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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

337 thoughts on “Pain After White Composite Filling

  1. Dr. Chris

    Dear Jim.
    I can see how this is frustrating…sorry.
    My thoughts are that since it hurts when floss passes by it that the it may be leaking or have a poor bond. This can happen to anyone and most dentists would of course look at it and correct it. This would entail redoing it often.
    Unless this was a super deep filling I would not expect you would need a root canal, but, the general rule is not to let this go on too long…we are in the service business and until you are happy we are here to help 🙂
    Keep smiling,
    Dr. Chris

  2. Jim F

    Dr Chris,
    I had 7-8 composite filling put in in 5-6 month span- I have had problems in all of the composite’s- I have had 2 tooth exacted after failed root canal..presently 2 other teeth that had root canal’s still hurt and 2 more on other side of my mouth are tight and sore. My dentists , based on x-rays , tell me the pain should go away. I think the worst of these teeth is fractured or something and this pain just is not going away as there is no ever minimal improvement after 3 months (from the root canal). I take about 400 mg of ibuprofen about mid day and that usually gets me at a min pain level. These composites were put in May 2015. I would really appreciate feedback. Thank you

  3. Dr. Chris

    Dear Jim,
    I am sorry to hear that you have had so much trouble…that is a long time to go with pain.
    If the composite fillings replaced large old amalgams then it is likely that the teeth had fractures. These fractures often require cuspal coverage (such as a crown or onlay). If a simple composite is placed it will make the situation worse and even a root canal will not solve that problem.
    Simply put, with all the trouble you had I feel you need a second opinion…there are just too many issues.
    I hope this helps.
    Keep smiling,
    Dr. Chris

  4. Dr. Chris

    There is a good chance Sharon that the teeth need to have the fillings redone and checked for fractures. A fractured tooth needs a crown m, not a filling and if this is not treated correctly you could loose the tooth.
    I hope this helps.
    Dr Chris

  5. Dr. Chris

    Dear Saba. Why would your dentist recommend they be replaced in the first place? If they are not leaking then leave them alone. If they are large and have decay then consider an onlay or a crown. Your dentist should give you options, not anxiety!
    Cheers,
    Dr Chris

  6. Dr. Chris

    Dear Mandy. With all the trouble you are having I strongly suggest you get a second opinion! This is a lot of issue at one time…
    Cheers,
    Dr Chris

  7. Dr. Chris

    Dear Yomnaallam. Without water or air a tooth can hear up and be damaged so yes, it is possible that the nerve was damaged. You need to find a more modern dentist ASAP!
    Keep smiling,
    Dr Chris

  8. Matthew Gulley

    Hello Dr Chris,

    I had three fillings done about three months ago, and have been in pain ever since. I had tried a new Dentist close to my house because my other Dentist had retired. After going back to this dentist twice for follow up appointments due to the pain, I decided to try another Dentist recommended by a family mbr. He took X-Rays, checked my teeth and said that they were poorly bonded, showed me a rather large spot that he informed me could only be an air pocket or decay, several chipped places and advised me that I should probably have all three redone. Any thoughts?

  9. Dr. Chris

    Dear Matthew. If you received a second opinion on your painful fillings and the new dentist was able to give you some good reasons to why the work was poor then you probably would be best of getting the work redone in my opinion.

    I hope the next time it feels better!

    Sincerely,

    Dr Chris

  10. Pat

    Dear Dr Chris
    My denist recently retired. A new dentist took over saying I need my silver fillings replaced. They are upper and lower. Even though I had no pain. So I agreed. Well now its close a week and I have severe pain and my jaw and ear just ache! They want to do two more on other side. I’m upset as I had no pain, now I’m suffering. Would antibiotics help to calm this dow. Should I give it more time..; Im near crazy. Thank you.

  11. Dr. Chris

    Dear Pat. This is very common…old amalgam fillings always crack teeth and it is critical to remove them carefully and check for fractures. If there are fractures present then you will need a full coverage restoration to hold the tooth together (onlay or crown).
    Also, often dentists place super large composites. This does not work and also causes tooth flexure and pain.
    Lastly, don’t do anything else until the current work feels better or has been fixed!

  12. Harsha

    Hi
    I had tooth restoration process , my filling just get of in 24 hours leaving only the tiniest of frame what happens next

  13. Dr. Chris

    Dear Harsha,

    I believe you have a “crown” preparation if I am correct. Next the laboratory will fabricate a cap that fits over your tooth. This usually takes 2-3 weeks at which point the dentist will place the cap onto your tooth 🙂 That is the simple answer…I hope this helps.

  14. Stephanie

    Hello Dr. Chris,

    I just had my first filling three months ago. I had a pit on my back molar that was filled with a white composite. I felt sensitivity for about 2 weeks after the filling and then my tooth felt great. Now almost three months later I have sharp piercing pain in that tooth occasionally as I chew. It has occurred within the last week. It only happens when I chew and not all the time. I went back to the dentist who said the filling was fine, that the filling was incredibly small, and nowhere near the pulp. He said that there is sometimes sensitivity with composite fillings and is recommending I get a silver. He said if that didn’t help then I might end up with a root canal. He gave me a prescription in case of infection, which I have not filled yet. Does all this sound right? My tooth did not bother me at all before the filling and in my thoughts it was just a stained pit. Since dentists kept pointing it out I finally said to just fill it. I never imagined I could end up with a root canal. Any recommendations?

  15. Dr. Chris

    No root canal! Ridiculous. Also, no Mercury filling, just as ridiculous. The filling most likely is high or/and the tooth cracked. Since it felt fine and then began hurting it sounds more like a crack. I would get a second opinion before proceeding!

  16. Lupe

    I had some fillings done and now i can’t chew on that side. I dindt have pain before the fillings. I went back to the dentist and she said it was ok that the pain would go away that it was. Normal for white filling to feel like that at first that my theeth just need to adjust. It’s been 3 weeks and I can’t eat anything on my left side. What should I do.

  17. Dr. Chris

    Dear Lupe. Slightly sensitivity may be normal. It not pain. When your teeth come together they should feel normal. If it feels like you are biting on a little piece of sand then the filling is not adjusted correctly and you could kill the tooth. Secondly, white fillings need to be bonded correctly (read the blog post on this in my blog) and many errors can happen. Any one of those errors could cause pain and the need to redo the filling or pick a different material (just not amalgam).
    So, it has been 3 weeks and I would expect any sensitivity to have gone away. If your dentist is not willing to fix this then you need a second opinion quickly before this turns into the. Exit step that dentists who cannot solve this issue always go to – a crown and then a root canal.
    I hope this helps,
    Dr. Chris

  18. Rose

    I had 6 amalgam fillings replaced with composite fillings a month ago and have been in severe pain since then. I have been living on ibuprofen and unable to chew. The pain wakes me through the night. I have contacted the dentist and he told me to wait it out and gave me a prescription for prednisone. After I complained about 3 weeks out, he said he could replace them with sedative fillings. I can’t help but think something is very wrong, severe pain like this is not normal. I’m scared to go to yet another dentist and get no improvement. Is there a dentist in my area you would recommend? I live in the Lexington, Ky area. Thanks.

  19. karissa

    I had 3 small tiny cavities on my top teeth so I had them filled all at once (white fillings), remind you no problems before I went to dentist, 2 weeks went by in pain I had take ibuprofen every 4 hours and def could not eat on that side so went back in to see if bite was wrong, he adjusted and only got worse. I made another apt because the pain got worse and he drilled out old ones and put in 2 more that were hurting the most. They are about 50% better than first fillings I had but its been 2 weeks and still don’t chew on that side and very sensitive. He said next step was root canal but the fillings are so small not even close to the root so should I just wait it out longer or seek another opinion??

  20. Dr. Chris

    Second opinion!!!! Do not get a root canal yet. That is the “I have no idea what is going on” solution. It has to be either a poor filling technique or fracture of the tooth in my opinion. Poor technique requires new dentist and fracture requires onlay or crown before it is too late.
    When I take out old silver mercury fillings I inform all my patients that fractures due to the expansion of this wonderful material (being sarcastic) often result in the need of cuspal coverage with an onlay or a crown to hold the tooth together. I hope you find a dentist that can help you correctly!

  21. Dr. Chris

    Wow, prednisone…you need a new dentist. You are in luck! Fred Arnold is an exceptional dentist and he is in your area! Tell him I sent you, he will help you, he really is one of the absolute best.

  22. Heather Dinnis

    Dr.Chris,
    I live in the Las Vegas area and I got 5 of old mercury fillings replaced 2 months ago with amalgam and I have had pain ever since. Like others I have been taking too much advil and I am really frustrated. I have went back to the dentist three times and I have a new small fracture on the gum line to add to the pain. He said it was too small and they usually leave them alone, but it really hurts with hot and cold. I don’t want to go back to my dentist but I don’t want to make it worse either by someone else. Any advice or do you know a dentist here?

  23. Dr. Chris

    Sounds like you need some good advice. The only accredited cosmetic dentist in Las Vegas is Dr. VreNon, I would see him. His number is 702-869-0032. I wish you all the best

  24. Keiara

    I just had my silver fillings removed and replaced with the white fillings. I feel a throbbing pain right after the numbing went away. And it’s only been some hours before I came and found this site. My doctor didn’t warn me of anything. I asked him to replace the filling and he said yes. Should I give it a couple days for the pain to go away?

  25. Dr. Chris

    Hello Keiara. There are so many things that could be going on as per the blog post above that you read. Yes, give it a day or two and then see how it feels. It could be normal or one of many bad things so let’s hope it is normal 🙂

  26. khaled

    for all the patient who ask about the pain after composite filling .you must know the filling contain phosphoric acid in its component which cause irritating for the pulp especially when the dentist dont put calcium hydroxide under it.

  27. Dr. Chris

    Dear Khaled, the filling does not have phosphoric acid in it. We use phosphoric acid to prepare the tooth before placing the filling. Calcium hydroxide works as a thin base if we are close to the pulp of the tooth but reduces the bond and turns to mush after a while. The phosphoric acid does not cause pain if used correctly.

  28. Chloe

    Dear dr. Chris,

    I had a white composite filling done 4 weeks ago. After the filling, I noticed the dentist left a large space in between my 2nd and 3rd molar. I didn’t think much of it. But after the 1st week I began to feel pain upon cold, hot, chewing on the tooth. Also the gap I had noticed between my teeth is gone. My 2nd tooth ( the one that got the filling) has moved closer to the 3rd molar. Also the weirdest part is that it hurts to floss in between my 2nd and 3rd molar only, which is where the filling was done. It doesn’t hurt in the front of the tooth to floss between the 1st and the 2nd. I went to my dentist… and he adjusted it a little and said if it doesn’t get better I need to see an Endo. It’s been three weeks since that and the cold and hot sensitivity has gone away but it still hurts to chew and floss. HELP. I don’t believe I need a root canal. 🙁

  29. Dr. Chris

    Dear Chloe,

    It sounds to me like a filling problem not a root canal problem. The absolute last and even then bad option is a root canal. If there was a gap between the teeth when the filling was placed I would venture to guess that the quality of the filling is poor and it should be redone by a good dentist. Sorry to be so blunt but I am frustrated by dentists that simple point patients to endodontists to solve their poor filling issues. That is not looking our for the patients best interest. A root canal is never a good option for the body.
    I would get a second opinion and have the filling redone prior to even considering a root canal.

  30. mydentalcare

    Both amalgam and composite fillings can leak. An amalgam filling sometimes leaks slightly after it is placed. You would notice this as sensitivity to cold. This sensitivity decreases for the next two to three weeks. Then it disappears altogether. Over that period, the amalgam filling naturally corrodes. The corrosion seals the edges of the filling and stops any leaks.

  31. Dr. Chris

    Dear “My Dental Care” marketing website,

    Thank you for your comment. Sorry I had to remove your spam link but I will be happy to respond to your comment!

    First, yes, everything we can do as dentists will leak. That being said, composite fillings leak more when placed incorrectly and amalgam (silver mercury) fillings leak all the time. Yes, the corrosion of the amalgam slowly fills in the gaps that the contraction and expansion causes. What a wonderful material – who would not want something in their mouth that “corrodes”?

    Secondly, fillings that contain 50% mercury which is proven to be vaporized into the mouth just my chewing alone would never be approved today – as a matter of fact I believe anyone proposing such a filling would be thrown out into the street. Yet still most dentists place these fillings that can only leave a dental office in two ways – in the patients mouth or in a hazardous material bag. Makes you think right?
    Lastly, maybe since most European nations and Canada have banned the use of this toxic material, maybe the USA needs to put the patients first for change.
    Just my opinion.

  32. Erin

    I don’t know if my comment before this one was published, so I’m gonna see if this one publishes, sorry

  33. Dr. Chris

    I see this one Erin but nothing before. What is your question?

  34. Erin

    Okay I think I’m having issues commenting… I’m sorry if I’m spamming the comments section but ugh. I originally posted that I have four fillings done in a row all next to each other about 3 months ago and I am experiencing pain in 1 or 2 of the teeth intermittently. I went back to my dentist who took x rays and said it looked fine and I should come back if the pain gets worse or it wakes me up at night, because then I’ll need to get a root canal, and if not then it should go away on its own. I guess I should get a second opinion, but does anyone know what the problem could be and if I really need to get a root canal? I don’t want to get a root canal… Thank you

  35. Dr. Chris

    Ok Eric, got it now. Ask as many questions as you like!
    I for one do not like to “wait” until something goes so wrong that you “need” a root canal. That is ridiculous.
    Often when old silver mercury fillings are replaced the tooth has so many fractures in it that it needs a full coverage restoration like a crown. Silver mercury filings in my opinion are the worst thing for teeth but great for dentists as we get lots of future work from placing them. Now if you did not have these fillings before then it is more likely that the white filling is placed wrong as mentioned in this article. Yes, a second opinion is always best but how do you know who to see? That is the challenge. The only way I know to answer this is to see a dentist that takes his/her career so serious that they lecture or have achieved a significantly higher level of education such as being AACD accredited. They pride themselves in their work and know what they are doing. Unfortunately you are looking at a small fraction of dentists out there so the next best thing is to find a dentist that does not, I repeat, does not accept any insurance in network. Once you sell your soul to the insurance companies in hopes of getting more patients you have lost the quality game. A dentist has to work twice as fast and hard to earn a living working for insurance companies by accepting their payments and rules that come with them. Avoid that trap.
    I hope that helps.

  36. Laney

    Dear Dr. Chris,

    I had a composite filling done on my left back molar at the beginning of last month. Exactly 4 weeks later, I experienced a sharp pain any time I drink something cold. I’m scared to eat anything on my left side and I have to drink through a straw in order to avoid the pain. I went to the dentist and he as me on desensitizing tooth paste. It been almost two weeks and I still fill pain on my left side when drinking. I have had two molar extractions on my left side so there is a big space there. My dentist said he doesn’t see any cavities. What do you think could be wrong? I wasn’t in pain before receiving the fillings and I could eat and drink normally and now I can’t.

  37. Dr. Chris

    Dear Laney, it sounds like there are several different problems that could be occurring. First, I do not know how large the filling is and if it replaced an old amalgam or not. Regardless, sharp pain to cold is not going to get better with desensitizing toothpaste. Most likely the filling was not bonded correctly, too big or the tooth has a fracture in it. None of these situations should be watched as it will only get worse. I suggest your dentist take a look at these options and gives you some real options…

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