Why Does My Tooth Hurt After a Filling?

One of the most frustrating things for a dental patient to experience is pain or sensitivity on a tooth that just had dental work.  Even more frustrating are those teeth that didn’t’ bother you beforehand.

Unfortunately, this is a very common phenomenon, and understanding it a little better might ease the sense of concern and frustration that comes after a new filling causes sensitivity.

“Normal” Post-Operative Sensitivity

Filling stepsIn general, patients should expect to feel some tenderness and sensitivity after any dental work.  Any time your dentist makes changes to a tooth (this even includes the “change” of a professional teeth cleaning removing all the bacteria from a tooth), there is the potential side effect of inflammation.  The nerve within each tooth sends signals of pain and/or sensitivity to the brain when the tissue around and within a tooth is inflamed.

Why Does Dental Work cause Inflammation?

Any surgery in the body is an injury.  It is a necessary injury in order to remove or repair whatever is wrong.  For example, cutting away an infected appendix can literally save your life, but the surgery site will suffer from inflammation as part of the healing process.

A filling or a crown is surgery on a smaller scale.  Your dentist uses a high-speed handpiece to remove the infected portion of a tooth (the cavity).  The body responds to this “injury” with inflammation.  Inflammation in the tooth makes it hypersensitive, so that chewing and drinking cold beverages cause pain.

What to ExpectSensitive teeth cold

Normal post-op sensitivity and/or pain should be expected, and it should be temporary.  The average time of sensitivity is two weeks following the dental work, and it should slowly recede during those first two weeks.  We recommend that you avoid chewing on a new filling for the first several days to allow the nerve to calm down.

Potential Post-Operative Problems

While we want all of our patients to be prepared for post-operative sensitivity and tenderness, not all pain after dental work is “normal”.  In some cases, the sensitivity is due to a problem with the new restoration, which requires a follow-up visit with the dentist to address.

Bite Problems

By far, the most common problem with brand new dental work is a bite problem.  In the vast majority of cases, patients are numb when the dentist refines and shapes the filling or crown.  This can make it difficult to determine whether or not your teeth come together correctly.

When a bite is not appropriate for a certain tooth, the new forces cause hypersensitivity in the nerve.  Unlike the normal post-op sensitivity, this will persist until you return for a bite adjustment.  This problem is especially prominent in those who clench or grind their teeth at night.

Problems with the Filling Material

More rare, but possible, are problems with the filling material itself.  At Prosper Family Dentistry, the majority of our restorations are composite resin.  This material forms a bond with the healthy, hard tooth structure exposed after removal of decay.  There can be times when the material does not bond to the tooth, leaving a microscopic gap for saliva, cold drinks, and eventually bacteria to penetrate.

Sometimes problems with bonding are due to technique (i.e. the dentist was unable to confirm perfect placement of the filling due to a difficult working field), but more often it is unexplained.  The fix for this is simple: replacing the filling will create a fresh bond and seal the tooth from any leakage that could cause sensitivity.

An Infected Nerve

This is the worst-case scenario, and thankfully is quite rare.  It is possible for bacteria to reach the nerve chamber in the center of the teeth when the teeth have large openings (called dentinal tubules).  In these rare cases, the bacteria can move through the tubules into the nerve ahead of the actual tooth decay.  So the dentist removes the entire cavity, exposing healthy, hard tooth structure, sealing the tooth from the outside, and it’s too late.

The other difficult thing about this potentiality is that we can only diagnose it by eliminating all other possibilities.  When a tooth continues to worsen after dental work and progresses to the irreversible inflammation of the nerve within in the absence of decay, this is what we are left with.  If the nerve is irreversibly inflamed or infected, it needs a root canal to remove that un-healable tissue.

Again, thankfully, this is rare.

What NOT to Do

In cases of post-operative sensitivity, many people wait too long before notifying the dentist.  Unfortunately, this can allow the nerve to worsen and become more and more irritated over time.  The most important thing for you to do is call us and let us know if you are experiencing any of the following things after dental work:

  • Sensitivity, pain, or tenderness that lasts longer than two weeks
  • Sensitivity or pain that gets increasingly worse
  • Swelling of the gums around the tooth that received the dental work
  • Noticeable changes in your bite
  • Looseness of the tooth or dental work, especially when flossing
  • Sharp, shooting pains when you are not eating or drinking

More Questions about Dental Work and Sensitivity?

Call 972-347-1145 today to schedule a consultation with Dr. Jill and Dr. Cara.  They can answer any question you have about sensitivity in general or a specific tooth that received dental work.

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