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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

407 thoughts on “Pain After White Composite Filling

  1. Dr. Chris

    Dear Rupinder, let me get the right. The filling did not hurt until you had it “fixed” right? Did the tooth hurt after you broke the piece off? I am asking this because if the dentist only extended the filling to cover an area that broke then it is unlikely he/she caused the problem. But, if the dentist removed the filling then it is a different story.
    Honestly my gut says it probably is fractured. I would ask the dentist to check for that. When you broke the filling/tooth you probably caused the fracture that then became worse when the dentist worked on the tooth.
    The aching is a sign of the nerve dying so this is urgent.
    If the fracture is too deep then the tooth may not be fixable, sorry….

  2. Dr. Chris

    Dear Willem, if the tooth is hurting right after the filling and it does not get better after a few days then you need to go back to the dentist for a checkup. Most likely it will be that the tooth will require a bite adjustment. I hope this helps. Don’t wait if it does not get better!

  3. Linnette

    Hi, really hoping for some advice on what to do and what could of gone wrong if anything .

    I got a white filling #18 DO about two months ago . Now previously I had a silver filling on that tooth that I’ve had for years. When I went for my cleaning the dentist said that I was getting a cavity that was starting under the silver filling, which is why I ended up getting a white filling on that tooth. So I got it back in December of 2017 , the dentis said it was close to the nerve of my tooth so he put a liner, and immediately after the nova Caine wore off I started getting a sharp pain when I would bite down and couldn’t floss between my teeth either . I went to the dentis office twice to get it my bite adjusted because they said the filling was too high . But that still didn’t help very much I still couldn’t eat not even soft foods. A couple of weeks later I ended up getting the filling replaced to see if that would help. It did help to some extent I could at least chew soft foods but still couldn’t floss. Till today it’s been about two weeks since I got the filling redone and it still hurts to floss between and when and if I put pressure with my nail on the filling i get a sharp pain. My filling isn’t too high because I already got it adjusted and my dentist saw the X-ray of the tooth and can’t seem to find anything wrong . So the endodontist checked my tooth out and couldn’t see anything either so she said if it keeps going on that I would need a root canal .

    I don’t know what to do I have been taking ibuprofen and the pain goes away for a little but it comes right back and can’t floss or chew any hard foods. What do you think the problem could be and if any advice I should take what would it be ? Thank you !

  4. Linnette

    #18 MO ( correction )

  5. Dr. Chris

    Dear Linnette,

    Good description! The flossing situation makes it a little more clear. If the filling was high then the pain would come from biting. Silver mercury fillings are notorious for creating fractures in teeth over time due to their expansion and contraction and once replaced the fractured are still there and can get worse. But, you have pain when flossing which in my opinion points towards a bond failure in the filling. Flossing should not have a significant effect on a fracture. Often a large white filling is placed “in bulk” or the loose enamel rods at the mesial margin of the cavity are not removed prior to filling the tooth. Both scenarios result in slightly open edges and pain. Also, proper bonding is key in those areas. Isolation from moisture and proper filling bonding can be a challenge. That being said, I do not know the skill level of your dentist. One thing that can be done prior to killing the tooth with a root canal (which is the last and worst thing that can be done) I would place a sedative filling that is not so moisture or technique sensitive. I would suggest Fuji IX (9). If this takes the pain away then you know it is the technique with the white filling that is the problem.
    I hope this helps,
    Dr. Chris

  6. Linnette

    Thank you so much for the response . I do have an X-ray and pictures as well if you would like to see them. I will talk to my dentis and see what we can do from there .

  7. Dr. Chris

    Sure, send them my way and I will take a look 🙂

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