A patient with a composite filling experiences sensitivity. What is the most appropriate initial response?

In cases where a patient with a composite filling reports sensitivity, the most appropriate initial response is to place a zinc oxide-eugenol (ZOE) dressing to sedate the pulp. This approach is beneficial because ZOE has sedative properties that can help alleviate discomfort by providing a temporary barrier and reducing inflammation in the pulp. It serves as a palliative measure while further evaluation or treatment options are considered.

Moreover, using a ZOE dressing allows time for the pulp to recover, especially if the irritation is mild and there is a possibility of reversal. It is a conservative step that prioritizes patient comfort and aims to avoid more invasive procedures unless absolutely necessary. It also helps in assessing the situation over time, allowing the clinician to make a more informed decision regarding the need for further intervention based on the patient's progress.

Other options, such as extirpating the pulp or repeating the restoration immediately, are more involved interventions that may not address the initial sensitivity and can lead to unnecessary procedures if the inflammation is mild. Asking the patient to return in six months does not address the immediate concern of sensitivity and could lead to prolonged discomfort for the patient. Thus, opting for a ZOE dressing is a sensible and effective first response.