A dental filling is a restorative procedure where a dentist removes decayed tooth material and replaces it with materials like composite resin or amalgam. Discomfort following this treatment is common. While temporary sensitivity or mild aching is normal as the tooth heals and adjusts, persistent, severe, or worsening pain is not typical and may indicate a problem requiring professional attention. Understanding the difference between expected temporary discomfort and a serious issue is key to managing recovery.
The Difference Between Pain and Sensitivity
The type of discomfort felt after a filling often provides clues about the nature of the issue. Sensitivity is characterized by a sharp, immediate, and fleeting discomfort that occurs in response to a specific stimulus. This feeling is most often triggered by temperature changes, such as hot or cold foods, or by sweet substances or cold air. This response happens because decay removal irritates nerve endings within the dentinal tubules, which lead to the tooth’s pulp.
Pain, conversely, is usually more persistent, throbbing, or manifests as a sharp ache when biting down on the filled tooth. A mild, dull ache that improves over a few days is part of the inflammatory healing process. However, a continuous, severe, or spontaneous throbbing sensation signals a deeper issue. Pain occurring only upon the pressure of chewing often suggests a mechanical problem with the filling itself.
Common Causes of Post-Filling Discomfort
The most frequent cause of discomfort after a filling is traumatic occlusion, or a “high spot.” This occurs when the new filling material is slightly higher than the surrounding tooth surface, disrupting the natural alignment of the bite. Even a microscopic elevation causes excessive pressure when chewing, leading to sharp, localized pain that is immediately resolved with a simple adjustment.
Another common source of temporary soreness is pulpal irritation, which is inflammation of the pulp tissue deep inside the tooth. The vibration and heat generated by the drilling process can temporarily stress the nerve, leading to transient thermal sensitivity. This mild inflammation, often called reversible pulpitis, should gradually subside within a few days to two weeks as the nerve calms.
If the original decay was very deep, reaching close to the pulp chamber, the discomfort may last longer. The tooth requires time to lay down a protective layer of secondary dentin to insulate the nerve from temperature changes and the filling material. During this healing phase, which can take several weeks, avoiding extreme temperatures and chewing on the opposite side helps manage sensitivity. Composite resins may also cause more initial sensitivity than amalgam due to thermal conductivity.
Warning Signs and When to Contact Your Dentist
While mild, temporary discomfort is expected, certain symptoms indicate a problem requiring prompt professional intervention. Any pain that worsens or persists beyond the expected two-to-four-week healing period should be evaluated. This prolonged discomfort can signal issues such as a microscopic gap between the filling and the tooth, known as microleakage, which allows bacteria to continue the decay process.
A particularly concerning symptom is spontaneous, throbbing pain that occurs without external stimulus, especially pain that wakes you up at night. This discomfort, often accompanied by lingering sensitivity to hot temperatures, is a sign of irreversible pulpitis. Irreversible pulpitis means the nerve tissue is dying and cannot heal, usually requiring a root canal procedure or extraction.
Further warning signs include visible swelling around the filled tooth or gum line, a localized fever, or the presence of pus. These symptoms suggest an active infection or abscess formation. Severe, sharp pain when biting down, even after a bite adjustment, could also point to a crack in the tooth structure. Contact your dental office immediately if any of these severe or persistent symptoms arise to prevent further complications.