Dentist drilled new filling too low. Can it be restored to normal height without further drilling?

[ToothPatient]

To be fair I told him it still felt too high and he ended up drilling too much off.

Question being, to add more composite to restore it back to its height, does further drilling need to take place? (don't want to "over treat" or sensitize the nerve further)

Or can they just add composite on top of the low filling and it's no big deal?

Area of filling that was excessively reduced is on the biting/occlusive surface of the tooth.

 

[Dr M]

They can add filling, but there is still some drilling needed in order to smooth the filling. If the filling is again too high after adding filling material, the occlusion would need to be adjusted again with a drill.

 

[ToothPatient]

They can add filling, but there is still some drilling needed in order to smooth the filling. If the filling is again too high after adding filling material, the occlusion would need to be adjusted again with a drill.

Drilling to smooth the filling would be fine AFTER the additional composite is placed to restore the correct height (so it's not so low as it is now).

But so long as they don't need to remove more tooth or filling BEFORE they add the additional composite?

I'm just concerned with the nerve responding badly if more were to be removed from the tooth itself or pre-existing filling to add the additional composite, as it feels so low at the moment already.

But that's not necessary to do?
They can just presumably clean the occlusive surface with water, add the composite, then smooth it out as normal when it's done?

 

[ToothPatient]

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[Dr M]

Usually a tooth with a filling that is bit more filed down than usual, should not cause any issues. What issues are you experiencing exactly.

 

[ToothPatient]

Usually a tooth with a filling that is bit more filed down than usual, should not cause any issues. What issues are you experiencing exactly.

What about one that is significantly more filed down than usual?

He took a lot out as I mistakenly complained it was too high.

Issues being....... aching, occasional shooting pain in the tooth. This was absolutely not present prior to getting the height reduced. Could be residual from the drilling, or the nerve being traumatized from filling being away from it?
When I compare it to the same tooth on the opposite side, the occlusive surface feels so much lower (closer to the nerve?)

 

[Dr M]

Don't think it is related to the filling being too filed down. Might be residual nerve trauma due to drilling on the tooth, which should go away with time, or it could be that the filling that was placed is actually a large and deep filling, in close proximity to the pulp of the tooth. Do you have x-rays you could share?

 

[ToothPatient]

When I say the filling is "too low", what I really mean is the filling was drilled away almost entirely, save for that covering the dentin (I assume, barely, as that area is more temperature sensitive now).

For that reason, it feels like when I eat or bite down, the entire tooth is weaker, especially on the lingual side where the filling was supporting, as that portion of the tooth feels very "thin" now, where normally it's got "bulk" and strength (according to how it feels when palpated with my tongue at least).

Top right in the pic, the tooth that's obviously filled, but it's top left, tooth 7 in my mouth.
This was unfortunately taken just BEFORE having the filling lowered or reduced so doesn't show how the tooth or filling looks now.

The mesial side filling is recent, two months ago.
The occlusive side was done in 2019 and was without issue until recently when too much was drilled out two weeks ago.

.........

Temperature sensitivity is acute on the buccal side of the tooth, has been since about one week after getting the recent mesial side filling two months ago. But no real temperature sensitivity on any other side of the tooth that I can tell.

Since having the occlusive height reduced two weeks ago, a pain/ache has emerged when biting down, or when I palpate the thin-feeling lingual side with my tongue.
My thinking is if I get the occlusive filling topped up, it may at least alleviate that pain?

As to the buccal side temperature sensitivity, I'd love to find the cause or reason for that?

 

[Dr M]

It seems like you have quite a large filling on the tooth. It also looks like there might be either a small gap or secondary decay on the tooth. It is indicated by the small dark shadow that you can see below the filling mesially.
I would suggest re-doing that part of the filling. The buccal sensitivity could be due to either gum recession or an abrasion lesion, which can also be filled in certain cases. You can the lastly add some filling lingually, where you feel it is thin, and then grind it down naturally with normal functioning.
It is important to keep in mind, that a large filling, close to the pulp or nerve chamber, can have some accompanying sensitivity.

 

[ToothPatient]

It seems like you have quite a large filling on the tooth. It also looks like there might be either a small gap or secondary decay on the tooth. It is indicated by the small dark shadow that you can see below the filling mesially.
I would suggest re-doing that part of the filling.

Can that being done without re-doing the entire filling?

The buccal sensitivity could be due to either gum recession or an abrasion lesion, which can also be filled in certain cases. You can the lastly add some filling lingually, where you feel it is thin, and then grind it down naturally with normal functioning.
It is important to keep in mind, that a large filling, close to the pulp or nerve chamber, can have some accompanying sensitivity.

I've had it checked for gum recession, which it doesn't seem to be. In addition that buccal sensitivity arose almost exactly one week following the mesial filling which was done two months ago.

I noticed there was a coarseness on the buccal side of the tooth and that was initially touch sensitive.

Then it became temperature sensitive about a week later.

When you say it can be filled, do you mean re-doing that part of the filling, or applying sealant on top of it?

Would an abrasion lesion be visible on the surface of the tooth as a gap or hole or such?

These pics were taken before I had the margin of that tooth corrected, but they seem to show something, looks like a stress emergent whitening or something, on the anterior buccal part of the surface (exactly where it's most temperature sensitive).

Would that constitute a abrasion lesion?

 

[ToothPatient]

Pics taken today of the buccal side of the tooth (after margin was corrected).

I don't' know what an abrasion lesion looks like; anything there to indicate it's present, or what the cause of sensitivity may be?

 

[Dr M]

Difficult to judge clearly on the photo. It almost looks like you had an abrasion lesion on the buccal surface that was previously filled. Sensitivity on a tooth is sometimes difficult to diagnose precisely. You would need to cancel out the most probable causes one by one. I would start by re-doing the filling ( mesial part). You would need to remove it, clean out the residual decay if found, and fill it again. I would then use a dentin sealant buccally and lingually and then follow-up.

 

[dental_care]

To be fair I told him it still felt too high and he ended up drilling too much off.

Question being, to add more composite to restore it back to its height, does further drilling need to take place? (don't want to "over treat" or sensitize the nerve further)

Or can they just add composite on top of the low filling and it's no big deal?

Area of filling that was excessively reduced is on the biting/occlusive surface of the tooth.

If your dentist drilled a filling too low, they can likely restore it to its original height without causing further damage. They may either add more composite material or re-shape the existing filling.

However, it's important to consult with your dentist directly to discuss the best course of action for your specific situation.