Tooth sensitivity after filling

While dental fillings are a common, safe, and effective way to treat dental cavities, in some cases, tooth sensitivity or discomfort can arise following the placement of a dental filling. In most cases, this sensitivity will resolve on its own relatively quickly. However, if you experience pain or discomfort following a dental filling, and this pain is extreme or presents alongside other symptoms, including fever or swelling, call your dentist for prompt treatment. There are many reasons that sensitivity may follow the placement of a filling and a few reasons that a prompt dental visit may be recommended.

To place a dental filling, your dentist will remove decay from a damaged tooth and fill the damaged area. This procedure protects the area from further decay and restructures the tooth with synthetic material to allow it to perform its optimal function. First, your dentist will numb the affected tooth with a local anesthetic. Your dentist will then use a dental drill to clean out the decay, finally filling the treated area with a dental filling. Dental fillings are made from porcelain, composite material, gold, or a metal amalgam, depending on the tooth's location and the needs and budget of the patient. Immediately following a filling and a few hours thereafter, your mouth and face will likely still feel numb and somewhat tingly. There may also be some swelling at the site of the filling. These effects may make it somewhat challenging to eat, swallow, or talk. Most dentists recommend that patients avoid eating for a few hours after having a dental filling placed, since residual numbness may allow the patient to bite the inside of their cheek or their tongue, which will be painful once the numbness has worn off. Once the numbness has subsided, however, these feelings will also subside, yet sensitivity in the tooth and the surrounding area may remain.

Sometimes, sensitivity may be caused only by certain triggers, like food or drinks that are extreme in temperature or very sweet or acidic, or by biting down on the tooth. These triggers may cause an uncomfortable, sudden sensation in the tooth that comes and goes quickly. If this sensitivity doesn’t resolve relatively quickly, usually in about one to two weeks following a filling, you may need to visit the dentist for further treatment.

An irritated nerve in the tooth may cause sensitivity following a dental filling. The tooth's outer layers usually protect the nerves inside the tooth, in the tooth’s pulp, from irritation or damage. However, if a filling is very deep, it may get too close to the nerve endings inside the tooth and aggravate the nerve, causing inflammation. As the nerve heals and inflammation subsides, the sensitivity should go away completely. You should not be able to tell the difference in feeling between the filled tooth and all the other teeth.

Sometimes, the filling's bite alignment is incorrectly calculated, which can make the filled surface of the tooth protrude higher than it is supposed to. When your dentist fills your tooth, especially the molars, one goal is to make sure that the biting surfaces remain even and line up equally. If your filling sticks up too high, this may cause extra pressure when you bite down with that tooth. It is common for there to be a brief adjustment period following a filling, and the bite will often correct itself. Still, it may occasionally be severe and require adjustment from your dentist. If the discomfort from biting is severe or you cannot close your teeth together properly following a filling, you may want to see your dentist to have the filling filed more to correct the bite and remedy the discomfort.

Some tooth sensitivity can be caused by pulpitis, which is inflammation of the pulp located inside the tooth. Pulpitis is not typical with smaller fillings, but it may occur in cases of dental trauma, very deep cavities, or repeated dental procedures on the same tooth. If the dental pulp is healthy but damaged, the pulpitis is considered reversible and will heal on its own, though this healing may necessitate a new dental filling. If the dental pulp is diseased or damaged and begins to die, the pulpitis is considered irreversible, and the patient is likely to need a root canal procedure to save the tooth. The patient may also need to take a course of prescription antibiotics to reverse any infection that may be present in the pulp.

If sensitivity does not appear until a few weeks or months after your filling, you may have an abscess, a loose or broken filling, or gum disease and should see a dentist. In most cases, sensitivity immediately following a dental filling can be treated with over-the-counter pain medications or by avoiding triggers and will subside quickly. See your dentist if sensitivity gets worse, affects your ability to eat, or if you also have a fever.

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