Why does my tooth still hurt after a filling?
By: Jennifer Berry, Medical News Today
Is tooth sensitivity after a filling normal?
Learn the reasons why it occurs, treatments to help relieve tooth sensitivity, and when to see us viaMedical News Today! The Oral Surgery DC Team
A filling is a dental procedure that involves a dentist cleaning away any decay from the tooth and then filling the space with new material.
After injecting a numbing agent around the tooth, the dentist will then clean out the decayed area of the tooth, usually with a dental drill. They will then fill the space with gold, silver amalgam, a composite, or porcelain.
For several hours after having a filling, a person's face may still feel numb, tingly, itchy, or puffy. They may have difficulty eating, swallowing, talking, or moving their face.
Sometimes, dentists recommend that people avoid eating or drinking for a few hours, as this may result in a person accidentally biting their tongue or cheek.
Once the numbing agent has worn off, these feelings will go away. But, in the following days and weeks, a person may notice some new sensations as they adjust to the new filling.
Sensitivity in the filled tooth or area around it is one of the most common occurrences during this time.
What does sensitivity after a filling feel like?
When a person has a sensitive tooth, they may notice that certain triggers cause a temporary, uncomfortable sensation in the filled tooth or surrounding area. It may feel like a shock of cold or sudden pain that comes on quickly and goes away.
Factors that can trigger tooth sensitivity after a filling include:
- cold foods or drinks, such as ice cream, popsicles, or beverages with ice
- hot drinks, such as coffee or tea
- air hitting the tooth, such as when breathing through the mouth, which may be worse with cold air
- sugary foods, such as candy
- acidic foods and drinks, including fruit, juice, and coffee
- biting down when eating
Why do fillings cause tooth sensitivity?
Some sensitivity after a tooth filling is normal and temporary. Sometimes, however, sensitivity after a filling is due to other causes that need treatment or repair.
Below, we discuss possible reasons for this symptom and when to see a dentist.
An irritated nerve
Short-term tooth sensitivity after a filling usually occurs because the filling procedure has aggravated or caused inflammation in the nerve inside the tooth.
Usually, the tooth's outer layers - the enamel and cementum - protect the nerve from exposure. But fillings, especially deep ones, can get close to the nerve endings and cause irritation and uncomfortable sensations.
As the nerve heals, the sensitivity will go away. This may take a few days or weeks. Once the nerve has healed fully, a person should feel no difference between the filled tooth and the other teeth.
Incorrect bite alignment
A dentist must ensure that the filling lines up with the other teeth in the mouth. If the filling is too tall, it can cause extra pressure as a person bites down. This can cause pain and sensitivity that is often more severe than normal post-filling sensitivity.
It is quite normal for a person to experience some minor sensitivity when biting down in the days following the procedure. Typically, the bite will correct itself within a few weeks.
However, if a person experiences severe sensitivity, or they have difficulty eating or putting their teeth together, they should ask their dentist to check the bite. The dentist may decide to smooth down the high point of the filling to properly fit the bite and eliminate discomfort.
Pulpitis is inflammation of the pulp deep within the tooth. It can cause tooth sensitivity and pain.
Pulpitis does not regularly occur with minor fillings, but it might happen if:
- the tooth has had trauma, such as from an accident that resulted in a cracked or broken tooth
- the cavity was very deep, reaching the inner pulp layer
- the tooth has undergone multiple fillings or procedures
There are two types of pulpitis:
- reversible pulpitis refers to mild inflammation where the pulp remains healthy, and the tooth will heal on its own
- irreversible pulpitis is when there is a damaged nerve that starts to die, in which case a person will need a root canal to save the tooth
A dentist can usually resolve pulpitis with a new filling or a restorative procedure, such as a root canal. A person may also need to take antibiotics to clear any bacterial infection.
How to treat a sensitive tooth
When a person experiences normal, post-filling sensitivity, a dentist may recommend that they use a desensitizing toothpaste.
These products contain an ingredient called potassium nitrate that helps stop the sensations on the surface of the tooth from reaching the nerve endings inside.
These products do not work immediately, but a person should notice relief within several days if they use the toothpaste twice a day.
A person may also try the following methods at home to help relieve tooth sensitivity:
- Over-the-counter pain relievers, such as acetaminophen or ibuprofen.
- Topical numbing ointment designed for the mouth.
- A toothbrush labeled for sensitive teeth. These are softer than standard toothbrushes and will be less harsh on the tooth enamel.
- Brush with gentle, circular strokes on the teeth and gums. Avoid scrubbing back and forth or aggressive pushing of the brush on the teeth.
- Floss once a day, taking care to be gentle on the gums and teeth.
- Take note of which foods or drinks cause sensitivity and avoid them if possible.
- Avoid whitening toothpaste and products, which can make sensitivity worse.
- Rinse the mouth out with water after consuming acidic foods or drinks, such as coffee and fruit. Acidic foods and beverages can wear away the tooth enamel.
- Avoid brushing the teeth immediately after eating acidic foods, as it may remove more of the enamel.
If tooth sensitivity does not improve in the days following a filling, talk to a dentist. It is essential that the dentist rules out other potential causes of sensitivity that may not be related to the filling.