DENTAL CHEWING PAIN AFTER A FILLING

On occasion, although the patient had no pain before getting fillings done, it will hurt to chew after the filling.  Why is that?

Sensitivity in Chewing

The first place to look is at the bite.  If that tooth is hitting first, that tooth will always hurt until the bite is adjusted.  By far this is the most common situation for sensitivity on chewing.

Pulpitis

Anytime a tooth is drilled the nerve can be affected which can cause some sensitivity.  This condition, known as reversible pulpitis, usually goes away within a few days or even a few weeks.   The occasion where the nerve does not heal but gets worse, is known as irreversible pulpitis and requires root canal therapy to remedy.  (Pulpitis means inflamed pulp – the area where the nerve and blood vessels are.)

When I take silver fillings (amalgam) out and replace them with white fillings I have noticed more sensitivity than when the white filling is done the first time.  I do not understand fully why that is.  The bonding materials that are placed under the fillings before the filling is placed can cause sensitivity all by itself.

As a rule patients are asked to give the fillings some time for the teeth to adjust to the new fillings.  A few people are impatient and some just seem more sensitive or allergic to some of the dental materials that we use. There is some risk to taking the filling out and putting a temporary filling since the nerve can once again be affected.

Sedative Filling

A sedative filling usually made from a glass ionomer cement can be the best solution.  The problem with this solution is that this will not hold up as long as a permanent filling.  When the new permanent filling replacement is finally done, the glass ionomer can be kept in the deep areas which will help keep the tooth from becoming sensitive once again.
I have personally had a filling that was sensitive for 8 months!  I couldn’t chew on it, and it was very temperature sensitive.  When it finally chilled out, it was fine and is still doing well after over 15 years.
If the patient decides not to have the filling taken care of, it is almost certain that trouble lurks on the horizon for the patient and that tooth.  Decay will spread and finally affect the nerve.  Then the patient has to choose between an extraction and a root canal.  Not a happy choice at all.