A dental filling restores the structure of a tooth after decay is removed, sealing it against further damage. While the procedure is typically painless due to local anesthesia, discomfort often follows once the numbing agent wears off. Feeling pain or sensitivity in the days or weeks after a filling is frequent, and understanding the source helps determine if it is normal healing or a signal of a larger problem.
Understanding Expected Post-Procedure Sensitivity
The most frequent post-filling discomfort is temporary sensitivity to external stimuli. This occurs because removing decay and placing the filling briefly irritates the nerve tissue (pulp) inside the tooth. This process causes a transient inflammation known as reversible pulpitis. The irritation makes the nerve react intensely to temperature changes, resulting in sharp, brief pain when exposed to hot or cold items. Mild discomfort may also occur when chewing as the nerve adjusts to the new restoration. This sensitivity is normal and should naturally fade within a few days to two weeks, though deeper fillings may require up to four weeks to fully settle down.
Mechanical and Internal Causes of Persistent Pain
Pain continuing beyond the normal recovery window often requires professional adjustment. One common mechanical cause is a high bite (occlusal trauma), where the filling material is slightly elevated compared to the natural tooth surface. This causes the filled tooth to receive disproportionate force when the jaw closes, leading to soreness and discomfort that persists when biting or chewing. Dentists can easily fix this by polishing the filling down to align with the natural bite.
A leaky margin is another cause of discomfort, which is a microscopic gap between the filling material and the tooth structure. If the seal is compromised, air or bacteria can seep into the tooth, reaching the sensitive underlying layer and causing persistent sensitivity or a dull ache.
In rare instances, pain might result from galvanic shock, occurring when a new metal filling is placed near an existing metal restoration, like an amalgam filling or a crown. The dissimilar metals and saliva create a small electrical current, resulting in a sharp, fleeting “zinging” sensation when they touch.
Sometimes, the pain is referred pain, meaning the sensation originates elsewhere but is perceived in the newly restored area. This happens because the trigeminal nerve system can misinterpret the origin of the pain signal. This type of pain is generally harmless and often resolves on its own within a week or two.
Recognizing Signs of Serious Complications
Persistent or worsening pain signals a serious complication involving the dental pulp that requires immediate attention. If inflammation (pulpitis) is severe or chronic, it can progress to an irreversible stage. Irreversible pulpitis is characterized by constant, throbbing pain that lingers long after a hot or cold stimulus is removed, or pain that spontaneously wakes a person from sleep. This condition indicates the nerve tissue is dying and typically necessitates a root canal procedure to save the tooth.
Sharp pain upon the release of biting pressure may indicate a cracked tooth or a fracture extending into the tooth’s structure. This structural failure compromises the integrity of the tooth and often requires a crown or other restorative treatment to prevent further damage.
A severe infection or abscess may develop if bacteria reach the pulp chamber. Signs of an abscess include:
- A persistent, bad taste in the mouth.
- Swelling in the gum or cheek tissue.
- The appearance of a small, pimple-like bump on the gum line near the tooth.
In very rare cases, the body may have an allergic reaction to components in the filling material. Symptoms are often localized to the tissue surrounding the filling, presenting as a rash, itching, or gum inflammation. Unrelenting, throbbing pain, visible swelling, or fever constitute a dental emergency.
Timeline for Recovery and When to Contact Your Dentist
Recovery from a standard filling is relatively short, with most sensitivity resolving within weeks. During this initial period, manage discomfort by avoiding foods and drinks at extreme temperatures to prevent triggering the nerve. Over-the-counter anti-inflammatory medications, such as ibuprofen, can help reduce localized swelling around the nerve tissue.
If sensitivity persists without noticeable improvement after two to four weeks, or if the pain worsens, schedule a follow-up appointment. This persistent discomfort may be due to a minor, easily corrected issue like a high filling.
However, immediate contact with the dentist is necessary if you experience severe signs of complication, including:
- Facial swelling.
- Constant throbbing pain that interferes with daily life.
- Sharp, debilitating pain when biting down.