New research from the University of Pittsburgh’s Swanson School of Engineering introduces a revolutionary treatment for these infections. The group, led by Tagbo Niepa, PhD, is utilizing electrochemical therapy (ECT) to enhance the ability of antibiotics to eradicate the microbes.

“We live in a crisis with antibiotics: most of them are failing. Because of the drug- resistance that most microbes develop, antimicrobials stop working, especially with recurring infections,” says Dr. Niepa, author on the paper and assistant professor of chemical and petroleum engineering at the Swanson School, with secondary appointments in civil and environmental engineering and bioengineering.

With this technique, the current doesn’t discriminate as it damages the microbe cell membrane.

“It’s more likely that antibiotics will be more effective if the cells are simultaneously challenged by the permeabilizing effects of the currents. This would allow even drug-resistant cells to become susceptible to treatment and be eradicated.”

The novel method passes a weak electrical current through the metal-based implant, damaging the attached microbe’s cell membrane but not harming the surrounding healthy tissue. This damage increases permeability, making the microbe more susceptible to antibiotics. Since most antibiotics specifically work on cells that are going to replicate, they do not work on dormant microbes, which is how infections can recur. The ECT causes electrochemical stress in all the cells to sensitize them, making them more susceptible to antibiotics.

The researchers hope this technology will change how infections are treated. Researchers focused their research on Candida albicans (C. albicans), one of the most common and harmful fungal infections associated with dental implants. But while dental implants are one exciting application for this new technology, Niepa says it has other potential applications, such as in wound dressings.

The U-M researchers compared the pain and satisfaction of those who used opioids to those who didn’t.

“I feel like the most important finding is that patient satisfaction with pain management was no different between the opioid group and non-opioid group, and it didn’t make a difference whether it was surgical or routine extraction,” said study co-author Romesh Nalliah, clinical professor and associate dean for patient services at the U-M School of Dentistry.

Surprisingly, patients in the opioid group actually reported worse pain than the non-opioid group for both types of extractions, Nalliah said.

The researchers also found that roughly half of the opioids prescribed remained unused in both surgical and nonsurgical extractions. This could put patients or their loved ones at risk of future misuse of opioids if leftover pills are not disposed of properly.

The findings are scheduled to appear March 13 in JAMA Network Open.

“The real-world data from this study reinforces the previously published randomized-controlled trials showing opioids are no better than acetaminophen and nonsteroidal anti-inflammatory drugs for pain after dental extraction,” said study co-author Chad Brummett, director of the Division of Pain Research and of Clinical Research in the Department of Anesthesiology at Michigan Medicine, U-M’s academic medical center.

Brummett co-directs the Michigan Opioid Prescribing Engagement Network, or Michigan OPEN, which has developed, tested and shared guidelines for the use of opioids in patients with acute pain from surgery and medical procedures.

“These data support the Michigan OPEN prescribing recommendations calling for no opioids for the majority of patients after dental extractions, including wisdom teeth extraction,” he said.

In this article, we look at the reasons why a person may have tooth sensitivity after a filling, how to treat it, and when to see a doctor or dentist. We also look at other possible causes of tooth sensitivity.

What should I expect after a filling?

A filling is a dental procedure that involves a dentist cleaning away any decay from the tooth and then filling the space with a new material.

After injecting a numbing agent around the tooth, the dentist will then clean out the decayed area of the tooth, usually with a dental drill. They will then fill the space with gold, silver amalgam, a composite, or porcelain.

For several hours after having a filling, a person’s face may still feel numb, tingly, itchy, or puffy. They may have difficulty eating, swallowing, talking, or moving their face.

Sometimes, dentists recommend that people avoid eating or drinking for a few hours, as this may result in a person accidentally biting their tongue or cheek.

Once the numbing agent has worn off, these feelings will go away. But, in the following days and weeks, a person may notice some new sensations as they adjust to the new filling.

Sensitivity in the filled tooth or area around it is one of the most common occurrences during this time.

What does sensitivity after a filling feel like?

When a person has a sensitive tooth, they may notice that certain triggers cause a temporary, uncomfortable sensation in the filled tooth or surrounding area. It may feel like a shock of cold or sudden pain that comes on quickly and goes away.

Factors that can trigger tooth sensitivity after a filling include:

• cold foods or drinks, such as ice cream, popsicles, or beverages with ice
• hot drinks, such as coffee or tea
• air hitting the tooth, such as when breathing through the mouth, which may be worse with cold air
• sugary foods, such as candy
• acidic foods and drinks, including fruit, juice, and coffee
• biting down when eating

Why do fillings cause tooth sensitivity?

ome sensitivity after a tooth filling is normal and temporary. Sometimes, however, sensitivity after a filling is due to other causes that need treatment or repair.
Short-term tooth sensitivity after a filling usually occurs because the filling procedure has aggravated or caused inflammation in the nerve inside the tooth.

Usually, the tooth’s outer layers — the enamel and cementum — protect the nerve from exposure. But fillings, especially deep ones, can get close to the nerve endings and cause irritation and uncomfortable sensations.

As the nerve heals, the sensitivity will go away. This may take a few days or weeks. Once the nerve has healed fully, a person should feel no difference between the filled tooth and the other teeth.

Gingivitis often resolves with good oral hygiene, such as longer and more frequent brushing, and flossing. In addition, an antiseptic mouthwash may help.

In mild cases of gingivitis, patients may not even know they have it, because symptoms are mild. However, the condition should be taken seriously and addressed immediately.

Types

There are two main categories of gingival diseases:

Dental plaque-induced gingival disease: This can be caused by plaque, systemic factors, medications, or malnutrition.

Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures. Sometimes, there is no specific cause.

Causes

The most common cause of gingivitis is the accumulation of bacterial plaque between and around the teeth. The plaque triggers an immune response, which, in turn, can eventually lead to the destruction of gingival, or gum, tissue. It may also, eventually, lead to further complications, including the loss of teeth.

Dental plaque is a biofilm that accumulates naturally on the teeth. It is usually formed by colonizing bacteria that are trying to stick to the smooth surface of a tooth.

These bacteria might help protect the mouth from the colonization of harmful microorganisms, but dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis, a gum infection.

When plaque is not removed adequately, it can harden into calculus, or tartar, at the base of the teeth, near the gums. This has a yellow color. Calculus can only be removed professionally.

Plaque and tartar eventually irritate the gums, causing gum inflammation around the base of the teeth. This means that the gums might easily bleed.

Other causes and risk factors

Changes in hormones: This may occur during puberty, menopause, the menstrual cycle, and pregnancy. The gingiva might become more sensitive, raising the risk of inflammation.

Some diseases: Cancer, diabetes, and HIV are linked to a higher risk of gingivitis.

Drugs: Oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin, an anticonvulsant, and some anti-angina medications can cause abnormal growth of gum tissue.

Smoking: Regular smokers more commonly develop gingivitis, compared with non-smokers.

Age: The risk of gingivitis increases with age.

Poor diet: A vitamin-C deficiency, for example, is linked to gum disease.

Family history: Those whose parent or parents have had gingivitis have a higher risk of developing it too. This is thought to be due to the type of bacteria we acquire during our early life.