[ACEsthetics] New Post/Thread Notification: Cosmetic Dentistry

Hello,

Peter has just posted in the Cosmetic Dentistry forum of ACE Dental World under the title of Sensitivity to flossing after veneer placement...!.

This thread is located at http://www.acedentalforum.com/forum/threads/1372-Sensitivity-to-flossing-after-veneer-placement-!

Here is the message that has just been posted:
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Hi all,

This hardly ever happens but it happened recently and I kind of knew it would. What I need to know is, what can I do about this?

We had what I will call the Perfect Storm for a veneer patient...

Reason for doing veneers was...crowding. Patient did not want ortho.

Case was: 6 lower anteriors. Lower anteriors. And for some reason, yeah, these are always more prone to sensitivity than the uppers.

Patient slightly whiny and nervous anyways...

Poor oral hygiene in temps and not great OH at other times.

Teeth were crowded so many areas at the gingival would be somewhat tight anyways, although I did try to free those areas up with strips.

Temps were fine...as per usual.

The day of insertion, I kind of knew, gonna be a problem. Bilateral blocks, rubber dam Dickerson-style. Superoxol to control bleeding.

Veneers were inserted in a blood-free environment, saliva free environment.

Ribbon saws, etc. Contacts are mostly good but mesial of cuspids on each side are catchy to floss (resin stuck in there..?) and sensitive. Luckily for me, she is not mad about it and honestly if I left it alone, she would be ok with it BUT it bugs me.

I can get her back, mental block her on one side and try re-stripping the contact smooth, but that's not going to help sensitivity.

OH is poor and if you floss it bleeds. So if you want to place a desensitizing agent...can't really do it. Plaque occludes the area preventing penetration.

Any ideas? The only thing I can think of is fabricating a little tray to fit over the lower 6 anteriors and then give her "something" to put in it like MI Paste or some other kind of desensitizing material.

Any ideas? I do not think it's an endo problem....I'm pretty sure it is a gingival sensitivity problem such as etching a root surface or denuding a root while stripping it to open a contact.

Advice...?


Thanks -

Peter Campbell
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