Experiencing pain in a tooth after a dental filling, especially when chewing, is common. While fillings restore a tooth’s function, some discomfort can arise as the tooth adjusts. Understanding the reasons helps determine if it’s a normal response or signals a need for dental evaluation.
Why Pain Occurs
A frequent cause of discomfort when chewing after a filling is a “high spot” or bite issue. If the filling is too high, it creates excessive pressure on that tooth when biting, leading to pain. This can also inflame the periodontal ligament, the tissue surrounding the tooth’s root.
Another reason for pain is pulp inflammation, or pulpitis. The drilling process to remove decay generates heat, irritating the pulp, the soft tissue inside the tooth. This irritation can lead to heightened sensitivity, especially to temperature changes or pressure. Pulpitis can be reversible, healing over time, or irreversible, indicating severe damage.
Sometimes, pain in the filled tooth is referred pain, originating elsewhere but felt in the filled tooth. This occurs due to the mouth’s complex nerve network. Temporary sensitivity to temperature or pressure is also normal after a filling, as the tooth adjusts. This sensitivity typically resolves within a few days to a few weeks.
Less commonly, a pre-existing or new crack can develop in the tooth. Large fillings can weaken tooth structure, making it susceptible to stress fractures, causing sharp pain when chewing. While rare, an allergic reaction to the filling material can also cause pain, often with swelling, redness, or itching around the tooth. Finally, new decay under or around the filling, or a poorly sealed filling, can allow bacteria to seep underneath, causing pain.
When to See a Dentist
While mild sensitivity after a dental filling is normal, certain symptoms indicate professional dental attention is needed. If pain or sensitivity worsens or persists for more than a few weeks, it suggests an underlying issue requiring evaluation.
Severe or sharp pain, especially when biting or chewing, is a clear sign to contact a dentist. This discomfort can indicate a high spot needing adjustment or a more serious problem like a cracked tooth. Constant, throbbing pain, or pain that keeps you awake, also points to nerve irritation or infection.
Additional symptoms warranting a dental visit include swelling, redness, or signs of infection around the filled tooth or gums, which can signal an abscess. If you have a fever with tooth pain, seek prompt professional care. If your bite feels “off” or uneven after the filling, where certain teeth touch before others, this misalignment should be addressed.
Professional Treatment Options
When persistent pain after a dental filling requires intervention, dentists have several treatment options. A common solution is a bite adjustment. This procedure involves identifying and shaping down high spots on the filling that cause uneven pressure when biting. The dentist uses thin colored paper to mark contact points, then smooths the filling, allowing teeth to come together properly and relieving pressure.
If pain is due to a defective, leaking, or compromised filling, replacement may be necessary. Fillings can wear down, crack, or lose their seal, allowing bacteria to penetrate and cause decay. Replacing the old filling re-establishes a protective barrier. This is done if the existing filling is damaged, discolored, or no longer protecting the tooth.
For severe cases, especially if the pulp has irreversible inflammation or infection, a root canal may be recommended. This procedure involves removing the inflamed or infected pulp from inside the tooth and its roots, cleaning, disinfecting, filling, and sealing the inner chambers. While extensive, a root canal aims to save the natural tooth.
In rare and severe situations where the tooth cannot be saved due to extensive damage, a deep crack, or untreatable infection, extraction may be the only option. After extraction, tooth replacement options can be discussed. For extreme sensitivity or small cracks, dental bonding or sealing might be used. This involves applying a tooth-colored resin to the affected area, bonding to the tooth, covering exposed dentin, or sealing minor cracks.