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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

358 thoughts on “Pain After White Composite Filling

  1. Amber

    I had a composite filling placed about 8 weeks ago. I had no pain or sensitivity for the first six weeks following, but about two weeks ago I noticed very sharp sensitivity to hot foods, and sometimes cold. I went back in today. The dentist poked around a bit, did a cold test, but did not take new x-rays. He then suggested I either wait a few more weeks or replace the filling. He also said he was somewhat “stumped” by my symptoms. Should I seek a second opinion? I don’t want a filling re-done if it won’t provide any relief. Your advice is greatly appreciated. Thanks!

  2. hahndds

    Dear Amber,

    Sometimes us dentists are “stumped” 🙂 We don’t know it all! In this case I can see why your dentists would be stumped. I also don’t feel another x-ray would be necessary at this point. We usually look for “aching” as a reason to take x-rays and check the root. I am sure your dentist also checked your “bite” and function right? What were the results of the cold test?
    If I did not see any obvious issues and your bite and function was good then I too would wait a little longer and see if it gets better. I don’t think a second opinion at this point is really necessary. Give it a few days. If it gets worse, see your dentist again and he/she will redo the filling.

    I hope this helps.

    Keep smiling,

    Dr. Chris

  3. Sandra

    For 23 years I did not put my feet into a dentists office, no problems, ever.. Decided to have my mercury filling removed 4 weeks ago ! And what a nightmare, I live on pain killers every 4 hours, eating is a pain, sleeping a pain, regret that I ever made this decision .

  4. Jane

    I emphathize with you, Sandra. Every time I try to do the “right” thing these days, I can ask a billion questions beforehand, and it’s never enough. I have substantial problems in my left lower jaw, but, as it happens, I lost a 50-year old filling – a small one, a few weeks ago. The tooth did not hurt, but I feared it would crack, and I’m already missing 4 teeth – all molars.

    So, I went to the dentist, thinking I’d get started with regular visits somehow, but have this filling replaced. I didn’t want mercury. (My mouth looks like a silver mine due to over-exhuberant drilling of teeth with tiny cavities). I asked about the cost difference for the composite, but was never anticipating handing over all but $50 that I have to my name. That might just be the way it is, but…

    The tooth hurts. Remember I said it hadn’t hurt. And, the composite seems to have shrunken. And, 4 hours later, my face remains severely numb. (It was a NEW kind of painkiller – arcti – something. Lucky me). I should have done what I had planned and asked for a temporary fillling, but they were hovering around saying oh you don’t want a temporary filling. The composite not only appears shrunken, but the tooth is now rough at the base, which it wasn’t before. I can go back to have this fixed — why the hell couldn’t it be done right the first time for so much money? – I have traded my non-painful tooth for more problems, and added a hole in my pocket that was unbelievable. Happy holidays, eh? I should just have gotten some tooth cement.

  5. Jane

    This is unrelated, but, with mouth still affected by anesthesia, why was I even given anesthesia for a tooth that had no decay, when the clean-out of the broken filling was nowhere near the nerve? Nothing like sitting here kicking myself, and hungry, for not stopping the procedure. I was given the articane – a first time. They had me rinse my mouth – I was surprised to see a lot of blood. Out the money, in pain… feel idiotic and poorer. Worried now about permanent nerve damage…

  6. hahndds

    Dear Jane,

    Very frustrating indeed. Sorry to hear about your bad experience. A white filling was the right answer, but the delivery method and outcome not… we have placed thousands of white fillings with little problems.

    Hope your next dental experience is better,

    Dr. Chris

  7. hahndds

    Dear Jane,

    Articaine, used correctly, is the most safe anesthetic there is (it has been used in Europe for decades now).
    Anesthetic is important as cleaning out a tooth can be quite uncomfortable, even if it seems like a small filing.

  8. Courtney

    Hello,

    I had two composite fillings placed yesterday, as well as a temporary crown on the last molar both on the upper left. Today, I am experiencing throbbing, sensitive pain. Any thought on this? Is this normal? The filling was deep but there was no active decay under the original filling that was replaced. What is the likelihood of having to get a root canal?!

  9. hahndds

    Dear Courtney,

    It is very hard to say how likely it is that you will need a root canal, but I can tell you that it rarely happens. Here is why…
    The root of a tooth dies for several reasons, one being a mechanical exposure by the dentist, deep decay, fractures, and several others that are not as likely. Replacing filling, as I am sure you have read in this forum, can result in problem. So it is really tough to say how likely a root canal treatment is. Last week I had a patient like you who had a temporary crown placed by a dentist and the dentist was referring the patient to a endodontist for a root canal treatment since she was having throbbing pain. She sought a second opinion and we redid the temporary crown (it was incredibly bad) and surprise surprise, she feels better.
    I am not saying you need a second opinion yet, but you do need to have your dentist look at this, maybe adjust the bite…

    Keep smiling,

    Dr. Chris

  10. Jeff

    Hello. I recently had a white composite filling placed in my bottom right molar. The type used was 3M Fill-Tech Z-250. There was a significant chip from a wisdom tooth extraction. From top to bottom, approximately 20% of the tooth was lost. I had this done 16 days ago. Since getting the filling there has been a terrible, bitter taste in my mouth. It’s constant, whether eating, drinking, or not injesting anything. My mouth is also dry and pasty, and producing saliva is not easy. My whole mouth feels almost as if it’s coated in something, even my lips. The taste is slightly, just slightly, better, but still persists, and the dry pastiness has not improved. During the first 4 days, the taste was so extreme, I had difficulty sleeping, and during the night, in addition to the bitterness, there was also a taste that I can only descibe as extreme halitosis, which has gotten better. I have few questions about what was done during the procedure, and wil give the details, so please bear with me. Nearing the end of the procedure, during the filing down of the filling, I made a comment about the smell of the vapor. The dentist then switched to using water while filing. Should this have been done. The water, I can only assume was accumulating the “vapor” from being filed, which was filling up in my mouth. The assistant was not present with suction at this time. I then choked slightly, and swallowed this nasty water. Prior to the assistant leaving she had dropped the suction device on the floor. Now after I swallowed the water/resin slurry, she returned, and put the suction device back in my mouth. They then did the drying. I expressed my concern that I may have had a suction device in my mouth that was just on the floor, and the dentist went and got some regular “green” flouride mouthwash, and then, a yellow-ish rinse which he said was “a powerful anticeptic”. I couldn’t taste much at this point, as my mouth was still frozen. As the freezing wore off my new, terrible mouth taste began to reveal itself. I ignored it as best I could, but after 8 days, I broke down, and began to panic. A subsequent conversation with my dentist has done little to assuage my concern, much less the persistence of the problems. His best idea is that the “powerful anticeptic”, ( I can’t recall the name), was used too quickly after the filling was set, and somehow bonded with it. He said the anticeptic he used has quite a bitter taste. Again, I couldn’t tell at the time. He wants to remove the filling and try again, with either the same material, or a different composite, but I’m quite skeptical, and frankly, at this point, scared sh**less that these conditions won’t improve and that my life has been ruined. I have to get a gold crown done on the tooth in front of this one too, and more composite must be used on that tooth prior to the crowning. Also a big concern. So, my questions are: Have you heard of these phenomena occurring with composite fillings in general, regardless of the technique used to apply them? Should water have been used during the file-down process? Was swallowing the water/resin slurry harmful? Should mouthwash and this other anticeptic been used so soon, literally a minute after the fillng was set? I’m so sorry for the wall of text, but I’m pretty desperate for help, and wanted to get all the details in.

  11. hahndds

    Dear Jeff,

    Let me jump right to answer your questions.
    First, I have not heard of such strong reactions as yours before, so I will give you my thoughts and hopefully you can get this resolved.
    When we prepare a tooth for a filling we use water 90% of the time to reduce heat. For decades dentists did not use water…mainly because the technology was not there. So, not using water to adjust a few areas is ok as you can see a lot better.
    The materials we use are not toxic to “most” people in the quantities we work with. Swallowing a little of “everything” we use in dentistry is pretty much inevitable!
    With regards to the dropped suction…it happens, but the assistant should have immediately replaced the tip and cleaned the hose…
    The antiseptic mouthwash probably was a chlorhexidine material (peridex or a generic) and it tastes pretty bad. It can leave a coating on your teeth and gums but not for 8 days. I do not believe the mouthwash could “bond” to the filling material.
    That being said, you still have a bad taste, so something is going on. Have you had fillings in the past? Are you sensitive to many materials (allergies?)? When was the wisdom tooth extracted? (that is where the taste usually comes from)
    So, lots of variables but if the tooth was extracted a long time ago then it may be best if the dentist adjusts the occlusion on the filling so you do not touch the material, and then make sure it is cured all the way and highly polished! If that does not help then a different material (gold) should be used.

    Keep smiling,

    Dr. Chris

  12. Jane

    hi i had a filling done about 6 weeks ago, there was no pain afterwards. but about a week ago it started to pain and is sensitive towards hot and cold. It also hurts ALOT when i floss. Is this normal or is there something wrong?

  13. hahndds

    Dear Jane,

    I would suggest you see your dentist as it is not normal to have pain after 6 weeks, especially after there was no pain initially.

    Keep smiling,
    Dr. Chris

  14. Jill

    I went to my dentist about 2 weeks ago to have an extraction of the back upper molar on the right side. My dentist knows that I have absolutely no money right now for a root canal. She looked at 3 other teeth and said they were close to needing root canals. She went ahead and filled the hole in one, and then cleaned out the other 2 on my left side and did core buildups. The 2 teeth she worked on that were not at all painful, are now in extreme pain. I’m afraid to go back and be told that I need the root canals. At first hydrocodone was helping, but now it won’t even touch the pain. Any advice would be greatly appreciated!

  15. hahndds

    Dear Jill,

    It is always sad to hear these stories…While I can’t really comment on the dentistry I can tell you that pain killers are not the answer to dental problems. If you have severe pain you need to go back as soon as you can as it only gets worse in dentistry. Maybe the bite on the filling is high…I cannot speak for how the filling was placed, how deep it was, or if there was some other sort of problem, but, I can recommend you see your dentist asap…

    Keep Smiling,

    Dr. Chris

  16. ANNA

    I had 3 teeth filled a month ago. One the first visit and (2) the second visit. My mouth was still hurting when i went back and had the other 2 done the dentist said it was the cavity in the tooth that was about to be filled. After having all this done my mouth hurts severely sometimes and when i drink something cold it hurts awful. They have adjusted the bite 3 times and it still did not work. They sent me to a dentist that checked (2) of the teeth and they told me those did not need a root canal im starting to think its the first one they done that needs the root canal.

  17. hahndds

    Dear Anna,

    If the bite is adjusted correctly then there are a few other issues that could be the problem…none easy to resolve unless you redo one of the fillings. I am assuming you had white fillings placed…so, they are very technique sensitive…your mouth should not hurt after placing fillings – at least not for more than a day or two. So, the problem may be the filling technique, which means you may want to seek out a second opinion and have a cosmetic dentist redo one of the 3 fillings to see if it helps.

    Keep smiling,

    Dr. Chris

  18. Vanessa

    I just had my silver fillings removed after years of having them in, and it was the worst decision of my life. I wish I would’ve done some research first or read the thousands of post I see now about having this work done and the nightmare afterwards. I feel the hot and cold, the pain with certain crunchy foods. I am so sick of it! I also now wake up with tight jaws. I used to go to the dentist every six months now I am a regular patient. My dentist keeps filing them down stating it maybe to high. However, thats not working. All I wanted was a beautiful smile not this.

  19. hahndds

    Dear Vanessa,
    Is is sad to read stories like yours…but remember this, people don’t usually write about their “success” stories online, only their pitfalls. For every unhappy patient there are many more satisfied ones that simply don’t post on the internet.
    That being said, replacing old fillings, regardless of what material they are made out of, has to be done correctly. There are so many variables that most good dentists are aware of (such as the maximum size of composite, shrinkage, different bonding options, function, the bite, etc.) that can cause the issues you speak of.
    I would suggest you get a second opinion from a dentist that is associated with high quality. How do you find a dentist like this? This is the hard part…the easiest way probably is to go to the AACD website and find a accredited or fellow dentist.

    Keep smiling,
    Dr. Chris

  20. Alex

    I just had a filing today and they got something on my lip. There was a tingly feeling but then it went away. I’m now home but I noticed that there’s a white blob on my lip. it’s a little hard so I’m guessing it’s from the filling. My question is how do I get rid of it?!

  21. Maximus Xavier

    I had 3 teeth filled. In about 6 months ago now 1 of those teeth hurts kind of a little throbing is it normal.

  22. hahndds

    Dear Alex,

    Most likely one of the chemicals we use, or possible the curing light that emits heat, caused the white spot. It should go away after a few days. If it still is present in a week I would see the dentist.

    Hope this helps,
    Dr. Chris

  23. hahndds

    Dear Maximus,

    No, throbbing is never good with teeth…I would see the dentist and have them take an x-ray to evaluate the root.

    Cheers,

    Dr. Chris

  24. Monique's

    I went to the dentist last Thursday and I switched from a silver filling to a white filling and I was sore only for two days after then I started getting really bad pain to the point where I can hardly sleep at night? Is this normal what would ou recommend? And are there natural remedies to help with this horrible pain since I’m nursing ?? 🙁

  25. Sree

    Hello Dr Chris,
    Two weeks ago I had my old filling of 3 years replaced with a white composite filling on my left bottom molar after I started getting a tooth ache. My dentist mentioned that it was a deep filling and it may be a candidate for root canal in the future.
    I had a tight feeling in that tooth and when it did not feel normal I went back to the dentist and said it was a bit high and she fixed it. Just after a day I developed severe pain on my left side as soon as I chewed 2 or 3 bites so I went yesterday and got another high spot fixed and after all the bite tests I felt better. She advised me to continue the pain killer for 2 days and not to chew on that side. Now I have teeth ache even with the pain killer if I accidentally have some food on that side.
    How long should I wait before I go back to her again?

    Thanks

  26. ann

    Had a composite filling on upper left 8 in 2006. Get intermittent pain/thobbing. Went to dentist recently, did cold test, very sensitive, suggested replsce filling, went back 3 wks later saw another dentist who said it wss my bite causing stress. No decay or fractures so why was it so sensitive to cold test???

  27. hahndds

    Hello Ann,

    There are several things that could be happening. First, let me explain how the “function” of the mouth works. Over time we wear our teeth down. Bruxism/grinding speeds this process up. Most of the time our teeth don’t wear down evenly and eventually some teeth are hitting more than others. Think of it like a car… tires wear down but often one wear more than another, depending on how you drive. If you don’t rotate the wheels then that tire will fail first.
    Teeth are very similar. Your dentist said it was your “bite”, which is probably a big component. Hitting one tooth just a little heavy or in the wrong way will kill that tooth. Also, hitting that tooth heavy can crack it. Either way you will start getting sensitivity to either hot/cold, sweets or chewing.

    This is what you do to find out:
    1. Take a x-ray
    2. Do a bit evaluation (function analysis)
    3. Check with loupes for cracks and looks for wear facets

    Once you know WHY the tooth is hurting (decay, crack, hitting heavy and bruised, filling leaking, or root dying) then you can fix it! Don’t let a dentist fix something they can’t explain…

    I hope this helps,

    Dr. Chris

  28. hahndds

    Dear Sree,

    This is a common problem…the bite needs to be perfect, especially when the filling is deep! Anyhow, you need to go back now as the tooth probably will need a root canal filling and a crown, from what I can make out right now. Aching most of the time is a sign of a dying root.

    Now, I would only take ibuprofin, not pain killers. The anti-inflammatory aspect of ibuprofin (advil or motrin) is what you need until the dentist can help you.

    Keep smiling,
    Dr. Chris

  29. hahndds

    Dear Monique,

    Your problem sound like a fracture, a very poor bond or a very deep filling. All require that you have the tooth looked at and x-rayed! You want to avoid a root canal, so don’t delay. To diagnose the problem or cause more efficiently I would need more info 🙂

    I hope this helps,

    Dr. Chris

  30. Kayla

    I had 4 filling done in October 2013 on my upper molars on both sides. Before these filings I had no pain. I knew I had cavaties because I could feel it being sticky. I floss and brush twice a day at the minimum. All of my teeth were very sore and sensitive at first. Only my right side has healed. I naturally chew on my left and I cannot do that anymore in fear of pain from the sensitivity. I can no longer drink cold beverages, especially water without a painful shooting pain on my left side where the fillings were done. I am unsure if it is one or both of the teeth. I have tried to be patient and I go to see the dentist next month for my routine cleaning, but is this normal? I am starting to get migraines only on the left side and my ear has been throbbing. (I do not have an ear infection) please help.

  31. Deb

    I have now had 3 white fillings in the same tooth over a period of 4 months. Each have appeared ok initially, then after a few weeks itching, throbbing and then acute, constant pain sets in. I can now feel it happening to this third filling. If I have to go back again, should I request no white filling but a return to the silver mercury type? I am very healthy, apart from a thyroid problem which is under control, and am only allergic to penicillin. Could I be allergic to white fillings?

  32. hahndds

    Dear Kayla,

    In short, it is not normal to have pain for that long after having a filling placed. The first step always is to return to your dentists so they can take a look. Waiting in dentistry only makes problems worse…If he/she cannot fix the problem, write again and we can see what is going on.

    Keep smiling,
    Dr. Chris

  33. hahndds

    Dear Deb,

    This is the first time I heard that someone has this type of reaction from a white filling…it could be an allergy. There are several options out there for you that might help.
    First, if you are allergic to something in that filling then it could be the composite or the bonding agent. You could have the dentist place a white glass ionomor filling without the need of adhesive and see if that works. Secondly, you could also have a gold filling placed which to this day is the best and longest lasting restoration available. I would stay away from silver mercury fillings at all cost.

    Keep smiling,

    Dr. Chris

  34. Sree

    Thanks Dr Chris,
    Appreciate your response !! Its almost 3 weeks since I wrote to you. Right now I dontt have any sensitivity to hot or cold or any pain on that teeth, The only problem I have is that I cannot chew/bite hard food on that side. The teeth hurts whes I bite and its severe when I bite some hardfood like nuts :(.
    when ever I press on that teeth I can feel the pain . I visited the dentist again and she sees no problem with the bite test.
    Can this happen because of the inflammation or Does this indicate any other symptoms?
    Just to let you know that I have a silver filling on my top molar and wonder if that hitting a composite filling on the bottom molar can cause this pain?

    Please advice
    Thanks and regards,
    Sree

  35. hahndds

    Hello Sree,

    If you have pain upon biting or releasing the the bite then it could be a fracture in the tooth…Usually with a fracture you would have pain when the bite is released…If it also hurts when you bite down then more variables come into play. Noting that your dentist said the bite is fine I will lean towards fracture…the only way to treat this is to have a full cuspal coverage restoration, like a crown. Tough position to be in because you don’t want to wait till the tooth dies or it cracks in half as then you will loose it, but doing a crown is expensive and no guarantee. If it was my tooth I would need to have great confidence in my dentist and his/her diagnosis…that being said, I would prefer to crown the tooth and save it vs needing a root canal treatment that would ultimately fail anyhow due to the fracture.
    Let me know what you decide!
    Keep smiling,
    Dr. Chris

  36. Lee

    Hi,
    I had a silver filling replaced with a white one 10 days ago (#30) and have had intermittent throbbing pain ever since, and have been taking Advil.
    . My dentist took xrays, and said I would need a root canal and a crown. With the percussion test, I felt slight pain, and the xray showed my roots were calcified. He said this was due to heavy grinding. I do wear a mouth guard nightly. I have sensitive teeth anyway and don’t want to get a root canal etc. if it is not necessary. Do I wait a few more days to see if the pain gets better and is just sensitivity or schedule the root canal? Also he mentioned a certain type of crown that is better for grinders. What do you think? Thank you!!

  37. hahndds

    Dear Lee,

    Good info about the pain…It sounds like it might be a crack, but hard to tell. Either way you will need a crown. I would get the crown down asap (by a good dentist) so that you minimize the possibility of a fatal fracture. Then, I would keep the crown in a temporary phase until the need for a root canal has been ruled out.
    Your dentist is probably referring to a zirconium crown. They are hard to break but require meticulous adjusting or you will damage your teeth! A gold crown still is the best, by far.

    Keep smiling,

    Dr. Chris

  38. Hannah

    I had a white composite filling on Saturday and when I bite really hard I get pain in my tooth – any ideas?

  39. ana

    hello
    i hada white filling done like almost a.month ago n i still have pain n before i didnt my back teeth felt good n now i.can even chew i told my dentist n he said i would need a root canal which i dont want becus my teeth never hearded until they did the filling what should i.do

  40. jayanti

    If the doctor has used the filling which has been expired any problem?

  41. Jeff

    Thank you for your response Dr. Chris. I honestly am in awe of the time you take to help people out with your expertise. I just paid $152 for a quick, fairly unsatisfying consultation. I am posting from a Playstation Vita, not an ideal device, so I will only say thank you again, and say that I have not fully recovered, months later, and am still concerned about the amount of “filling water” I swallowed. It was not an insignificant amount, it was essentially a mouthful of water that was accumulating the material of a large composite filling that was being filed. Just putting that out there again for the sake of absolute clarity. I am certain that proper procedure was not followed ( no assistant, no suction, no dental dam during this event), and although the bitter taste is almost totally gone, my mouth still does not feel right, especially my tongue. Still dryer and pastier than normal, with greater than usual white coating on my tongue. After my intial post, things got worse before they got better. For 2 months, I suffered from a host of symptoms related to dryness. For weeks, I could not produce tears, or saliva properly. I feel in poorer physical health in general, but do feel a better now wih most of the symptoms. I am just worried about the amount of material I swallowed. I fear I may never fully recover. Sorry for another text wall. Cannot edit posts with the Playstation Vita, so I may have repeated myself.

  42. Rose

    Hi Dr. Chris!

    Not sure if you are still reading this forum but worth a try. I had a small cavity on one of my tooth, no pain and decided to be proactiv and go to the dentist. My dentist did a white filling and after that my tooth has never been the same. I have cold and hot sensitivity and sometimes when I bite down on food I get a jolt of sharp pain. I went back to the dentist and he told me that the cavity was too small for him to have hit the nerve and that this is common with white fillings and I should give it a year. It’s been almost year and I’m still in the same boat. I went to a new dentist recently and got x rays done. My new dentist said he same thing- nothing is wrong with the tooth and that the filling is too small for it to hit the nerve. What can be happening? I’m frustrated and it’s not easy living pain.

    Thanks for reading.

  43. hahndds

    Dear Ross,

    I check the forum almost daily 🙂

    It is pretty disappointing to have those two dentists ignore your pain…a failure on our profession.
    If you had a silver mercury fillin replaced then my main concern would be that there is a fracture. These old amalgams fracture teeth all the time. So, you should have the white fillin removed, the tooth checked for fractures, and then the appropriate filling or onlay placed.
    If there is a fracture then a fillin is useless and you need a restoration like an onlay or a crown to hold the tooth together.

    Keep smiling,
    Dr. Chris

  44. Patrick

    Dear Dr. Chris,

    A week ago I went to my hygienist for a cleaning and mentioned that I had a bad taste between two specific teeth when flossing every night. I asked if there was a food trap in the gap between those teeth. She poked around and felt a cavity. We took an xray which revealed a smooth surface cavity in my #12 bicuspid, near the gumline, where it faces the #13 tooth. The dentist took a look and commented that it looked pretty deep on the xray, and may have infected the pulp. The dentist drilled the tooth later that same day. He said he cleaned out the decay he could see, but that it was very close to the pulp and he worried it had been exposed (although there was no bleeding), explaining it’s often a microscopic issue. He applied an antiseptic and then placed a hybrid composite filling (giomer resin with glass ionomer components as filler). He gave it a 50/50 chance that the tooth would need coot canal therapy sooner or later. Over the past 4 days, I have had a dull pain in the tooth which comes and goes, and some sensitivity to cold. The pain has been causing me to have a constant dull headache. I’m not sure what to make of this pain. I guess it could be from the trauma of drilling so far down in the tooth, or it could be that the pulp has been infected. It’s strange because the tooth did not ache even slightly before the filling was placed. Does the pain have to be pretty severe to indicate the pulp is infected? Also, I’ve read that Giomers, which are composite/glass ionomer hybrids, leach fluoride, aluminum, and other metals. My mom had a glass ionomer placed a few years ago and had a severe reaction. She became very sick and had to have it removed in order to feel better. She believes this was due to the fluoride, aluminum, and other ions leached from the glass ionomer cement. It appears that Giomers leach much less fluoride than the cement versions of glass ionomers, but I wonder if I have some of the same hyper-sensitivity to these materials that my mom experienced, and whether that could account for this constant headache. Thanks for any insights you might have!

    -Patrick

  45. hahndds

    Dear Patrick,

    It looks like your dentist did fine, but here are some points to consider…
    First, if it was really deep we often place a pulp cap (calcium hydroxide) to improve the chances of the tooth needing a root canal treatment.
    Glass ionomer fillings (such as Fuji IX) have been highly successful when used correctly. Clinical studies show that the pulp heals just fine after being exposed to glass ionomer.
    It is possible to have a reaction to almost anything, including glass ionomer and its ingredients. Since your mother had a reaction this is worth looking at.
    Lastly, the sensation you have (dull ache, throbbing) is usually an indication that the tooth is dying. I would return to your dentist and have him/her evaluate how it is doing.
    I hope this helps,

    Dr. Chris

  46. Jassmyn

    I went to the dentist today to get two white fillings. Well first off they didn’t numb me correctly and I could still feel a sharp pain in my tooth. Second they only took 30 mins to do my fillings . I don’t know how long it should take but 30 mins just seems a little fast. Now my teeth are hurting and I can’t close my mouth all the way cause the fillings are not molded with my teeth it’s more like a big bulk of filling just sitting on my teeth. My friend has the same dentist as I do and she had the exact same problem. It took 5 months for her fillings to mold to her teeth. Now her filling is coming out and she is in pain . Any suggestions on what I should do? I would greatly appreciate it .

  47. K

    Dear Dr. Chris,

    Thought I would write a comment and ask a question, since you’re so kindly active with responses 🙂

    Until January of this year I had been seeing the same dentist my whole life. I had a few small fillings about 2-3 years ago, but was told that otherwise everything was fine. I did have a sweet tooth and was open about it, but he said that I brushed well etc so although I could stand to cut down everything looked okay. Then came January, when I went for the yearly checkup. My usual dentist was not there, so I saw a new one for the first time. He took one look, an xray to be sure, and basically said “I have no idea what the heck the other dentist was doing telling you everything is fine, because it isn’t, and you need some fillings as soon as possible”. This was pretty upsetting-as I was told everything was fine and I was doing things right, I never had the opportunity to prevent this. Ever since I have changed diet, bought fluoride toothpaste/mouthwash, brush before food and rinse after to help with acids, now drink green tea instead of black as it doesn’t need sweetening for my tastes, and so on. Not that I didn’t brush twice a day etc beforehand, but obviously it wasn’t good enough, and I didn’t know.

    There were no appointments available though for months, and as I spend half my time in another country, I decided to get treatment there rather than fly back as it worked out cheaper. The dental practice I went to is owned by a family member of my partner, and has a good reputation, so no issues there that you may expect with treatment abroad. The dentist speaks relatively good English but my partner is fluent in both languages so can translate more technical issues.

    The dentist I have there also echoed the sentiments of the second dentist, saying that things were not fine and that I needed treatment-not even taking an xray to see this. So far, I have had three fillings, deep ones, with apparently three little ones left to go. For two of the teeth, she mostly replaced the old silver coloured with the white tooth coloured kind (sorry if my explanation is poor, I didn’t ask too much about the details yet, felt it wouldn’t help my nerves/fear) and for the third just used the tooth coloured kind. She said the original filling was coming away a bit, and could be expected of older fillings-though as I wrote above, the fillings were only a few years old at most. Because of this there was additional damage to the cavities and she feared it would need orthodontic (?) treatment, but it seemed to be fine.

    Two of the fillings are fine, feel great, all is well. The first one she did, which I don’t believe she commented about fearing it needing treatment but which did have an older filling, this one still has a small problem. It is not sensitive to cold or heat, but it is sensitive to pressure when eating/chewing. It isn’t the whole tooth, and the pain doesn’t really linger. As far as I can tell, it is in the center of the tooth on top, if it matters. On the second visit I mentioned this and she added varnish (?) to the tooth, though I am not sure if that was related. I mentioned it again at my visit yesterday, and she did something to it which decreased the area of sensitivity (though when she applied the drill to it, that was hellish) but it does still have a sort of… sharp? throbbing? pain. Reading around, some sensitivity is normal for 2-3 weeks after a filling but I’m unsure if this is the kind of thing it applies to. What advice would you give? My next appointment is Friday.

    Apologies if my explanations were poor, I didn’t want anything more than the bare details until everything was over-as I got older I seem to have become frightened of the dentist for some reason (maybe the pain? The injections of anesthetic didn’t work easily any of my visits so far) and not knowing what to fear seems to help a bit.

    Thank you for reading 🙂

  48. K

    *sorry, to clarify this sentence:

    “but it does still have a sort of… sharp? throbbing? pain.”

    I don’t mean that it feels this way all the time, again only when applying pressure (chewing), and only in one part of the tooth from the top.

  49. hahndds

    Dear Jassmyn,

    Sounds like you need to find a new dentist 🙂

    A quality white filling does not take long to place, it just needs to be done correctly. Right now your filling is a bit too big and needs to be adjusted as soon as possible! Not adjusting the tooth/bite can kill the tooth and cause major issues.

    1. Get your white filling adjusted
    2. Find a new dentist

    Cheers,

    Dr. Chris

  50. hahndds

    Thank you for taking the time to write all that! Sounds like you really care about your teeth. First, it is important to note that there are many type of dentists out there…some like to “watch and see”, some are more proactive. I prefer proactive!

    With your desire to do everything right you will do just fine with your teeth 🙂

    So, to your teeth. Old silver mercury amalgam fillings crack teeth, ALL THE TIME. They are awful and should be illegal. That is my opinion 🙂 So, when you need to replace them often there are fractures in the tooth that can result in problem…For the tooth that still hurts the first thing to do is make sure the bite is perfect, meaning the white filling is adapted correctly into the tooth. If that does not solve the problem then the dentist needs to look at a possible fracture in the tooth. If that is the most likely diagnosis then only a restoration that hold the tooth together will work, such as a crown. Try to avoid waiting till the dentist recommends a root canal treatment as that is not a great solution…the fracture will still be there, now probably down the side of the root and possible result in the tooth being lost.

    I wish you well,

    Dr. Chris

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