Experiencing tooth pain after a dental filling is common. While concerning, discomfort often stems from treatable causes. Understanding these reasons can provide clarity and help determine when professional dental care is necessary. This article offers insights into why a tooth might hurt when biting down after a filling.
Common Causes of Discomfort
One frequent reason for discomfort after a filling is an uneven bite, often called a “high bite.” If the filling material is not perfectly shaped, it can create a slightly elevated spot. This unevenness leads to pain when biting down, as pressure is not distributed evenly. This issue typically resolves once a dentist adjusts the filling to align with the natural bite.
Temporary sensitivity is another common occurrence following a filling. The procedure can irritate the tooth’s nerve endings, causing heightened sensitivity to hot or cold temperatures, sweet foods, or air. This discomfort is usually transient, with symptoms typically subsiding within a few days to a couple of weeks as the tooth adjusts.
Sometimes, the nerve within the tooth experiences mild, temporary inflammation, known as reversible pulpitis. This can occur if the cavity was deep or due to drilling. While irritated, the nerve is expected to heal on its own. This condition often presents as short, sharp pain, particularly when biting or chewing.
Deeper Reasons for Pain
A less common but more serious cause of pain after a filling is a cracked tooth. The procedure might reveal an existing crack or contribute to its formation, especially if the tooth was already weakened. Pain from a cracked tooth is often sharp and sporadic, particularly when biting down or releasing pressure. If the crack extends into the pulp, further treatment may be necessary.
More severe and persistent inflammation or infection of the pulp indicates irreversible pulpitis. Unlike reversible pulpitis, this condition will not heal spontaneously and requires more extensive treatment. Symptoms often include severe, throbbing pain that may linger after exposure to hot or cold stimuli, or constant pain. This signifies that decay reached the tooth’s innermost layer, necessitating a root canal to remove the infected pulp.
Sometimes, pain can be “referred,” meaning it originates from a different tooth or area but is perceived as coming from the recently filled tooth. For example, pain from an adjacent tooth or a sinus issue could be felt in the filled tooth.
In rare instances, an allergic reaction to the filling material can cause discomfort. Another infrequent cause is galvanic shock, which can occur if different metal fillings are in contact. This creates a mild electric current, leading to a sharp, brief sensation.
When to Seek Dental Care
While some post-filling discomfort is expected, certain symptoms warrant a prompt dental visit. Pain that worsens steadily over time, rather than improving, requires professional attention. Severe, throbbing, or constant pain that does not subside, especially if it interferes with sleep, indicates a need for immediate evaluation.
Other concerning signs include swelling in the gum tissue around the filled tooth or in the face, which can suggest an infection. A fever accompanying tooth pain is also a concern. If pain does not respond to over-the-counter pain relievers or persists beyond a few weeks after the filling, contact a dentist.
Dental Assessment and Treatment
When a patient experiences persistent pain after a filling, the dentist conducts a thorough diagnostic process. This typically involves checking the bite with articulating paper to identify high spots. X-rays may be taken to assess the tooth’s internal structure and surrounding bone for underlying issues, such as deep decay or infection. Vitality tests might also be performed to evaluate the pulp’s health.
Based on the diagnosis, various treatments can be employed. If a high filling is the cause, the dentist will perform an occlusal adjustment, gently reshaping and polishing the filling until the bite is even and comfortable. If the filling itself is compromised, replacing the filling may be necessary.
For more severe conditions like irreversible pulpitis or infection, root canal therapy is often the recommended treatment. This procedure involves removing the inflamed or infected pulp, cleaning the inside of the tooth, and then sealing it to prevent further infection. In very severe cases, such as an extensive crack or a failed root canal, extraction might be the only option.