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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

280 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.
    -Amy

  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….

    Sincerely,

    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.

    -Natalia

  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 http://www.drillthedentist.com

  9. Sharon

    Almost 2 months ago my dentist replaced 2 fillings. Since then, I have pain when I bite down on food on one of the teeth. I have gone back twice to have the bite adjusted. Is there a way to tell whether the filling needs to be redone or I need a crown?

  10. Saba

    Dear Dr Chris, I have two deep fillings with composite, I went for check up last week and my doctor made me so anxious since she told me you should wait until these two teeths require root canal sincd shrinkage will happen, I have these two filled teeth with composite for more than 6 years. I asked my doctor to replace them,however she siad, if I want to replace them, it is likey thar they require root canal,therefore, it is better not to do anything.would you please tell me what should I do now, i am so concerned about having root canal in the near future.I dont want to loose my teeth at all

  11. Mandy

    I went to the dentist with very little pain he looked at an old X-ray and said he had missed that I needed 3 fillings I had them done ( one white ) 2 days later I was back in a lot of pain 2 of the fillings where removed and temporary filling where put in another 2 days later I was back in more pain he pulled out my back tooth and then 2 days later I was back to see him again he said I had an infection 3 days of antibiotics I was still in a lot of pain I went back and he’s refilled my other tooth … I’m now having to go back as that tooth is still hurting me so is the white filling and I still have pain from him taking my tooth out 3 weeks ago .. I’m really feeling like I don’t want to go back to him but can’t stand the pain many thanks mandy

  12. Yomnaallam

    Hi Dr. Chris
    Two months ago,I went to a doctor to restore my carious molars with composite resin. He said the cavities were shallow. My teeth ached soon after. The restoration height was proper. I had no problems with occlusion. I was on anti-inflammatory drug for 5 days but pain was back soon after. I went back to the doctor who replaced the restoration with a temporary one, and said to be back when pain goes away but it isn’t. At first, it was associated with cold but now with biting, and at times spontaneous and lingering. The doctor didn’t use air-water coolant. I’m worried my teeth pulp is irreversibly damaged.

  13. Dr. Chris

    If the doctor did not use cooling then the pulp can be damaged. Did he use anesthetic? If not then you would most likely have felt pain way before damaging the tooth but if you were numb then you would not be able to tell if the temperature was too high…
    So you are right, it may he irreversible pulpitis but it could also be a fracture (which is difficult to diagnose). A sedative filling was the right choice by the dentist so it looks like he does know what to do. You may want to check for fractures with your dentist.
    I hope this helps…
    Dr. Chris

  14. Meg

    Hi Dr. Chris,
    Last month, a new dentist gave me two fillings on my back bottom molars (#31&#32). The drilling hurt a bit even with anesthesia, but all ended up okay, until about two weeks ago, when a dull throbbing pain began on one of my front bottom teeth (two away from my right canine, #25 I believe). The pain is so persistent now that I am taking about 6-8 ibuprofen a day. Other teeth near my throbbing tooth are starting to feel an achey pain, and are a bit sensitive to cold water. Last week when I went to my dentist, she thought this was all residual pain from the filling, and that it would go away. I went to the dentist again yesterday because the pain now wakes me up at night, and she thinks the front tooth is dead and wants to do a root canal, though nothing came up on my xrays.

    Is this the best option? I’m worried that the surrounding front teeth are now starting to hurt as well.

    Thanks for your time!
    Meg

  15. Tom

    Dr. Chris,

    I had four composite fillings placed this morning. Now that the anesthetic has worn off I have intense jolting sensitivity to touch and negative pressure in one of the teeth. Temperature extremes don’t seem to bother it. It’s tooth 31 and it was a deep filling. No prior work had been done to the tooth. Is such a jolting sensitivity normal for a period of time?

  16. Becca

    I just got a filling on Monday. Today is Tuesday. It was a deep filling and there is a dull ache/pain. I have little to no sensitivity to cold and none to hot. I can feel the filling with my tongue where I never could with any other fillings. It doesn’t hurt to chew though. It actually feels normal when im chewing. Is there anything I can do? The day after my filling it did not hurt at all but then a dull ache came so what now?

  17. Mac

    Hello,
    I had two composite fillings a month ago. I went back twice for high bite adjustments. The second one helped to a while but it has started to feel sore again. The pain seems to affect the teeth in front of the molars that had cavities. It is sensitive to hot and cold but not biting. What could be wrong? I’m a nervous wreck about a root canal.

  18. Greg

    Hi Dr. Chris,
    About a week ago I had an older silver filling replaced at the recommendation of my dentist in #19. I’m now experiencing intermittent intense pain. I’ve read a number of similar posts on this website but am having what appears to be a different experience and received a different answer from my dentist and am hoping you can offer some advice. First, my pain is initiated somewhat randomly, sometimes from opening my mouth, sometimes while talking, sometimes while eating, sometimes while moving my tongue around in my mouth or pursing my lip. It does not happen every time in the mentioned examples and I cannot identify anything else specific that might trigger. I do not have sensitivity to temperature or pressure.

    The pain is sever and massive enough it has brought me to my knees. The pain is also severe enough that I can’t tell where it’s coming from, it radiates the entire side of my face and lasts a few seconds. I’ve noticed the pain mostly from the back of my mouth and my jawline as well as up near the sideburn/ear. I’ve returned to my dentist explaining this issue and he took X-rays. He saw no issues in the X-ray and offered a possible solution that is related to a near tooth (#22) that my gum are receding and exposing an area of the tooth unprotected by enamel and more easily irritated. He had me switch to Sensodyne toothpaste, take Motrin, and reduce the setting on my Sonic toothbrush to “sensitive,” stop brushing at the gumline, or possibly switch to a manual brush.

    Thank you in advance for any advice or recommendations you might have and thank you for offering to help!
    Greg

  19. Dr. Chris

    Hello Greg,

    Dental pain is often elusive…You mentioned the pain “began” after the filling was replaced? If you had no pain before then I would focus on that tooth. When replacing old amalgam fillings there is quite a bit of damage that is done to the tooth. Your differential diagnosis for me would be a fracture (cusp most likely), poor bond, or void in the filling. Depending on the size of the filling I would replace it with a sedative filling such as Fuji 9 or temporize with a cuspal coverage restoration such as an onlay if cracks are present. An x-ray shows issues with the root which can take some time to materialize…

    I hope this helps!

    Keep Smiling,
    Dr. Chris

  20. Dr. Chris

    Hello Mac,

    The bite may be correct now but if you are still having sensitivity that was not there before I would look at possibly a cuspal flex issue or a poor bond. Sensitivity could also take a few months to go away…The only way I know how to solve this is to first try to seal the restoration again (etch and seal) or redo it….
    I hope this helps.
    Dr. Chris

  21. Dr. Chris

    Hello Becca,

    Has the dull ache gone away? Since you just had the filling I would give it a little time since the bite feels normal and it is not sensitive. The fact that you can feel the filling with your tongue is interesting…I would need more info on this to comment.
    IF the dull ache is still there then you may have a root problem and need to see your dentist again…sorry.

    Cheers,

    Dr. Chris

  22. Dr. Chris

    Hello Tom,

    Jolting pain is never “normal” :) The only way you can feel jolting pain is if something is bothering your nerve inside the tooth…you need to discuss this with your dentist! Since it only happened to one of the teeth I am sure your dentist can help with it. Most likely a large filling that was bulk filled in my opinion.

    Cheers,
    Dr. Chris

  23. Dr. Chris

    Hello Meg,

    Throbbing pain, especially at night, is nearly 100% diagnostic for a dying/dead root. The question is “why” did it die…The only treatment option is a root canal therapy (or extraction).

    I hope this helps,

    Dr. Chris

  24. Dr. Chris

    I am sorry for all your trouble Mandy. Dentistry is quite involved but most importantly you need to “trust” your dentist…Once trust is lost you need to switch. Your situation has many variables so I am not able to give you specific answers and hope you find a dentist you trust.

    Cheers,
    Dr. Chris

  25. Dr. Chris

    Hello Saba,

    First of all I am sorry your dentist made you anxious…that is terrible. Removing fillings does not usually result in the need for a root canal! If shrinkage is a concern (due to the size of the fillings), you can build the fillings up a little at a time or use gold or porcelain. There are many solutions but none should make you anxious! Maybe you need a new, less anxious dentist :)

    Keep smiling,
    Dr. Chris

  26. Dr. Chris

    Dear Sharon,

    It really is not easy to tell what needs to be done…has the pain gone away? A crown is used when the tooth is ready to break or has little tooth structure left. Biting pain often is due to flexing of the tooth and oftne a crown is the only way to fix that (or an onlay).

    I hope this helps,
    Dr. Chris

  27. Pamela R.

    Hi Dr Chris. Can’t Thank u enough for responding to all of us. I have heard u talk about pain due to fractures but my question is, what could be causing pain after having a fracture fixed with a white filling. I already had a silver filling on that tooth that was at least probably 10/20 yes old. The filling doesn’t seem to high but I’m feeling awful pain when I breath in on that side and can’t chew at that side at all due to the pain wjich feels like a needle being stuck into the nerve. When I’m not doing anything,the pain is just slight. The dentist said to wait til next week but I was told by another dentist that I needed a crown and this dentist said there was no need for it. What do u think? Am I just out the $300 I paid even though he may have made a mistake? Thanks so much for responding. Sincerely Pamela r

  28. Henry

    Hello Dr.Chris,

    I’d like to first apologize if I am posting this question in the wrong place.

    I’ll try to keep my story as short as I can.
    One of my top molar teeth has a deep amalgam filling, which was filled about 10 years ago. Recently, a small piece of the tooth chipped off and I noticed some small decay. I remember biting on something hard (by accident) a while back and it must have fractured the tooth and eventually developed decay. The decay was along the margin of where my natural tooth and amalgam filling met. It was determined by my dentist that the amalgam filling is “still good”, and rather excavate the entire filling and possibly “disturb the sleeping giant”, AKA the pulp, he decided to clean/remove the small decay and fill it with composite filling (he does not use amalgam filling). The filling he placed extends over to the amalgam side just a bit, and the gap/margin between the two types of filling is covered/capped with composite filling.
    My question is, is it normal to use composite filling on amalgam fillings? I am super concerned about micro-leakage between the margin of the two fillings, even though it was “capped”.

  29. Dr. Chris

    Dear Henry,

    Good question! So, first of all, your dentist is right that often removing large fillings can irritate the pulp, but, leaving the amalgam that is failing is not solving the problem, in my opinion. I am not a fan of amalgam and carefully remove them when they are failing. When they are removed I usually find fractures in the tooth that would have spread and cracked the tooth! So, in my opinion, I would remove the old beast and fix the tooth rather than patch it.
    Secondly, no, composite does not bond to amalgam so it will leak.

    Cheers,

    Dr. Chris

  30. Dr. Chris

    Dear Pamela,

    So fractures cannot be fixed by a “filling” as they will continue to wedge the tooth apart. The dentist that said a crown would be appropriate is right. A crown goes all the way around the tooth and holds it together!
    So, don’t wait, get it fixed before it is too late!
    you did not waste your money as a “core” would have been necessary anyhow and that is what you have now :)

    Cheers,
    Dr. Chris

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