You Tube
image description

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).

[ad]

posted in Announcements, Blog, Cosmetic Dentistry, General Dentistry

210 thoughts on “Pain After White Composite Filling

  1. hahndds

    This sounds more and more like a fracture! Let me know what happens on Friday :)

  2. hahndds

    While it is not good to use expired material, I would not be worried about that so much, assuming you are talking about a white filling material. The expiration date really is far beyond what the date on the tube says :) The material only gets harder to work with and dries out, at which point it cannot be used any longer.
    Dr. Chris

  3. hahndds

    If you have pain and you don’t agree with what your dentist says then I suggest you get a second opinion. There is always a chance that the filling was deep and large which could have resulted in the tooth dying. Often people don’t feel pain but have large areas of decay…

    Dr. Chris

  4. hahndds

    Dear Hannah,

    First, go back to the dentist and see if the “bite” is perfect.
    Second, if that does not solve it contact me again with more details about the pain etc. :)

    Thanks,

    Dr. Chris

  5. sukun

    Im facing d same problem, and it hurts terribly.

  6. K

    To Dr. Chris,

    Hello again! I’m the one who commented a few days ago with the possible fractured tooth. I went again to the dentist, and I’ll try to write what happened to the best of my memory, hopefully without too many mistakes. Thank you again for reading and giving your opinion, it’s very helpful and reassuring even if you aren’t able to confirm things in person! :)

    I asked whether the hurting tooth could be fractured, and my dentist said she didn’t think it was likely, but more that the previous silver-coloured filling had put pressure on the tooth that wasn’t replaced when she replaced it with the composite filling. She filed it yet again, and put a coat of varnish on it. In the morning when I tried to floss, there was the pressure pain on one side, but when she finished varnishing and did the after floss there wasn’t really pain/there was improvement. However, now that I’ve been able to eat, it feels as if the pain is still there but now spread out a little over the surface, if that makes sense? Again, not in the whole tooth or any time it’s touched, just in parts. She said that we would give it another week or so, and if things didn’t improve, she would suggest a root canal. I’m terrified at the thought :(

    I apparently also need my upper right wisdom tooth either fixed (filling), or removed. It had no issues coming in, and doesn’t have problems now besides the decay, but it is at an odd angle which makes it hard to clean even with the smaller toothbrush heads. I don’t mind having it removed-not as if I am using it!-but it is probably more drastic that way. What would you think? If the tooth is already out and in place, can it be pulled like any other tooth?

    I also had a filling in molar 7 on the bottom right, and it needs to be filed further (which I will have done next week), but it feels as if it’s causing my bite to be misplaced as one of my front lower incisors is now pushing on the top left one, including when I chew which isn’t ideal. Hopefully that will be fixed with a filing? I have a small jaw so had to have a lower incisor removed followed by braces when I was a teenager, so I’m very worried about them being pushed out of place again.

    Finally, we’ve been having problems with the anesthesia every session. Yesterday I had five injections, four on the same side for that lower molar, and still only my cheek and lips went numb. My tongue/gums/etc didn’t at all, and when she drilled down the tooth for the filling, I felt it and it was very painful. We tried three times inject/wait/file, but it didn’t take. In the end I said to get it over with, rather than come back, and she did but it was awful and hurt a lot. She said that it might be because I am so nervous (and this doesn’t help) but surely it has to work at some point regardless? :D This additionally makes me terrified of a possible root canal-they have the reputation for being painful, and if anesthesia doesn’t work, well… do you have any advice there either please?

    Thank you again for reading and replying, it’s really nice to have a second opinion/additional thoughts :)

    -K

  7. Austin

    I recently went in to get a cavity filled and received the composite filling. The pain and sensitivity after the novacaine wore off was brutal, especially to cold and extreme pressure. After going in to get the resulting bite checked out a few days later, the dentist suggested that shrinkage may have occurred (no one likes shrinkage) and he re-did the filing with amalgam or whatever the temporary filling is. It has felt much better since he did the procedure, so luckily it seems a root canal will not be in my near future.

  8. hahndds

    Dear Austin,

    Glad it worked out for you. Composite restorations are an amazing filling type but do require meticulous attention to detail and technique. Sounds like you had a bad experience there…hopefully in the future you can have that amalgam filling replaced with a proper white filling to prevent the tooth from fracturing.

    Cheers,

    Dr. Chris

  9. maxine

    I went to the dentist he said my fillings where leaking. So he replaced them. My right sided teeth where still hurting to bite on as well as to cold, so I waited about 3 days, I went back he did the freezing thing and it hurt bad. So he said they needed to be adjusted and said he was going to put basically so sort of installation before. It has been almost a week since and my jawline near my my ear and up to my ear is hurting as well as my tongue it feels as if I was biting it. The pain comes and goes but I cant tell if its my teeth still or my jaw still sore.

  10. hahndds

    Dear Maxine,

    When you do an ice test on a tooth you are looking for specific results:
    1. Quick response to cold and goes away quick = normal
    2. Quick response to cold and lingering = irritated tooth
    3. Slow, building response with aching = dead or dying tooth

    So, there are many issues that could be at play here. How large is the filling? Was it a silver mercury filling before?
    Adjusting the bite is always the first step. If that does not work the filling may need to be redone or a larger type of restoration such as a onlay or crown could be indicated.
    Send me more info and I will try to help more :)

    Keep smiling,
    Dr. Chris

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>