carbohydrates from foods and drinks into acids.
  • The acid and bacteria mix with saliva to create dental plaque, which sticks to your teeth.
  • Without daily flossing and brushing, acids will wear your tooth enamel and create cavities.

What Increases the Risks of Getting Cavities?

The following factors increase your risk of getting cavities:

  • Dry mouth – Drink plenty of water while wearing Invisalign. Thoroughly rinse your mouth after meals and drinking beverages. Speak to your dentist if you take medication or have a medical condition that leaves your mouth dry despite drinking plenty of water.
  • Frequent snacking and consuming sugary foods or drinks – You can minimize acid and bacteria in your mouth by snacking less often and limiting your sugar intake.
  • Gum recession – Receding gum tissue exposes tooth roots and makes teeth more susceptible to decay.
  • Inadequate brushing flossing – Lingering plaque promotes to tooth decay. Maintain a flossing routine between your teeth daily and brush twice daily. Removable Invisalign aligners make it easier to prevent cavities and clean your teeth thoroughly.

If you continue to experience cavities while wearing Invisalign, speak with your dentist about possible causes and how to prevent future cavities.

Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.

Will Dental Insurance Cover Porcelain Veneers?

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My upper front teeth are clearly uneven when I smile, and I have an almost ¼-inch gap between my teeth. Three left teeth look like strays because of their spacing and position. I have searched online for solutions, and it seems that porcelain veneers or braces are my best options. Is that correct? Also, I know that upper-level dental plans offer some orthodontic coverage, but what about coverage for veneers? Thanks for your response. – Darcie from San Diego

 

Darcie,

Thank you for your question. Dr. LeSage would need to examine and x-ray your teeth to determine treatment options, but we will compare veneers and braces and the type of insurance coverage you can expect.

Will Dental Insurance Cover Porcelain Veneers?

Dental insurance usually does not cover porcelain veneers because they are cosmetic treatment. Dental procedures that improve the appearance of your teeth rather than resolve oral health concerns are elective, and insurance will not cover them. Your dentist can give you a pretreatment estimate to submit to the insurance company and help you understand your out-of-pocket costs for porcelain veneers.

Will Dental Insurance Cover Braces?

Most higher-tiered or premier dental plans pay for a percentage of your treatment with traditional braces and clear aligners, like Invisalign. Still, dental insurance does not pay for all your treatment costs. Plans that offer orthodontic benefits have a lifetime maximum for payments toward your treatment. Ask a dentist for a pre-treatment estimate for braces, and your dental insurance company will explain how much the plan will pay and what you can expect for out-of-pocket costs.

How Do Porcelain Veneers and Braces Compare?

Porcelain veneers and braces can straighten your teeth, but how do they compare? Some cases of spacing and misalignment are so complex that they require braces. Still, dental technology offers options for braces with clear brackets and clear aligners, such as Invisalign, which makes braces less noticeable.

Porcelain veneers

  • Correct mild misalignment
  • Require conservative tooth preparation by removing tiny amounts of enamel
  • Transform your smile in a few visits
  • Enhance tooth shape, size, and color

Braces

  • Correct mild to severe misalignment
  • Do not require tooth preparation
  • Align your smile in six to 18 months, depending on the complexity of your case
  • Reposition teeth without changing shape, size, or color

Request a Consultation

Porcelain veneers before-and-after photos, for info on dental insurance and veneers

Dr. LeSage achieves beautiful results with veneers

We recommend scheduling a consultation with an advanced cosmetic dentist who provides treatment with porcelain veneers and braces. After a comprehensive exam, the dentist will explain and compare your treatment options and costs. Read our post on other factors to consider before getting porcelain veneers.

Dr. Brian LeSage of the Beverly Hills Institute of Dental Esthetics sponsors this post. He is an accredited Fellow of cosmetic dentistry and among the top cosmetic dentists in Beverly Hills and internationally. See examples of Dr. LeSage’s aesthetic dentistry in his smile gallery.

Persistent Tooth Sensitivity After a New Crown

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I saw my dentist for sensitivity to heat, cold, and pressure in an upper left molar tooth in late December. My dentist placed a crown over the tooth. But a few days later, the symptoms increased. I returned to my dentist, who said she would adjust the crown. I even asked her if I needed a root canal, but she said it was unnecessary. She told me that the tooth should settle down within three weeks. The tooth did not settle down, so I took Advil. Now the tooth is still slightly sensitive. I have not decided if I will return to my dentist or switch dentists because I was supposed to start Invisalign last month but cannot because my dentist has not resolved the issue with my crown. I am concerned that I might lose the tooth and need a dental implant. How can I tell if the problem is with the crown or my tooth? – Nate from San Diego

Nate,

Thank you for your question

We recommend that you ask another dentist to x-ray your tooth. It is unusual for a dentist to use a dental crown to resolve tooth sensitivity without checking for infection.

What Causes Tooth Sensitivity?

A tooth is sensitive to heat, cold, or pressure due to irritation. Irritation may increase when a dentist prepares a tooth for a crown, reducing tooth structure on all sides. If you have tooth decay or an old filling, removing it first and applying bonding or a glass ionomer might relieve the irritation and allow for a dental crown. But if the irritation persists or increases, you need root canal treatment and a dental crown.

When Sensitivity Decreases without Intervention

Invisalign alignersThe pulp (living tissue and nerves) likely died if tooth sensitivity decreases without your dentist’s intervention. And if that is the case, you still need root canal treatment.

The only way to confirm the status of your tooth is with an x-ray. If you are not confident that your dentist can resolve the issue, please get a second opinion. Although tooth infection can spread and result in tooth loss, prompt care can prevent the need for tooth extraction and a dental implant. Although it is disappointing to delay Invisalign treatment, it is best to resolve your concerns now rather than interrupt it due to a flare-up later.

 

Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.

Persistent Tooth Sensitivity After a New Crown

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