Ouch! Pain Free Dentistry and Dental Biomaterials

Ouch! Pain free dentistry. The "new" boon, right? Is some discomfort to be expected with dental care?

As I recent patient I was surprised to experience pain that I did not expect. All professionals should experience their own medicine, just to experience, and learn what it's like from the other side. I was treated for replacement of an old amalgam that had broken. No problem. With today's adhesive dentistry the amalgam was replaced with a bonded composite. The injection. No problem. Removal of the remaining amalgam. No problem. Cleaning up the prep. No problem. Acid etching the dentin. No problem. Washing away the phosphoric acid and air drying. No problem. Placement of the bonding agent. OUCH, that really hurt!

So maybe a dentin tubule blocker should have been placed, but given that I was already anesthetized, and felt no pain from all of the drilling and cavity cleaning I was really surprised, that the acidic bonding agent would hurt so much. It just goes to show you how the bonding agent penetrates into the tubules, bonds, and therefore that is why it hurt! Well after several days, the pain is finally subsiding. I wonder now if the vital tooth will survive? Something for us to consider.

On a different but related note. I have had a similar conversation with my friendly endodontist who commented how thankful they (some endodontists) were for bonding agents, particularly when when placed on young children. Something else to think about?

I think we can do better. Someone looking for a nice graduate or doctoral thesis project might take up this problem.