Should My Tooth Still Be Sensitive After a Filling?

My dentist replaced the silver filling with a composite one on my bottom right second molar two weeks ago. When I wake up in the morning, I do not feel pain. But I have moderate tooth pain when I chew. The tooth is also sensitive to cold food or drinks. By the end of the day, I feel spontaneous mild pain and discomfort around my jaw and some tingling and numbness that radiates to my chin. I take ibuprofen if the discomfort bothers my sleep.

The dentist who placed the filling is a new dentist for me, so I want some advice on whether it seems that I will need a new filling or if something else is going on. I hope to resolve this soon because I plan to go out of town in mid-April. Could this issue become so severe that I need an extraction and implant? – Thanks. Simeon from CA

Simeon,

Thank you for submitting your inquiry. Dr. Sirin would need to examine your tooth and x-rays for an accurate diagnosis. But we will use the information you provided to explain what might be causing your pain and sensitivity.

Sensitivity and Pain After a New Filling

See your dentist for lingering discomfort after a filling

Sensitivity and pain after a new tooth filling can have several causes. We will review the symptoms you described.

Pain After Getting a New Tooth Filling

If you have pain after getting a new tooth filling, the type of pain helps determine the cause:

• Sharp pain when chewing – If you feel a sharp pain when chewing but do not have other symptoms, the issue is likely from the bonding process for your composite filling. A dentist must replace the filling with a secure bond.
• Moderate pain when chewing – A change in your bite or trauma to the ligament that attaches your tooth to the jawbone may cause moderate pain with other symptoms. A traumatized ligament will eventually improve. But a significant shift in the bite can lead to TMJ symptoms, including jaw pain, earaches, headaches, and neck pain.
• Spontaneous pain – Inflamed tooth pulp can cause pain that increases when you lie down. If a filling is deep and bacteria get into the pulp, inflection and inflammation can result. But it does not mean your dentist is at fault. Removing decay can push bacteria into a tooth’s dentinal tubules. Spontaneous pain might indicate that you need root canal treatment.
• Jaw and tonsil pain – Neither your tooth nor the filling would cause jaw or tonsil pain. But the stress on your jaw from the procedure might be the culprit.

Sensitivity or Numbness After a New Tooth Filling

Sensitivity or numbness after a tooth filling has different causes.

• Mild sensitivity to cold – If a filling is large or deep, tooth pulp can get irritated as the dentist removes the decay. If your sensitivity does not improve or gets worse, your dentist must examine your tooth and filling.
• Jaw numbness and tingling – If your dentist hits or slightly nicks a nerve during the numbing injection, you will feel numbness or tingling. However, the irritation will gradually improve.

Although most of your symptoms should improve, you can follow up with your dentist regarding the spontaneous pain. Irritated or infected tooth pulp will need root canal treatment, which helps prevent tooth removal and an implant.

You also can consider getting a second opinion or scheduling an appointment with an endodontist (root canal specialist). It is best to follow up promptly to avoid a dental emergency while traveling.

Elgin, Illinois, dentist Dr. Steve Sirin sponsors this post.