In a BW x-ray of an amalgam restoration, what does a patient complain about that could indicate an issue?

Pain when provoked by hot or cold can be a significant indication of an issue related to an amalgam restoration. This type of sensitivity often suggests that there is a problem with the seal of the restoration, which may lead to the exposure of the underlying tooth structure to external stimuli. This exposure can cause the pulp (nerve) of the tooth to react to thermal changes, resulting in discomfort or pain.

Sensitivity can arise for several reasons, including an incomplete seal, microleakage, or even improper placement of the amalgam, leading to thermal sensitivity. If a patient frequently reports pain triggered by temperature changes, it’s crucial to assess the restoration for these potential issues, as they may indicate a need for adjustment or replacement to ensure the tooth remains protected and healthy.

The other options, while they may indicate issues, are less specifically tied to the amalgam restoration itself in terms of immediate clinical assessment regarding sensitivity. Swelling and discoloration can point to infection or inflammation but do not directly relate to the effectiveness of the amalgam material at that moment. Loosening of the restoration can indicate a problem, but it may not always manifest with immediate sensitivity reactions like thermal pain does.