All Posts Tagged: houston dentist

What Causes Tooth Sensitivity?

Do you ever experience tooth pain upon chewing, or upon drinking something hot or cold? There are several types of sensitivity, and several possible treatments. Many patients fear the worst upon the first sign of sensitivity, but don’t panic! Oftentimes, the problem and solution are actually quite simple. But it’s always best to see your dentist to rule out any serious problems and get treatment early. The following are the most common causes of sensitivity.

Worn or eroded enamel:
Our teeth have 3 layers, the inner pulp, which contains the nerve; the middle, softer layer called dentin; and the outer, hard layer called enamel, which protects the tooth from decay, sensitivity, and other damage. There are several reasons the protective enamel can be worn away, including acid erosion, which can result from certain dietary habits or health problems such as acid reflux. Some patients also cause erosion by brushing too hard or using an abrasive substance to clean their teeth. Sometimes the sensitivity can be reduced by the use of a toothpaste for sensitive teeth, application of a desensitizing agent, or a small bonded filling, as long as the wear is not severe enough to necessitate a crown.

Physical wear on the teeth due to grinding or an uneven bite is another potential cause of sensitivity. Your dentist should be able to identify the source of wear and may recommend a nightguard or refer you to an orthodontist to correct any misalignment of your teeth.

Recession of the Gums:
Our gums should ideally cover the roots of our teeth to protect them from cavities and sensitivity, but occasionally, they can recede, or pull away, causing an exposure of the roots to air and water. In these cases, the teeth become sensitive to cold air and even brushing. The good news is, this type of sensitivity is often the easiest and quickest to relieve with the use of a desensitizing agent or a special toothpaste. However, recession tends to get worse over time if the underlying cause is not treated, so make sure to talk to your dentist about how best to prevent further recession!

An illustration of gingival recession

Uneven Restorations:
Did your sensitivity begin after a filling or a crown was placed? Our teeth have ligaments which are very sensitive to extra pressure from an uneven bite. Oftentimes, you may not even realize your recent filling or crown is too high, but your dentist may be able to make a small adjustment to even things out and relieve your symptoms! Make sure to go back to your dentist if a restoration remains sensitive for more than two weeks after being placed.

Deep Cavities:
Many patients assume a sensitive tooth must be due to a cavity. However, cavities can be present for months or years without causing any symptoms. Typically, a cavity will not cause any pain until it is quite close to the nerve, in which case it may be too late for a simple filling, and a root canal may be necessary. This is one more reason to see your dentist every 6 months in order to detect any cavities while they are still small!


Sinus Problems:
I have personally seen many patients who were convinced something was terribly wrong with one of their teeth, only to have their sensitivity resolve by treating a congested sinus! Allergies and other causes of sinus congestion can often place pressure on the roots of the upper teeth, making them extra sensitive. Your dentist may refer you to your physician to recommend allergy treatment or to refer you to an ENT if sinus problems are identified.

Fractured Teeth:
There are many reasons a tooth can crack, or fracture, and the severity can range from very minor chips, which can be repaired with a small filling, to major fractures requiring a crown or even a root canal. In rare cases, a tooth can fracture through the root, in which case it must be removed. Your dentist may do some tests or specific imaging to diagnose whether a fracture is present.

I hope this post has been beneficial, and as always, please feel free to email me with any specific questions at Thank you for reading!

-Ayham Nahhas, DDS

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Should I remove my silver fillings?

Amalgam fillings, otherwise known as silver fillings, have been used for over 100 years to restore decayed and broken teeth, but have recently become quite controversial. As with any aspect of your health, it is important to be well informed about amalgam in order to make the right decision!

 So what is amalgam?

Dental amalgam is a mixture of metals, including silver, copper, tin, and mercury. Mercury is necessary to make the metal soft enough to use for a filling, but is also toxic and known to cause adverse health effects, which has lead to great concern among patients.

In the past, it was thought that, after the initial placement, the mercury in an amalgam filling became completely inert, and therefore safe. But recent studies have shown that very small amounts of mercury vapor are released when chewing. But like any toxic substance, we are exposed to mercury all the time via food, air, and water, and the real question is whether the amount released by an amalgam filling is high enough to cause adverse effects. The FDA has determined that this amount is not enough to cause harm to the general population, and has deemed amalgam fillings to be safe for individuals over the age of 6. However, a significant amount of mercury vapor and powder is released upon initial placement and removal of amalgam fillings, so precautions should be taken. For example, it is not recommended for women to have amalgam fillings placed or removed during pregnancy.

What other options do I have?

Most patients no longer want to have metal fillings placed in their teeth, for cosmetic reasons as well as concerns about mercury. Composite resin is a plastic-like, tooth colored material that is most commonly used for ordinary fillings. Although mercury-free and more esthetic than amalgam, composite resin is not quite as strong and may not be indicated for larger fillings. Also, many patients do not realize that most composite resins contain a small amount of BPA, a potentially carcinogenic material, so it is not entirely consistent to choose composite over amalgam out of fear of toxic materials. (All the more reason to practice preventive care and keep your teeth cavity-free!) Some newer composites do not contain BPA, so if this is a concern for you, speak with your dentist about the type of composite they use. Finally, composite resin requires very dry conditions in order to bond properly to the tooth, so some cases are not very suitable for composite resin. Here at Wave Dental, we strive to use the best materials possible, and our composite is a newer, hybrid ceramic-like material that is BPA free and more resilient than traditional composite resins.

In addition to composite resin, ceramic or gold inlays and onlays may be indicated in some cases. Keep an eye out for a future blog post discussing all the possible restorative materials!


Before and after replacing amalgam fillings with composite.

“I’m worried about mercury and don’t want metal in my mouth anymore”

It’s understandable to want to be on the safe side and avoid mercury, but that doesn’t mean that you should rush to your dentist and have your amalgam fillings removed. In fact, significant amounts of mercury vapor are released upon destruction and removal of an amalgam filling, so you would actually be increasing your mercury exposure by having them replaced! Amalgam fillings should only be replaced if they are broken or have developed recurrent decay. Be wary of dentists who try to convince you to replace all of your metal fillings for health reasons, as this is unnecessary and counterproductive.

But what if I’m allergic?

Some people have sensitivities to metal in general, but an actual allergy to the mercury in amalgam is extremely rare, and there have been less than 100 cases ever reported. If you know that you are allergic to certain metals, you should discuss this with your dentist and consider other filling materials.

Thank you for reading! If you have any more questions about amalgam, feel free to email me at or check out the FDA website here for information:

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