By Michael G. Rehme, DDS, NMD, CCN
I found out a long time ago that if you want to make a new friend and patient for life, get them out of dental pain and as quickly as possible. As a dentist, there’s nothing more gratifying than helping a patient completely relieve their chronic toothache within a matter of minutes.
How is this possible?
Well, we’re not talking about abscessed or infected teeth here, nor tooth pain associated with periodontal disease. Those are usually more obvious and detectable. We’re talking about subtle aches and pains that are related to dental occlusion, i.e., how your teeth touch together when you close your mouth.
During most dental procedures, when anesthesia is used, it becomes a bit more challenging for both the dentist but the patient to accurately detect the exact positioning of the teeth as they come together. Although it’s not unusual or uncommon for teeth to be sensitive days after dental work is performed, these discomforts normally calm down within 7 to 10 days.
Only after years of clinical experience – and with some persistence – have I learned a valuable lesson in my practice: Dentistry is not perfect, and sometimes we dentists need to check our work once, twice, or even three times before it’s right and our patients are finally comfortable.
If you’ve recently had a new filling, crown, or fixed bridge placed or repaired, with no history of pain beforehand and then notice a week or two later that your tooth is still sensitive to temperature changes, especially cold, you might want to have your bite checked again.
If you can’t chew any hard foods on this particular tooth and it’s not waking you up at night, check the bite.
Anatomically speaking, the periodontal ligaments (elastic fibers that hold the teeth in place within the bone socket) get compressed over and over again as the upper and lower teeth come together if the new restoration is too “high.” This constant repetitive pressure causes the tooth to be traumatized and creates a very uncomfortable situation.
What’s interesting about these malocclusions is that, most of the time, patients can’t even detect that there is something wrong. I wish I had a dollar for every time a patient has told me, “My bite feels fine, Doc; it just hurts.” Once the bite is correct, the patient will immediately notice a reduction in pain. The sensitivity, whether it’s been bothering them for a week or even a year, can disappear completely within 24 hours.
Adjusting 0.2 to 0.3 millimeters can make all the difference between enjoying your next meal with a glass of iced tea or taking pain relievers until the problem is finally solved.