A dental filling restores a tooth damaged by decay or fracture by removing the damaged material and replacing it with a restorative material, such as composite resin or amalgam. Some degree of immediate post-procedure sensitivity is extremely common. This initial reaction is generally temporary, reflecting the tooth’s response to the necessary work performed.
Normal Post-Filling Sensitivity
Following a restoration, transient sensitivity, particularly to temperature changes, is typical. This thermal sensitivity manifests as a sharp, short-lived twinge when consuming hot or cold foods. The dental pulp, which contains the nerve tissue, is directly below the area that was drilled and filled.
The mechanical vibration and heat generated during preparation cause a temporary inflammatory response within the pulp chamber. This inflammation lowers the tooth’s threshold for external stimuli, causing intense reactions to temperature fluctuations or air. Mild pressure sensitivity when chewing is also normal as the ligaments surrounding the root adjust to the new restoration.
This initial sensitivity is a natural biological reaction and is considered a normal part of the healing process. The discomfort should gradually diminish over time, with most patients noticing a significant improvement within a few days. While minor sensitivity can linger, it typically resolves completely within one to two weeks.
Identifying Abnormal Pain
While temporary sensitivity is expected, certain types of pain indicate a complication requiring professional attention. Pain that is severe, throbbing, or spontaneous (occurring without a trigger like hot or cold) is a warning sign. Normal sensitivity is fleeting, but problematic pain may linger for several minutes after the trigger is removed.
Pain that wakes a person from sleep often suggests a level of inflammation that the pulp cannot manage on its own. Furthermore, if the discomfort increases in severity after the first two days post-procedure, rather than improving, it signals a potential issue. Any of these signs suggest the need for an immediate re-evaluation by the treating dentist.
Common Causes of Persistent Pain
One frequent mechanical reason for post-filling discomfort is a restoration that is slightly “high,” known as occlusal interference. If the filling material is not perfectly level, it absorbs excessive force when biting or chewing. This undue pressure traumatizes the periodontal ligament and irritates the pulp, leading to chronic discomfort until the filling is adjusted.
If the decay was deep, the procedure may have caused acute irritation of the nerve tissue, termed reversible pulpitis. This inflammation can cause exaggerated and prolonged pain in response to cold stimuli. Although the pulp is irritated, the condition is usually temporary, and the nerve tissue is expected to heal fully.
Pain can signal a more extensive problem if the decay was deeper than anticipated, potentially leading to irreversible pulpitis. In this scenario, the inflammation is severe, and the pulp tissue cannot recover, often requiring root canal therapy. Pain may also result from a hairline fracture exacerbated by the filling process or from secondary decay forming underneath an existing restoration.
In rare instances involving older amalgam fillings, galvanic shock can occur if a new metal filling is placed next to an existing one made of a different metal. This creates a mild electrical current when the two metals touch, resulting in a sharp, fleeting pain. This is less common with modern composite materials.
Managing Discomfort and Seeking Help
To minimize post-procedure discomfort, patients should take proactive steps immediately following the filling. It is advisable to temporarily avoid placing excessive stress on the restored tooth by chewing hard or sticky foods. Reducing exposure to temperature extremes, such as ice water or very hot coffee, will also help limit the inflammatory response in the sensitive pulp.
Over-the-counter anti-inflammatory medications, such as ibuprofen, are highly effective in managing the swelling and discomfort associated with pulp irritation. These medications work by targeting the inflammation at its source, providing comprehensive relief. Follow the recommended dosing guidelines provided on the packaging or by a dental professional.
If the sensation of the filling being too “tall” persists for more than a day, a simple bite adjustment appointment is recommended. The dentist can quickly reduce the height of the filling, often providing immediate relief from pressure-related pain. If sensitivity continues past the two-week mark or if signs of abnormal, spontaneous pain develop, contact the dental office for a follow-up examination.