A dental filling is a common procedure used to restore the structure of a tooth damaged by decay or trauma by removing the damaged section and replacing it with restorative material, such as composite resin or amalgam. While a filling resolves pain caused by a cavity, it is followed by a period of temporary sensitivity or soreness. This post-procedure discomfort is a normal part of the healing process as the tooth adjusts.
Understanding Post-Filling Sensitivity
The soreness experienced after a filling is a physiological response to the dental work performed near the tooth’s sensitive inner structures. One common sensation is thermal sensitivity, which is a sharp, brief pain triggered by hot or cold foods and drinks. This occurs because the drilling process, which generates heat and vibration, can temporarily irritate the pulp, the soft tissue inside the tooth that contains the nerve endings. The resulting inflammation is known as reversible pulpitis, where the nerve is temporarily stunned but expected to recover.
Another frequent type of discomfort is pressure or bite sensitivity. This sensation is often caused by a slight discrepancy in the filling’s height, where the restorative material is slightly high compared to the surrounding tooth surface. When the teeth close, this high spot receives excessive force, stressing the periodontal ligaments and the nerve. The general trauma of the procedure can also cause localized tissue irritation, leading to tenderness that fades as the tissues heal.
The Expected Timeline for Recovery
The initial soreness after a filling begins once the local anesthetic wears off, typically within two to seven hours. Patients may notice tenderness in the gum tissue or jaw. This immediate, localized discomfort is generally mild and should peak within the first 24 to 48 hours before starting to subside.
Short-term sensitivity, particularly to temperature, is the next phase and typically resolves quickly, often within three to seven days. As the nerve tissue inside the tooth calms down, the exaggerated reaction to hot or cold stimuli diminishes. For deeper fillings, where the decay was closer to the pulp, sensitivity may linger longer.
For deeper restoration cases, occasional thermal or pressure sensitivity may persist for up to two to four weeks. The pain should be steadily decreasing over time, indicating the tooth is successfully healing and adjusting to the new filling. If the filling was slightly high, a quick adjustment by the dentist can often resolve pressure sensitivity immediately.
Warning Signs That Require Dental Attention
While some post-filling soreness is expected, pain that deviates from the normal healing trajectory may signal a complication. A major warning sign is pain that worsens after the first 48 hours, or sensitivity that lasts beyond four weeks without improvement. Discomfort should be improving, not intensifying, over time.
Another concerning symptom is spontaneous, throbbing pain that occurs without being triggered by hot or cold temperatures. This type of pain, especially if it wakes a person up at night, suggests that the pulp inflammation may have progressed to an irreversible stage, potentially requiring a root canal. Any visible swelling in the gum tissue or face near the filled tooth, or the presence of discharge, could indicate a developing infection.
Severe or sharp pain upon biting that does not resolve after a week may indicate a significant issue with the filling’s occlusion or bite alignment. If the filling is too high, it creates constant trauma that prevents the nerve from settling down. Similarly, sharp pain upon chewing may be a primary symptom if a crack or fracture has occurred in the tooth structure during or after the filling procedure.