Expert: Mark Bornfeld DDS - 9/22/2007

Question
Yesterday, my son was getting a filling and when he complained that the outside of his mouth was burning the dentist said that some of the filling material had gotten on him and he should just wipe it off. When we left the dental office this was a little red patch, which the dentist said would go away. Today it is looks like a nasty burn. What happened???? How should I treat this?

Answer
Dear Susie,

Assuming your son's dentist placed a resin (tooth-colored) filling, there are two possibilities:

1. your son is allergic to the resin (this is not common, but certainly not unprecedented). If this is the case, he may be in danger of developing some manifestations of the sensitivity inside his mouth, especially on those soft tissues that are in direct contact with the filling. You should have a look to assess the extent of any of these "burns", and return to the dentist to substitute a filling of different composition. In allergic individuals, the resin fillings continue to act as an allergen, and can cause contact dermatitis-like lesions in the mouth.

2. Your dentist inadvertently allowed phosphoric acid-- a chemical etchant usually used prior to bonding the resin to the tooth-- to contact your son's soft tissues. This would cause the type of injury one would expect when living tissue comes in contact with strong acid. If this is the case, this would not be considered your dentist's finest hour. Instead of asking your son to wipe off the acid (perhaps further worsening the injury), he ideally shouldn't have allowed the acid to contact the soft tissues in the first place. It was just plain sloppy.

You should continue to monitor the size and severity of the burn. If it is more than about one-half inch in diameter or appears deep, you should return to a dentist (that dentist?) for assessment and treatment as needed. In the meantime, you can use any of the oral topical anesthetic or protective products available at your local pharmacy, such as Anbesol, Orabase, or Zilactin, to make your son more comfortable while the burn is healing.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY