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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

356 thoughts on “Pain After White Composite Filling

  1. Erin

    Two and a half weeks ago I had a crown and two fillings done (one of which was deep) on the lower right back three molars. Since, I have had a throbbing pain especially at night and slight sensitivity to hot and cold. I have been alternating Ibprofuen and Tylenol as recommended and it helps. I have gone back to the dentist twice. First he adjusted my bite. That didn’t help. He also prescribed an amoxicillan in case I was developing an infection of some type. The second time, he did a tap test, extreme cold test, xrays, and checked my bite again. Nothing felt off to me. He couldn’t get a conclusive diagnosis as I couldn’t pinpoint exactly which tooth it was. Today, I believe I have narrowed it down to the tooth with the deep filling. Is it possible it is just taking a while for the deep filling to heal? I’ve had this type of work done before and normally bounce right back. My dentist is great and I appreciate that he isn’t rushing into any unnecessary procedures to try to fix a problem he can’t see.

  2. Dr. Chris

    Hello Erin. Sounds like a clear case of a dying tooth. If the amoxicillin makes it feel better then you will most certainly need a root canal as the pain will return after about 2 weeks. Sorry. The root canal treatment will solve you issue.

  3. johnnie Hewettle

    Hi,
    I had a filling done two weeks ago and I feel a throbbing sensation in my jaw. I called my dentist and the dentist prescribed some antibiotics and 800 mg Ibuprophen and it still throbs. Why is that?

  4. Dr. Chris

    Hello Johnnie, sounds clearly like a root problem. Antibiotics will mask the pain for about 2 weeks if it is a root issue. Ibuprofen will manage inflammation and pain for a limited time. Neither “solves” the issue and only prolong the problem. This is a very common practice and if not followed up with a root canal evaluation is futile. The tooth is in destress due to many reasons and the dentists needs to put his/her thinking cap on and actually come up with a solution, not a bandaid fix. If your dentist won’t see you to figure out the “reason” behind the problem then you will need a new “doctor”, not someone that just prescribes medication without finding the cause.

  5. Lou joe

    I had a old mercury filling replaced. They used white composite never an issue for 2 months. 2 days ago super sensitive to hot and cold and pressure. What could it be? Thanks

  6. Dr. Chris

    Hello Lou. Since your problem is new after 2 months I would say it either is a fracture or decay. If the white filling replaced a large amalgam then it is highly likely that the tooth had fractures in it already. The general rule is that the white filling should be less than 1/3 the distance between the cusps. Most are much larger. If it is beginning to fracture then you would need a crown or onlay. Decay on the other hand would be at the edge of the white filling and a dentist should be able to determine that.

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