Hello! I am a fourth-year dental medicine student. About a month ago my dentist replaced an occlusal amalgam filling on tooth 16 with an MOD composite restoration. Before the procedure I had no problems with the tooth, but since then I experience severe pain when biting, especially on harder food. The pain is sharp and disappears soon after the stimulus is removed. Because of this I have not eaten on that side for a month. Otherwise the tooth is not sensitive to heat or cold, nor to light percussion. I also do not feel that the filling is too high. What could be causing this pain? Thank you for your answer and kind regards.

Dear Sir/Madam!

Amalgam is still the best filling material for restorations in the posterior region. Disturbances in the form of hypersensitivity to changes in osmotic pressure or temperature changes occur very often after replacement. Based on what you have written, however, I believe that a small area of dentine may have remained uncovered or may have become exposed while polishing the filling. It is also possible that the filling is too thin and flexes slightly under heavy force, which triggers the described problem. Sometimes an air bubble becomes trapped in the composite, which could also cause similar problems.

Have a nice day!