Composite gum line filling still sensitive after 2 weeks normal settling or something else?

[mic]

Hi everyone,
I'm looking for some advice or insight on a tooth that’s playing up. Exactly two weeks ago, I had a composite filling placed right at the gum line (Class V).
Ever since, the tooth has been quite sensitive to hot, cold, and sudden pressure. However, the sensitivity is incredibly fleeting—it only lasts for a split second and then completely disappears.
Here are a few specific details:
The bite feels fine: It doesn't feel high or like it's hitting early when I chew.
No pain on constant pressure: If I clench/press my teeth together, or even if I press hard directly on the tooth with my finger, there is absolutely no pain.
The trigger: It’s just that initial sharp, split-second zap from temperature or sometimes chewing bite pressure.
Is it normal for a gum line composite to take this long to settle down, or does this sound like something else might be going on (like a micro-leak, bonding issue, or nerve irritation)? I'd love to hear if I just need to give it more time or if I should head back to my dentist.
Thanks in advance!

 

[Dr M]

It depends on the depth of the cavity that was filled. If the cavity was close to the nerve, then there is a chance that you might have some sensitivity with tempratures for a while, before it ceases. As long as this sensation is not spontaneous and not lingering for a minute or so, then it should not be anything to worry about. As to comment on the quality of the filling, we would need to see some photos or x-rays to comment. There is also a chance that the sensitivity might be unrelated to the filling, but due to exposed dentin on the rest of the tooth, due to a lack of enamel. I would try to use Sensodyne toothpaste. Brush with the toothpaste, and then spit out, don't rinse. Leave a layer on the teeth, and additionally apply some to the tooth in question as well and leave it on. Give it a few days and see if you notice a difference.

 

[mic]

Hi Dr M,
Thank you so much for the detailed advice! its five weeks since the filling was placed on June 11th), and I have a quick update.
First, the biting/pressure sensitivity has almost entirely resolved now—the nerve seems to have settled on that front. Currently, the main lingering issue is mostly just sensitivity to cold.
I did get in touch with my dental practice via email, and their reception team sent this reply:
"White fillings can take a lot longer to settle compared to an amalgam (grey filling). This is quite common, however, if you feel the pain is increasing rather than subsiding, I would advise speaking to your Dentist."
On a separate note, I've noticed something physical with the tooth. If I run my fingernail along the side of the tooth, I can distinctly feel a a "ledge" where the composite meets my natural enamel.
With that in mind, I have two quick questions for you:
Is it normal to feel a physical margin or join like that with your fingernail on a Composite filling, or should it feel completely smooth? Could an uneven margin or tiny ledge be allowing cold liquids to seep in and trigger the cold sensitivity?
Since the biting sensitivity has already gone away, do you think I should keep giving the cold sensitivity more time to settle ?
Thanks again for your help!

 

[Dr M]

The fact that you can feel a margin with your finger, might be due to two reasons. Either there is an overhang present ( too much filling material ) or the filling formed a gap, which could cause leakage of fluid, resulting in sensitivity. Based on the fact that I don't have any clinical image of the tooth, I would maybe suggest going back to your dentist, just to make sure. Rather safe than sorry.

 

[mic]

Just got back from the dentist today for a follow-up!
I explained the sensitivity issues (mostly to cold and sweet, but also a bit to heat/pressure). He mentioned that heat sensitivity can sometimes be a sign that the nerve is dying, which had me a bit worried! However, after a thorough check, he found a couple of clear reasons for the issues:
A tiny gap at the bottom of the original filling.
A small spot of decay right along the margin that had been missed.
He went ahead and refilled it to seal the gap and cleaned out that spot. He also checked the bite height and polished a tiny bit off the top.
Given there was an open gap and exposed dentin, it makes total sense to me that heat (along with cold and sweets) was triggering it, so I'm hoping that sealing it up fixes the problem.
I'm still completely numb right now, so I can't test it yet. Once the anesthetic wears off later today, I'll see how it reacts to temperature and chewing. Fingers crossed sealing that gap lets the nerve finally settle!

 

[mic]

Hi everyone,
Just wanted to post a quick update following the redo on Friday.
I’m now sitting right around the 48-hour mark and the nerve is completely quiet—zero tooth pain, no heat/cold zaps today, and even the injection site tenderness is mostly gone. Giving the ligament a rest by chewing on the other side seems to be working a treat.
Only minor snag: I’ve noticed a bit of excess composite resin bonded between the teeth at the contact point, so I can’t get floss through at the moment.
Given that my Orlando trip is coming up on August 14th, should I contact the dentist to pop in and get it smoothed down, or is it better to just leave it and wait to see if it resolves itself?

 

[Dr M]

If it is indeed filling material, I don't think it will resolve on its own. Best would be to contact the dentist to have it corrected.