Dental fillings are materials used to repair teeth that have been damaged by decay or minor chips and cracks. While fillings are effective, experiencing pain in a filled tooth can be unsettling.
Common Reasons for Pain
Sensitivity after a new dental filling is a common occurrence. This can happen because the filling procedure, which involves removing decayed tissue, might irritate the nerves inside the tooth. This post-procedure sensitivity often manifests as discomfort when the tooth is exposed to hot or cold temperatures, pressure, or even air. Typically, this sensitivity subsides within a few days to a couple of weeks as the nerve heals.
Pain can also arise from deep decay or inflammation of the tooth’s pulp, known as pulpitis. If the cavity was very deep, the drilling process to remove decay can generate heat, inflaming the pulp. If the inflammation is mild and reversible, the pulp can heal; however, if it’s severe and irreversible, the tooth’s pulp may be unable to recover, potentially requiring further treatment.
A cracked or leaky filling can also lead to pain. Over time, fillings can wear down, crack, or pull away from the tooth, creating small gaps. These gaps allow bacteria and temperature changes to reach the sensitive inner parts of the tooth, causing discomfort and potential new decay.
Teeth grinding (bruxism) or clenching puts excessive stress on teeth, including those with fillings. This can lead to pain in the filled tooth and surrounding areas. An uneven bite, where a new filling is slightly too high, can also cause increased pressure and pain when biting down.
Sometimes, the pain felt in a filled tooth originates from another area, called referred pain. This can be caused by issues like a sinus infection, which can cause pain in the upper teeth because of their proximity to the sinuses. Other sources of referred pain include migraines or other teeth.
An allergic reaction to the filling material can also cause pain. Symptoms might include swelling, redness, itching, or a burning sensation around the filled tooth. Materials like mercury in amalgam fillings or certain components in composite resins can trigger these reactions in sensitive individuals.
When to Seek Dental Care
Contact a dental professional if tooth pain in a filled tooth persists or worsens. While some sensitivity after a new filling is normal and should resolve within a few weeks, prolonged discomfort warrants an evaluation. Severe, throbbing, or sharp pain, especially if it interferes with daily activities like eating or sleeping, indicates a need for professional help.
Other concerning signs include pain accompanied by swelling in the gums or face, fever, or difficulty opening the mouth. These symptoms can suggest an infection that requires immediate attention. Visible damage to the filling itself, such as a chip, crack, or if the filling feels loose, also means a dental visit is necessary. Any sensitivity that does not improve with over-the-counter pain relievers or home care should be assessed by a dentist.
Dental Diagnosis and Treatment
When a patient experiences pain in a filled tooth, a dentist conducts a thorough examination to determine the cause. This begins with a visual inspection of the tooth and surrounding gums, followed by dental X-rays to look for decay under the filling or issues with the tooth’s root. The dentist may also perform sensitivity tests, applying hot or cold stimuli to the tooth, or a percussion test, gently tapping the tooth to check for pain. A bite assessment ensures the teeth align properly.
Treatment options vary depending on the diagnosis. If the pain is due to a slightly high filling, the dentist can adjust the bite by carefully reshaping the filling’s surface. If decay is present under an old filling, or if the filling is cracked or leaking, replacing the filling is often necessary to prevent further damage and infection.
For more severe issues, such as deep inflammation or infection of the tooth’s pulp, root canal therapy may be recommended. This procedure involves removing the infected pulp, cleaning the inside of the tooth, and then sealing it to save the tooth. If the tooth is extensively damaged and cannot be saved, extraction may be necessary.
Infections might also require antibiotics to manage bacterial spread, though antibiotics alone do not resolve the underlying dental issue. These medications are typically prescribed in conjunction with a dental procedure to address the source of the infection.