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Pain After White Composite Filling

 


Question:  Why does my tooth hurt after it just received a new white filling?  It did not hurt before!

Answer:  Your tooth should obviously not hurt after the filling, especially if it did not hurt before.  In this practice I do not have patients complaining of pain after white fillings are placed.  If you are experiencing pain, here are some reasons why:

  • Polymerization Shrinkage:  Composites (white fillings) shrink a little when they harden.  Generally the dentist will place the material into the cavity in a liquid to pasty form and then use a strong light (LED or Halogen) to instantly harden the material.  If the composite material is placed incorrectly or in bulk then the composite will shrink enough to either allow a little gap to form around the filling, or it will actually pull the tooth together.  Either way the tooth will become sensitive to hot and cold.
  • Too Large Composite:  Composite is a great material, in small fillings.  Once the filling reaches a certain size (1/3 the distance between the cusps or more than 2 surfaces) then it generally is not strong enough to function correctly.  Composite material is not strong enough to function exactly like tooth structure.  The tooth will bend, the composite will wear or fracture, and eventually failure is inevitable.  When the filling fails it will then require a much larger restoration or worse.
  • Fractures in Tooth: Often old silver mercury fillings, amalgams, are removed and replaced with white fillings for various reasons. These amalgams have too many issues to list here (let’s see if any ADA dentists complain), but the main one is that the expansion and contraction as well as compression over time results in tooth fractures. Removing these fillings and not recognizing the fractures (visually) will result in trouble. A fractured tooth should not receive a white composite filling!
  • Other Issues:  The two scenarios above are fairly common.  Often I see patients that have super large composite fillings (patches), and that is usually a warning sign to the quality of dentistry found in all the other teeth.  Composite material is great if used correctly.  It is not a cure-all.  It can have bubbles in it, fail to bond correctly, not cure all the way, etc.  Composite is very technique sensitive and is often placed without enough care.  This is where experience becomes important!

So, to answer this persons’ question – Your tooth could hurt for many reasons, none are good.  Talk to your dentist about this problem and see what they say.  If the answer is “wait and it will get better”, then seek out a second opinion.  Unfortunately Kentucky is not known for its quality dentistry (we are 49th and 50th in the US when it comes to number of teeth in adult mouths and oral health), so do your research and find a top dentist.  I suggest you look at the AACD (American Academy Of Cosmetic Dentistry) as one of your sources.  Select an accredited member as they have gone through some of the most rigorous training in the world and must live up to their reputation (there are several in Lexington and I am the only one in Louisville).

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posted in Announcements, Blog, Cosmetic Dentistry, General Dentistry

299 thoughts on “Pain After White Composite Filling

  1. Dr. Chris

    Please check my Drill The Dentist podcast for your answer – Episode 4!

  2. Dr. Chris

    Please check my Drill The Dentist podcast for your answer – Episode 4!

  3. Dr. Chris

    Please check my Drill The Dentist podcast for your answer – Episode 4!

  4. Amy

    Hello there!
    Around a year ago I had a tooth extraction and 8 fillings. As far as pain goes I just had really bad headaches for a few days. Until about a month ago, the fillings on the right side of my mouth just started hurting. Either from temperature or out of the blue and the only thing that makes them feel better is gum. Why after all this time are my fillings bothering me? What can I do to prevent them from hurting again?
    Thanks for your time and I look forward to hearing from you.
    -Amy

  5. Dr. Chris

    Dear Amy,

    This is a unique problem that requires diligent evaluation of the bite and the fit of your new restorations…I would check for an acidic environment in your mouth (soda, etc.) which can quickly cause problems. Bacteria also releases acid and if the restorations are bacteria traps then this will also cause the problem you mentioned above.
    I hope you have found relief from your discomfort….

    Sincerely,

    Dr. Chris

  6. Dr. Chris

    Dear Spence,

    Sorry to just get to your question….there are just too many! :)

    So number one, you need a good nightguard to control the bruxism or you will destroy your teeth! Secondly, dull ache means “dead or dying” tooth…sorry. Deep filings can result in a tooth dying and then the stress of gringind on the tooth is the last straw if you know what I mean.
    I hope by now you have resolved this issue and got yourself a good nightguard :) If you have more questions I promise I will respond quickly!

    Keep Smiling,

    Dr. Chris

  7. Natalia

    Hi Dr. Chris :)
    I had two fillings done on my 2 last top left molars. It’s been 12 days since my procedure. I have had fillings before but never have they hurt, nevertheless hurt this badly. I couldn’t chew (sharp throbbing pain) cold and hot massive sensitivity, and the pain would just linger for 30 min after activating every time i tried to chew. (I say 30 min which would be time it took for ibuprofen 800 to kick in. I couldn’t have anyone talk to me and I just had the urge to crash my head onto a window! I did notice that filling was too high and so I went back to my dentist 3 days later to explain to her my pain and get the filling lowered. she drilled again to file it down. After my anesthesia wore off, the pain from before was 2x worse!! It wasn’t only activating anymore when I ate but now it was waking me up at night. I kept taking ibuprofen to relieve the pain. A week later I went back for my other appt. For more fillings, but I told her that my pain had worsen and that I was not going to allow any more procedures in my mouth until this was taken care of. She told me that some people react differently to the fillings and so she removed my fillings, replaced it with an antibiotic temp filling and to take 7day supply of antibiotics orally. she wants to see me in another week. She told me I would be able to eat. But it’s been 3 days and the pain has subsided a bit but I still have it. I’m scared to get anymore work done. And I also noticed that when she did the fillings the first time, she was too quick she didn’t even use the light to cure the fillings, didn’t smooth out, etc. I’m scared, pissed, disappointed. Is it too soon to know what happened? Or is it best to get a new dentist?
    Fillings are composite.
    Thank you Dr.

    -Natalia

  8. Dr. Chris

    Dear Natalia!

    Sorry to hear about your bad dental experience. First and foremost, no more dentistry till that problem is resolved!
    You read the post about the fractures of the tooth…over time the teeth begin to fail due to fatigue failure. Drilling out an old filling and placing a new one is traumatic to the tooth no matter how you look at it. Placing a filling incorrectly and leaving it hitting the opposite tooth often is fatal.
    The way your tooth is responding – aching, etc., already tells me the root is dead or dying. Giving a patient antibiotics will only make it feel better if the root is the problem. So, if it feels a little better after about 2 days of antibiotics then the tooth is “dead or dying” and will need root therapy. Sorry.
    While all patients react differently to fillings, every tooth reacts the same to a high filling :) They die over time.

    So, no more fillings, new dentist, preferably someone with a great reputation such as a speaker, AACD Accredited person, etc.

    Keep smiling,

    Dr. Chris

    PS: Check out the podcasts and the new site http://www.drillthedentist.com

  9. Sharon

    Almost 2 months ago my dentist replaced 2 fillings. Since then, I have pain when I bite down on food on one of the teeth. I have gone back twice to have the bite adjusted. Is there a way to tell whether the filling needs to be redone or I need a crown?

  10. Saba

    Dear Dr Chris, I have two deep fillings with composite, I went for check up last week and my doctor made me so anxious since she told me you should wait until these two teeths require root canal sincd shrinkage will happen, I have these two filled teeth with composite for more than 6 years. I asked my doctor to replace them,however she siad, if I want to replace them, it is likey thar they require root canal,therefore, it is better not to do anything.would you please tell me what should I do now, i am so concerned about having root canal in the near future.I dont want to loose my teeth at all

  11. Mandy

    I went to the dentist with very little pain he looked at an old X-ray and said he had missed that I needed 3 fillings I had them done ( one white ) 2 days later I was back in a lot of pain 2 of the fillings where removed and temporary filling where put in another 2 days later I was back in more pain he pulled out my back tooth and then 2 days later I was back to see him again he said I had an infection 3 days of antibiotics I was still in a lot of pain I went back and he’s refilled my other tooth … I’m now having to go back as that tooth is still hurting me so is the white filling and I still have pain from him taking my tooth out 3 weeks ago .. I’m really feeling like I don’t want to go back to him but can’t stand the pain many thanks mandy

  12. Yomnaallam

    Hi Dr. Chris
    Two months ago,I went to a doctor to restore my carious molars with composite resin. He said the cavities were shallow. My teeth ached soon after. The restoration height was proper. I had no problems with occlusion. I was on anti-inflammatory drug for 5 days but pain was back soon after. I went back to the doctor who replaced the restoration with a temporary one, and said to be back when pain goes away but it isn’t. At first, it was associated with cold but now with biting, and at times spontaneous and lingering. The doctor didn’t use air-water coolant. I’m worried my teeth pulp is irreversibly damaged.

  13. Dr. Chris

    If the doctor did not use cooling then the pulp can be damaged. Did he use anesthetic? If not then you would most likely have felt pain way before damaging the tooth but if you were numb then you would not be able to tell if the temperature was too high…
    So you are right, it may he irreversible pulpitis but it could also be a fracture (which is difficult to diagnose). A sedative filling was the right choice by the dentist so it looks like he does know what to do. You may want to check for fractures with your dentist.
    I hope this helps…
    Dr. Chris

  14. Meg

    Hi Dr. Chris,
    Last month, a new dentist gave me two fillings on my back bottom molars (#31&#32). The drilling hurt a bit even with anesthesia, but all ended up okay, until about two weeks ago, when a dull throbbing pain began on one of my front bottom teeth (two away from my right canine, #25 I believe). The pain is so persistent now that I am taking about 6-8 ibuprofen a day. Other teeth near my throbbing tooth are starting to feel an achey pain, and are a bit sensitive to cold water. Last week when I went to my dentist, she thought this was all residual pain from the filling, and that it would go away. I went to the dentist again yesterday because the pain now wakes me up at night, and she thinks the front tooth is dead and wants to do a root canal, though nothing came up on my xrays.

    Is this the best option? I’m worried that the surrounding front teeth are now starting to hurt as well.

    Thanks for your time!
    Meg

  15. Tom

    Dr. Chris,

    I had four composite fillings placed this morning. Now that the anesthetic has worn off I have intense jolting sensitivity to touch and negative pressure in one of the teeth. Temperature extremes don’t seem to bother it. It’s tooth 31 and it was a deep filling. No prior work had been done to the tooth. Is such a jolting sensitivity normal for a period of time?

  16. Becca

    I just got a filling on Monday. Today is Tuesday. It was a deep filling and there is a dull ache/pain. I have little to no sensitivity to cold and none to hot. I can feel the filling with my tongue where I never could with any other fillings. It doesn’t hurt to chew though. It actually feels normal when im chewing. Is there anything I can do? The day after my filling it did not hurt at all but then a dull ache came so what now?

  17. Mac

    Hello,
    I had two composite fillings a month ago. I went back twice for high bite adjustments. The second one helped to a while but it has started to feel sore again. The pain seems to affect the teeth in front of the molars that had cavities. It is sensitive to hot and cold but not biting. What could be wrong? I’m a nervous wreck about a root canal.

  18. Greg

    Hi Dr. Chris,
    About a week ago I had an older silver filling replaced at the recommendation of my dentist in #19. I’m now experiencing intermittent intense pain. I’ve read a number of similar posts on this website but am having what appears to be a different experience and received a different answer from my dentist and am hoping you can offer some advice. First, my pain is initiated somewhat randomly, sometimes from opening my mouth, sometimes while talking, sometimes while eating, sometimes while moving my tongue around in my mouth or pursing my lip. It does not happen every time in the mentioned examples and I cannot identify anything else specific that might trigger. I do not have sensitivity to temperature or pressure.

    The pain is sever and massive enough it has brought me to my knees. The pain is also severe enough that I can’t tell where it’s coming from, it radiates the entire side of my face and lasts a few seconds. I’ve noticed the pain mostly from the back of my mouth and my jawline as well as up near the sideburn/ear. I’ve returned to my dentist explaining this issue and he took X-rays. He saw no issues in the X-ray and offered a possible solution that is related to a near tooth (#22) that my gum are receding and exposing an area of the tooth unprotected by enamel and more easily irritated. He had me switch to Sensodyne toothpaste, take Motrin, and reduce the setting on my Sonic toothbrush to “sensitive,” stop brushing at the gumline, or possibly switch to a manual brush.

    Thank you in advance for any advice or recommendations you might have and thank you for offering to help!
    Greg

  19. Dr. Chris

    Hello Greg,

    Dental pain is often elusive…You mentioned the pain “began” after the filling was replaced? If you had no pain before then I would focus on that tooth. When replacing old amalgam fillings there is quite a bit of damage that is done to the tooth. Your differential diagnosis for me would be a fracture (cusp most likely), poor bond, or void in the filling. Depending on the size of the filling I would replace it with a sedative filling such as Fuji 9 or temporize with a cuspal coverage restoration such as an onlay if cracks are present. An x-ray shows issues with the root which can take some time to materialize…

    I hope this helps!

    Keep Smiling,
    Dr. Chris

  20. Dr. Chris

    Hello Mac,

    The bite may be correct now but if you are still having sensitivity that was not there before I would look at possibly a cuspal flex issue or a poor bond. Sensitivity could also take a few months to go away…The only way I know how to solve this is to first try to seal the restoration again (etch and seal) or redo it….
    I hope this helps.
    Dr. Chris

  21. Dr. Chris

    Hello Becca,

    Has the dull ache gone away? Since you just had the filling I would give it a little time since the bite feels normal and it is not sensitive. The fact that you can feel the filling with your tongue is interesting…I would need more info on this to comment.
    IF the dull ache is still there then you may have a root problem and need to see your dentist again…sorry.

    Cheers,

    Dr. Chris

  22. Dr. Chris

    Hello Tom,

    Jolting pain is never “normal” :) The only way you can feel jolting pain is if something is bothering your nerve inside the tooth…you need to discuss this with your dentist! Since it only happened to one of the teeth I am sure your dentist can help with it. Most likely a large filling that was bulk filled in my opinion.

    Cheers,
    Dr. Chris

  23. Dr. Chris

    Hello Meg,

    Throbbing pain, especially at night, is nearly 100% diagnostic for a dying/dead root. The question is “why” did it die…The only treatment option is a root canal therapy (or extraction).

    I hope this helps,

    Dr. Chris

  24. Dr. Chris

    I am sorry for all your trouble Mandy. Dentistry is quite involved but most importantly you need to “trust” your dentist…Once trust is lost you need to switch. Your situation has many variables so I am not able to give you specific answers and hope you find a dentist you trust.

    Cheers,
    Dr. Chris

  25. Dr. Chris

    Hello Saba,

    First of all I am sorry your dentist made you anxious…that is terrible. Removing fillings does not usually result in the need for a root canal! If shrinkage is a concern (due to the size of the fillings), you can build the fillings up a little at a time or use gold or porcelain. There are many solutions but none should make you anxious! Maybe you need a new, less anxious dentist :)

    Keep smiling,
    Dr. Chris

  26. Dr. Chris

    Dear Sharon,

    It really is not easy to tell what needs to be done…has the pain gone away? A crown is used when the tooth is ready to break or has little tooth structure left. Biting pain often is due to flexing of the tooth and oftne a crown is the only way to fix that (or an onlay).

    I hope this helps,
    Dr. Chris

  27. Pamela R.

    Hi Dr Chris. Can’t Thank u enough for responding to all of us. I have heard u talk about pain due to fractures but my question is, what could be causing pain after having a fracture fixed with a white filling. I already had a silver filling on that tooth that was at least probably 10/20 yes old. The filling doesn’t seem to high but I’m feeling awful pain when I breath in on that side and can’t chew at that side at all due to the pain wjich feels like a needle being stuck into the nerve. When I’m not doing anything,the pain is just slight. The dentist said to wait til next week but I was told by another dentist that I needed a crown and this dentist said there was no need for it. What do u think? Am I just out the $300 I paid even though he may have made a mistake? Thanks so much for responding. Sincerely Pamela r

  28. Henry

    Hello Dr.Chris,

    I’d like to first apologize if I am posting this question in the wrong place.

    I’ll try to keep my story as short as I can.
    One of my top molar teeth has a deep amalgam filling, which was filled about 10 years ago. Recently, a small piece of the tooth chipped off and I noticed some small decay. I remember biting on something hard (by accident) a while back and it must have fractured the tooth and eventually developed decay. The decay was along the margin of where my natural tooth and amalgam filling met. It was determined by my dentist that the amalgam filling is “still good”, and rather excavate the entire filling and possibly “disturb the sleeping giant”, AKA the pulp, he decided to clean/remove the small decay and fill it with composite filling (he does not use amalgam filling). The filling he placed extends over to the amalgam side just a bit, and the gap/margin between the two types of filling is covered/capped with composite filling.
    My question is, is it normal to use composite filling on amalgam fillings? I am super concerned about micro-leakage between the margin of the two fillings, even though it was “capped”.

  29. Dr. Chris

    Dear Henry,

    Good question! So, first of all, your dentist is right that often removing large fillings can irritate the pulp, but, leaving the amalgam that is failing is not solving the problem, in my opinion. I am not a fan of amalgam and carefully remove them when they are failing. When they are removed I usually find fractures in the tooth that would have spread and cracked the tooth! So, in my opinion, I would remove the old beast and fix the tooth rather than patch it.
    Secondly, no, composite does not bond to amalgam so it will leak.

    Cheers,

    Dr. Chris

  30. Dr. Chris

    Dear Pamela,

    So fractures cannot be fixed by a “filling” as they will continue to wedge the tooth apart. The dentist that said a crown would be appropriate is right. A crown goes all the way around the tooth and holds it together!
    So, don’t wait, get it fixed before it is too late!
    you did not waste your money as a “core” would have been necessary anyhow and that is what you have now :)

    Cheers,
    Dr. Chris

  31. Alison Price

    Hello Dr. Chris,
    Question for you on material appropriate for larger areas…. I have some cavities that need to be filled and doing some research. You mention in your blog that resins work well when the spot to be filled is less than 1/3 of the distance between cusps. What do you use if the area is more? My decay is along the gumline and a “thin” line in width, but the dentist said the decay is “deep”. What you are saying about the resins expanding and contracting makes sense in that it is not ideal if over large area…. what would you recommend for my situation? I have a pictures and also x-rays.

    I so wish I was closer to you! I live in SC. Would even consider traveling, but I am not sure I have enough time and need to get this filling done soon. Hoping to avoid a crown (she said she won’t know until she is “in” there). You are doing wonderful work and spreading important information. THANK YOU!

  32. Dr. Chris

    Thank you Alison :)

    For the gumline restoration composite resin works well. IF you are unable to clean the area or if the decay is deep onto the root surface I usually recommend a glass ionomer material such as Fuji 9. No crown :)

    Have a super day,

    Dr. Chris

  33. Alison Price

    Thank YOU. I am recovering chronic fatigue and have chemical sensitivities. I am probably going to do the biocompatibility testing to help me find the best resin for me. I read a bit about glass ionomers as I think in general they are more biocompatible?

    Since I do know the dentist described the decay as “deep” would you consider Fuji 9 pretty biocompatible?

  34. Alison Price

    OH! And I don’t want a crown either. How would I gauge the necessity to have one or if my dentist is just a “crown pusher”? The fact that she mentioned that I may have to get one and she won’t know until she is in there leads me to believe she uses them liberally.

  35. Pamela R.

    Hi Dr . Chris! I just wanted to Thank You so much for answering my question and everyone else’s . your so kind to try to help us even though were unfortunately not your patients. God Bless. ?. Pamela R

  36. Whitney

    I had a filling ( was told it was small) done approx 4 weeks ago, I started to notice some slight issues when eating anything crunchy, so I did go back and they adjusted the filling, which helped a little, but the pain I continue to have is in middle of tooth and now I cant eat anything on that side of the mouth. I went to get a 2nd opinion and had the tooth x-rayed. The 2nd dentist said the tooth was good and that I needed to give it more time….but how much more time should this really need? I can’t chew anything on the left side now without it hurting. Is there anything else I can do? I’ve never had anything like this from a simple filling

  37. Dr. Chris

    Dear Whitney,

    I am sorry you had a second opinion and no solution…I would be concerned about a fracture which would not get better. If the bite adjustment did not work then the dentist needs to redo or check for fractures!

    I hope this gets resolved soon,

    Dr. Chris

  38. Ahmed

    Hi Dr Chris
    At first, I have to thank you in advance to advise about all those patients! really it’s a great work. I have got a composite filling class IV in my upper canine after strong pain, two days ago. I have been told that this pain is gonna decrease by time. currently, I am still suffering and taking pain killers! the real problem is I have a pain in many places not included that filled canine! Is it normal after filling to have pain in different locations?

  39. Ruth

    Hi Dr Chris

    Last night I started experiencing a dull constant but bearable pain in the back of my right jaw top and bottom and I thought that it was because of the cavities I needed to get filled with composites. When I went to my dentist appointment I told my dentist about the pain and he said that there was nothing wrong with the top of my right jaw that he could see in the X Rays.

    He guessed it was an old large filling at the bottom right corner of my jaw that was causing the sensation. but he was unable to say it beyond a reasonable doubt that it was that area that was causing me the discomfort.
    He told me to wait and if the pain got worst I would need a root canal. This worries me because he isnt able to identify where the pain is coming from, yet he insist that is my only option.

    Can an old large composite filling do this and is there any way?

    Since the pain is not unbearable is root canal my only option?

    Is it possible that the pain may go away Its only been less than 24 hours.

    Help!!

  40. Tracy

    I had a metal filling replaced in July 2015 right before deploying overseas, I was back in the US on a short visit in December and had to have the filling redone because of extreme pain, sensitivity, and couldn’t chew anything on that side. In February, again I had to have the filling adjusted because the bite was not right (now using a foreign dentist), the pain diminished but the tooth is still extremely sensitive to chewing and cold. He also filled another tooth that had a cavity on the edge of another metal filling which he removed and replaced with this white filling. Now, both sides of my mouth are bothering me, the new filling throbs, the first filling that has been fixed several times has sharp stabbing pain with cold or sometimes when chewing. Also the filling doesn’t “feel” right (it makes the tooth feel flat on the top), it feels as though something is stuck in my tooth so I am constantly picking at it with my tongue and have been grinding my teeth to try to get rid of it. I never had a problem with the metal filling that was replaced and this has gotten to the point that I am worried I am going to have to get the tooth pulled. One dentist has told me that I may have a sensitivity to this type of filling because it has irritated the tooth so badly, another has said it could take another year for it to truly calm down, another has said that I should just get a root canal (I have had one of those before and don’t want another!) The irritation, sensitivity and pain are becoming intolerable and getting conflicting opinions are only causing me more distress. Any advice?

  41. Samantha

    A day ago I had two broken teeth “restored” with white composit material. They shaped the teeth to their original look. One feels fine but the other hurts to no end. It’s a terrible sharp throbbing pressure. Today I had to get it filed down more but still no relief. What should I do? ?

  42. Dr. Chris

    Dear Samantha,

    There are so many variables associated with your problem…the blog post above does address the possible reasons such as a fracture, polymerization shrinkage and poor bonding, all of which could be the problem…
    Since one is ok and the other is painful it does make it more difficult to diagnose. This is something your dentist will need to work on or the tooth will need a root canal (throbbing pain is related to dying pulps). So, don’t wait, get it checked for fractures and see if the filling possibly was very deep and the tooth just gave up…which would be sad.
    Dr. Chris

  43. Dr. Chris

    Dear Tracy,

    It does sound like you have had the runaround, sorry. Seeing so many different dentists makes it difficult to isolate any problems…what I would recommend is to fix one area and wait till it feels good until moving on to another tooth.
    I have not seen anyone with a sensitivity to white filling material in 20 years so I don’t believe that this is the problem. IF the pain persists then it could lead to the tooth dying and the need for root canal treatments.
    I am not sure what type of dentist you have seen but getting a new patient exam and consultation from a top, non-insurance dentist, would be the most important thing in my opinion. This should cost no more than $250 and save you a lot of uncertainty!

    Cheers,

    Dr. Chris

  44. Dr. Chris

    Dear Ruth,

    I am not a fan of “waiting and seeing” what will happen as in dentistry it usually will get worse!
    Old restorations, bite problems, etc. can all cause this issue and I would not “wait”.
    X-rays do not show everything. They do not show fractures, bite problems, bond failures etc.
    If it is a fracture then you will need full coverage – a crown or onlay, to hold the tooth together.
    I would check the bite, adjust the bite, fix any decay or fractures and then think about root canal therapy as a last resort.

    I hope this helps,
    Dr. Chris

  45. Dr. Chris

    Dear Ahmed,
    I don’t usually have pain after placing white fillings…that is a concern that needs to be addressed. Pain can mean many things, all which require the dentist to take a look and fix it.
    Since you are feeling the discomfort in other areas as well that means it could be a root problem as well now.
    If your dentist is not able to help, please see a second dentist!

    Sincerely,

    Dr. Chris

  46. Steve

    Dr. Chris:
    I recently had 2 teeth fixed ( lower molars) one had a broken composite filling that was replaced — no issues. The tooth in front of it was damaged from a cherry pit — pain had subsided after about 3 days of damaging the tooth — it was about 2 1/2 wks. before I could get an apt to get both teeth fixed. Both were fixed at the same time. The tooth that was damaged has been sensitive to touch ever since the repair. Touch not pressure. My bite was adjusted twice NC and it helped a bit. However the tooth is still sensitive to being touched in the middle of the top surface. Very soft food is tolerated unless something firm contacts the middle of the tooth, then it is very painful. No throbbing no pain at night. I have never had a composite filling that has acted this way. It is now about 3 weeks after the repair and the tooth is very sensitive to being touched in the center of the top surface. Any suggestions?

  47. Dr. Chris

    Dear Steve,

    It does sound like it may be fractured. Fractures are very hard to see/diagnose but the history you present is very clear. I would strongly consider an onlay or a crown to prevent the tooth from fracturing.

    If you were my patient I would remove the filling and take a magnified look at all the inside surfaces, looking for hairline fractures – this should be your next step.

    Keep smiling,

    Dr. Chris

  48. Flemming

    Dear Dr. Chris,
    Thanks a lot for taking your time answer questions. I have two teeth bothering me: first lower left molar (1LLM) and second lower right molar (2LRM). 1LLM had a medium sized amalgam for more than 25 years. Six years ago, I wanted it to be replaced and my dentist drilled out the amalgam, analyzed thoroughly for any fractures and didn’t find any, and then placed a white filling. It has served me perfect, but now this tooth has become very sensitive for hot and cold and it aches – typically when laying down, worst during the night, not throbbing but constant aching.
    2LRM has never had amalgams but white fillings for about 20 years since it erupted. It started with a small filling but there has been tiny recurring cavities in this tooth very often – stopped counting after five – often explained by small gaps round the filling. I have never had pain from that tooth. Last time I had it filled was five years ago, where the tooth and the present white filling was done – don’t know if it is many small fillings or one large and if so, how large. My bite was checked and the filling and tooth shaped a little lower than the other teeth so it is not taking the same tough chewing pressure as the other teeth. The filling has served me very good in these last five years, but now the tooth has started hurting, mostly in short intensive jags / jolting when it is toughed. Now that these two teeth hurt, it is very difficult eating anything so I visited my dentist – she didn’t see anything obviously wrong neither on the x-ray, but she replaced the filling in 1LLM and polished (reshaped) 2LRM once again to lower the pressure. Once the numbness wore off the pain continued in both teeth. Would you please tell me what can be wrong in these two teeth and what can be done to relief me from the pain.

  49. Dr. Chris

    Dear Flemming,

    It sounds like a pretty clear fracture scenario. Teeth take a lot of abuse and dental amalgam pretty much cracks teeth all the time. You can’t often see fractures. The symptoms of the tooth that is aching sounds like a root canal problem…
    Both teeth should have full coverage or onlay/crown restorations to help with the fractures. A fracture is often hard to treat and results will vary. The sooner you treat a fracture the better!

    Cheers,

    Dr. Chris

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