After a dental filling, many individuals experience an unusual sensation when biting down. This feeling can range from mild discomfort to sharp pain, often causing concern. This article explores the various reasons behind this phenomenon, from normal post-procedure adjustments to more significant underlying issues, and provides guidance on when professional dental advice is necessary.
Understanding Immediate Post-Filling Sensations
Some discomfort or an unusual feeling immediately after a new filling is normal, typically within the first few days or weeks. As local anesthesia wears off, the tooth and surrounding tissues regain normal sensation, which can feel different. The new filling material itself can also initially feel different in the mouth, requiring a short period for adaptation.
The tooth may also exhibit temporary sensitivity to hot or cold temperatures, pressure, or sweet foods as it recovers. This sensitivity often arises because the procedure can irritate the tooth’s nerve, particularly if the cavity was deep. This mild inflammation of the dental pulp, known as reversible pulpitis, usually resolves as the nerve heals.
Common Reasons for Persistent Sensitivity
If a filling continues to feel strange or sensitive beyond the initial adjustment phase, typically after a few weeks, several issues can be responsible. One frequent cause is a “high spot” or uneven bite, where the filling is slightly taller than the surrounding tooth surface. This can lead to premature contact when biting, causing discomfort, pressure, or a feeling that the bite is uneven. This issue can also cause pain, jaw joint problems, and headaches if left unaddressed.
Another reason is galvanic shock, a rare phenomenon occurring when two different metal fillings are in close proximity and create a small electrical current. This can result in a “zinging” sensation or mild shock when they touch. Referred pain can also occur, where discomfort originating from the filled tooth is perceived in another tooth or area of the mouth. Excessive force from teeth grinding or clenching (bruxism) can also place stress on a new filling, leading to persistent discomfort or sensitivity.
When the Feeling Signals a Larger Problem
While many post-filling sensations are benign, a persistent or worsening feeling when biting can signal a more serious dental problem requiring prompt professional attention.
Cracked Tooth Syndrome
One issue is cracked tooth syndrome, where a tooth develops an incomplete crack. This often causes sharp, fleeting pain when biting down, especially upon the release of biting pressure, and increased sensitivity to temperature changes. The presence of a filling might exacerbate or reveal an existing crack.
Deep Decay and Pulpitis
Deep decay under the filling is another possibility. If new decay forms around or beneath the filling, it can progress and affect the tooth’s nerve. Symptoms can include sensitivity, pain, or visible changes like discoloration around the filling’s edges. Severe or persistent inflammation of the tooth’s pulp, known as irreversible pulpitis, indicates nerve damage that may necessitate root canal therapy. This condition is characterized by throbbing pain and sensitivity to heat or cold that lingers for more than a few seconds.
Fractured Filling or Infection
The filling itself might also be fractured or broken. This can lead to instability, sharp pain, or discomfort when biting, and may even be felt by the tongue as a rough edge or hole. If bacteria enter through a compromised filling, it can lead to an infection. The most serious issue is an abscess, a collection of pus caused by a bacterial infection. An abscess can cause intense, throbbing pain, swelling, fever, and a bad taste in the mouth, requiring immediate dental intervention.
Seeking Professional Dental Care
Any persistent discomfort, sharp pain, swelling, or worsening symptoms after a dental filling warrant a visit to the dentist. The dentist will conduct a thorough examination, which typically includes checking the bite with articulating paper to identify high spots. They may also perform X-rays to look for decay under the filling, root issues, or fractures, and conduct vitality tests to assess the health of the tooth’s nerve.
Based on the diagnosis, various treatment approaches may be recommended. For a high filling, the dentist can adjust and reshape it to restore a balanced bite. If the filling is fractured or decay is present underneath, the filling may need to be replaced. For more serious conditions like irreversible pulpitis or an abscess, treatments can range from root canal therapy to remove the infected pulp, or, in rare cases, tooth extraction if the tooth cannot be saved. Addressing dental issues promptly can prevent more serious complications and help preserve the long-term health and function of the tooth.