A dental filling is a common procedure used to restore a tooth damaged by decay. It involves removing the decayed material, cleaning the area, and placing a restorative substance like composite resin or amalgam. Experiencing some discomfort afterward is a normal reaction to the procedure. Understanding the difference between expected sensitivity and a serious complication is important for proper healing.
Expected Temporary Discomfort
Mild sensitivity or discomfort following a filling is a normal part of the healing process. The drilling and preparation needed to remove decay can cause temporary inflammation in the dental pulp, the soft inner tissue containing nerves and blood vessels. This inflammation, known as reversible pulpitis, creates a brief period of heightened nerve response.
The sensation usually manifests as a sharp but fleeting pain when exposed to temperature extremes, such as cold air or hot beverages, or sweet foods. This sensitivity typically resolves within a few days, but can persist for up to four weeks as the nerve calms down. The discomfort should steadily decrease over this period, indicating the tooth is adjusting to the new filling material.
Mild tenderness when biting down, especially in the first 48 hours, is also common as the surrounding tissues recover. This healing response is generally manageable with over-the-counter pain relief.
Common Causes of Extended Pain
When discomfort lasts longer than two weeks, or is triggered by chewing, it often points to an issue fixable by a dentist. One frequent cause of prolonged pain is an occlusal discrepancy, known as a “high bite.” If the filling material is slightly too tall, the tooth hits the opposing tooth prematurely and with excessive force when biting down.
This uneven pressure can inflame the ligament surrounding the tooth root, causing a dull ache or a sharp jolt when chewing. Ignoring a high filling can lead to jaw discomfort or loosening of the tooth due to constant trauma. A quick adjustment by the dentist to shave down the excess material usually resolves the problem.
Another source of extended sensitivity is irritation to the dental pulp from a deep filling. If the cavity was large and close to the nerve, the pulp may be severely irritated, leading to prolonged reversible pulpitis. This condition causes sensitivity to cold that may last for weeks or a few months before resolving as the pulp recovers.
In some cases, pain may be felt in surrounding teeth or the jaw, which is known as referred pain. The nerves in the face and mouth are closely connected, making it difficult to pinpoint the exact origin of the discomfort. This does not necessarily indicate a problem with the filled tooth itself.
Warning Signs Requiring Immediate Attention
While mild, transient discomfort is normal, certain symptoms indicate a more serious problem that warrants an immediate call to the dentist. Severe, intense, or throbbing pain that keeps you awake at night is a significant warning sign. This type of unrelenting pain, especially if it cannot be managed with standard over-the-counter medication, may signal irreversible damage to the dental pulp or the onset of an infection.
A pain that increases in intensity rather than subsiding over time suggests the underlying issue is worsening, not healing. Swelling around the gum line or in the cheek near the filled tooth is another indicator, often pointing to a developing abscess or infection. Pus or discharge near the tooth is a clear sign of a bacterial infection that requires prompt treatment.
Lingering sensitivity to heat, where the pain persists for minutes after the hot stimulus is removed, is characteristic of irreversible pulpitis. This condition means the pulp tissue is dying and requires advanced treatment, such as a root canal, to save the tooth. Addressing these severe symptoms quickly is necessary to prevent the infection from spreading.