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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).


posted in Announcements, Blog, Cosmetic Dentistry, General Dentistry

258 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.

  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….


    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.


  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

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