Dental fillings are a common restorative treatment, used by millions of people to repair teeth affected by decay or damage. While they are designed to be durable and long-lasting, dental fillings are not permanent and can, over time, become a source of discomfort or pain. Understanding why an old filling might cause pain and what symptoms to look for can help in addressing these issues promptly. This article will explore the reasons behind filling-related pain, how to recognize the signs, and the typical dental interventions available.
Understanding Dental Fillings
Dental fillings restore the function, integrity, and shape of missing tooth structure due to cavities or trauma. When a dentist removes decayed tooth material, a filling fills the resulting space, preventing further decay and protecting the inner part of the tooth. This maintains the tooth’s structure and allows for proper chewing.
Various materials are used for dental fillings, each with distinct properties. Common options include amalgam, a silver-colored mixture of metals, and composite resin, a tooth-colored plastic and glass mixture. Gold and porcelain are also used, with the choice depending on the filling’s location, decay extent, and patient preferences.
Reasons Old Fillings Cause Pain
New decay is a common reason for pain around an old filling. Cavities can form at the margins of an existing filling, or even underneath it, as bacteria accumulate in gaps where the filling no longer seals tightly. This underlying decay can reach the deeper layers of the tooth, causing sensitivity or pain.
Fillings experience wear and tear over time, like natural tooth structure. Chewing forces can gradually wear down the filling material, especially in areas of heavy biting contact. This wear can lead to the filling losing its original shape or seal, exposing the tooth to bacteria or thermal changes.
Fractures in a tooth or filling can cause pain. Chewing hard foods, teeth grinding, or temperature changes can create cracks in the filling material or surrounding tooth structure. A cracked tooth might cause sharp pain when biting down, which then subsides upon release, indicating a fracture needing immediate attention.
If decay beneath a filling progresses deeply enough, it can irritate or infect the dental pulp, which contains the tooth’s nerves and blood vessels. This condition, known as pulpitis, can cause significant pain, ranging from mild sensitivity to severe, throbbing discomfort. Pulpitis signals that the infection has reached the tooth’s innermost living tissue.
Galvanic shock can occur when two different types of metal fillings come into contact. This creates a mild electrical current, resulting in sudden, sharp, and brief pain. While not a common cause of chronic pain, it is an unsettling sensation.
An old filling can cause pain if it is “high,” meaning it interferes with the natural bite. If a filling is too high after placement or if surrounding teeth shift, it creates excessive pressure on that tooth during chewing. This constant pressure leads to soreness, tenderness, or a feeling of a bruised tooth. Gum recession can also expose the root surface near an old filling, increasing sensitivity to hot, cold, or sweet stimuli. Exposed dentin, less protected than enamel, allows external stimuli to reach the nerve more easily.
Recognizing Symptoms and When to See a Dentist
Recognizing problematic filling symptoms is important for timely intervention. Sensitivity to hot or cold temperatures, or to sweet foods, is a common early indicator that a filling is compromised or decay is progressing. This sensitivity can be sharp and fleeting, or more prolonged, depending on the issue’s extent.
Sharp pain when biting down or releasing the bite suggests a cracked tooth or fractured filling. This pain indicates structural issues requiring a dentist’s assessment. The discomfort can be localized to the problematic tooth or radiate to surrounding areas.
A dull ache or throbbing pain around a filled tooth signals deeper inflammation or infection within the tooth’s pulp. This persistent pain indicates a more advanced problem needing professional evaluation. Visible damage, such as a chipped, loose, or missing filling, is a clear sign the restoration needs attention.
Seek prompt dental attention if you experience persistent pain, swelling around the tooth or jaw, or fever, indicating a more serious infection. Ignoring symptoms can lead to more extensive damage to the tooth or surrounding tissues. Early diagnosis and treatment prevents the issue from escalating.
Addressing Filling-Related Pain
When an old filling causes pain, a dentist diagnoses the underlying cause through examination and X-rays. If the existing filling is faulty, or if new decay is minor, the dentist may recommend replacing the old filling with a new one. This involves removing the old filling and any decayed tooth structure, then placing a new restorative material.
For more extensive damage to the tooth structure, especially if a large portion of the tooth is weakened or fractured, a dental crown is necessary. A crown is a custom-made cap that covers the entire visible part of the tooth, providing strength and protection. This option is considered when a filling alone cannot restore the tooth’s integrity.
If the pain is due to deep decay or infection reaching the tooth’s pulp, a root canal treatment is required. This involves removing the infected or inflamed pulp, cleaning and disinfecting the inside of the tooth, then filling and sealing the root canals. A crown is often placed over a root canal-treated tooth to protect it from fracture.
In cases where the tooth is severely damaged, extensively fractured, or beyond repair, tooth extraction may be the only option. This is considered a last resort when other restorative treatments are not possible or would not be successful. After extraction, options for tooth replacement, such as a dental implant or bridge, are discussed.
Ultimately, the appropriate treatment for filling-related pain depends on the diagnosis made by a dental professional. A thorough examination is necessary to determine the cause of the pain and to recommend the most effective treatment plan. Self-diagnosis and delayed treatment can lead to more complex and costly dental issues.