Introduction
Tooth sensitivity following placement of a filling is fairly common. A tooth may be sensitive to pressure, air, sweet foods, or temperature. Usually, the sensitivity resolves on its own within a few weeks. During this time, avoid those things that are causing the sensitivity. Pain relievers are generally not required.
Contact your dentist if the sensitivity does not subside within 2 to 4 weeks or if your tooth is extremely sensitive. He or she may recommend you use a desensitizing toothpaste, may apply a desensitizing agent to the tooth, or possibly suggest a root canal procedure.
Pain Around Fillings
There are several explanations for pain around fillings, each resulting from a different cause.
- Pain when you bite. With this type of pain, the pain occurs when you bite down. The pain is noticed soon after the anesthesia wears off and continues over time. In this case, the filling is interfering with your bite. You will need to return to your dentist and have the filling reshaped.
- Pain when your teeth touch. This pain is a very sharp pain that occurs only when your teeth touch. The pain is likely caused by the touching of two different metal surfaces (for example, the silver amalgam in a newly filled tooth and a gold crown on another tooth with which it touches). This pain should resolve on its own within a short period of time.
- “Toothache-type” pain. If the decay was very deep to the pulp of the tooth, this “toothache” response may indicate this tissue is no longer healthy. If this is the case, “root canal” treatment will be required.
- Referred pain. With this type of pain, you experience pain or sensitivity in other teeth besides the one that received the filling. With this particular pain, there is likely nothing wrong with your teeth. The filled tooth is simply passing along “pain signals” it’s receiving to other teeth. This pain should decrease on its own over 1 to 2 weeks.
Allergic Reactions to Amalgam (Silver) Fillings
Allergic reactions to silver fillings are rare. Fewer than 100 cases have ever been reported, according to the ADA. In these rare circumstances, mercury or one of the metals used in an amalgam restoration is thought to trigger the allergic response. Symptoms of amalgam allergy are similar to those experienced in a typical skin allergy and include skin rashes and itching. Patients who suffer amalgam allergies typically have a medical or family history of allergies to metals. Once an allergy is confirmed, another restorative material can be used.
Deteriorating Fillings
Constant pressure from chewing, grinding or clenching can cause dental fillings to wear away, chip or crack. Although you may not be able to tell that your filling is wearing down, your dentist can identify weaknesses in your restorations during a regular check-up.
If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscessed tooth.
If the filling is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.
New fillings that fall out are probably the result of improper cavity preparation, contamination of the preparation prior to placement of the restoration or a fracture of the restoration from bite or chewing trauma. Older restorations will generally be lost due to decay or fracturing of the remaining tooth.
Reviewed by the doctors at The Cleveland Clinic Department of Dentistry.
Edited by Charlotte E. Grayson, MD, February 1, 2003.
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