Discomfort after a dental filling is common. While some sensitivity is a normal part of healing, persistent or severe pain can signal an underlying issue requiring attention. Understanding these reasons helps determine when to seek further dental care. This article explores common causes of pain after a dental filling and outlines how dentists diagnose and address the problem.
Understanding Initial Sensitivity
Temporary sensitivity is common immediately after a dental filling. The tooth’s nerve and surrounding tissues can become irritated during decay removal and filling placement, causing increased response to hot, cold, or biting pressure.
This initial sensitivity is typically mild to moderate and should gradually subside as the tooth adjusts. Discomfort usually resolves within a few days to two weeks, though deeper fillings might cause sensitivity for up to three or four weeks.
Common Reasons for Ongoing Discomfort
When pain or discomfort lingers beyond the expected initial sensitivity, or if new symptoms emerge, it often indicates a specific problem with the filling or the tooth itself. Several distinct issues can cause ongoing pain after a dental filling.
A “high bite” is a common cause, where the filling is slightly elevated compared to the rest of the tooth surface. This unevenness creates undue pressure when biting, leading to pain. A dentist can easily resolve this by adjusting the filling to align with your natural bite.
Pulp inflammation, or pulpitis, is another potential cause. The pulp, the tooth’s innermost part containing nerves and blood vessels, can become inflamed if the cavity was very deep or the tooth experienced trauma during the filling procedure. Pulpitis can be reversible (healing once the irritant is removed) or irreversible (more extensive damage where the pulp may not recover).
Secondary decay or leakage also causes pain. This occurs when new decay forms around the edges of an existing filling, or if the seal between the filling and the tooth becomes compromised. Gaps allow bacteria and food particles to seep underneath, causing further decay and irritating the tooth’s nerve.
A cracked tooth, sometimes a result of the decay or the filling process itself, can cause sharp pain, especially when biting down or releasing pressure. This happens because the crack allows fluid movement that stimulates the tooth’s nerve.
Though rare, an allergic reaction to the filling material can cause discomfort. Symptoms might include swelling, redness, and discomfort around the filled tooth. Certain components, such as mercury in amalgam fillings or specific plastics in composite resins, can trigger reactions in susceptible individuals.
Signs It’s Time to See Your Dentist
While initial sensitivity is normal, certain signs warrant a professional dental evaluation. Contact your dentist if pain persists for more than two to four weeks, or worsens instead of improving. Sharp, throbbing, or radiating pain, especially when biting or chewing, also indicates a deeper problem.
Other concerning symptoms include sensitivity to hot or cold temperatures that lingers for more than a few seconds. Swelling or irritation of the gums near the filled tooth, or a feeling that the filling is uneven or too high, also require attention. Any pain interfering with daily activities like eating, drinking, or sleeping should prompt a call to your dentist.
What Your Dentist Will Do
When you visit your dentist for ongoing pain after a filling, they will conduct a thorough examination to pinpoint the cause. This typically begins with a visual inspection of the tooth and surrounding tissues. The dentist may gently tap on the tooth or have you bite down on a special tool to identify sensitivity or uneven pressure.
X-rays are often taken to reveal problems not visible during examination, such as recurrent decay beneath the filling, deep inflammation near the pulp, or a hidden crack. The dentist might also perform pulp vitality tests, applying cold or heat to assess the nerve’s response and determine inflammation extent.
Once the cause is identified, your dentist will discuss treatment options. If the filling is too high, a simple adjustment to reshape the filling can resolve discomfort. For reversible pulpitis, removing the irritant and potentially placing a new filling may allow the pulp to heal.
If pain is due to secondary decay or a compromised filling, the old filling will be removed, decay cleaned out, and a new filling placed. In cases of irreversible pulpitis or a significant tooth crack extending to the pulp, root canal therapy may be necessary to remove the inflamed or infected pulp. In severe situations, tooth extraction might be the only viable option.