Why does a tooth under a temporary filling hurt when pressed and what to do?

Modern dentistry is a fairly advanced and effective branch of medicine today. However, even the most reliable system sometimes malfunctions. For example, after a filling is placed, a person's tooth may begin to hurt. This may happen the next day after the filling or appear several years after the restoration. Everything depends on the specific situation. However, this problem exists and needs to be sorted out.

Why does a filling hurt: main reasons

To date, there is no clear classification of pain syndrome associated with filling. Therefore, it would be reasonable to consider the 15 main reasons that most often provoke pain after dental intervention.

The first reason is tooth hypersensitivity after professional hygiene. The fact is that teeth are always cleaned before treatment. Ideally, professional hygiene should be aimed at the entire oral cavity. However, due to the fact that this procedure entails additional financial costs for the patient, many dentists clean only the causative tooth. It is worth noting that careful implementation of this procedure in some patients causes hypersensitivity of dental tissue. That is, sour and cold foods provoke toothache and, thus, cause great discomfort when eating. A person, remembering that this tooth was recently treated, thinks that the reason is poor treatment and improper filling. However, this is not so, the dentist could have done his job at the highest level. And his only mistake could be that he did not tell the patient about this side effect and the methods for eliminating it.

The second reason is the effect of photopolymerizers on the pulp tissue (nerve, vascular-nerve bundle). Many people who have visited a dentist have heard the terms "photopolymer filling", "photopolymer" and "photocomposite". This is a material that contains a polymer matrix, filler and binder. The binding of all these components into a single system (hardening of the filling) occurs by absorbing photons directed from a light source, which everyone has also seen at a doctor's appointment. It looks like an ordinary lamp emitting blue light. But, in addition to cyan light, the lamp is also a source of ultraviolet and infrared radiation, which emits heat. And this heat flow has an adverse effect on the vascular-nerve bundle. In short, blood stagnation, cell edema and vasodilation occur in the pulp. Together, these processes can lead to post-filling pain.

There is no need to be afraid of this, as it is a completely common phenomenon, and in most cases it goes away on its own. The only exceptions are those situations when patients without indications begin to use various drugs, incorrect concentrations of solutions and alternative methods of medicine to relieve toothache.

The third reason is post-filling pain due to overdrying of dentin. The fact is that when preparing a tooth for filling, it must be thoroughly dried. However, thoroughly does not mean “maximum” and “as much as possible”. Drying must be done in such a way that there is no liquid on the surface of the dentin, and an optimal level of moisture remains deep inside. If there is none, the pulp cells will intensively secrete liquid to compensate for its deficiency. This causes post-filling hypersensitivity, which manifests itself as pain in the tooth when eating cold, hot, sour, spicy food after installing a new filling. When the pulp function is normalized (in 1-2 weeks), the pain completely goes away.

The fourth reason is pain under the filling due to failure to follow the dentin etching technique. Etching is one of the stages of preparing a tooth for filling. Since dentin has a tubular structure, when prepared with burs, the dentin tubules become clogged with sawdust and other foreign substances. In order to free these canals, etching gels based on orthophosphoric acid are applied to the tooth. It is important to strictly adhere to the duration of this process, since excessive exposure to the gel contributes to deeper etching. As a result, the photocomposite or cement penetrates too deeply into the dentin tubules during filling, irritating the pulp tissue. As a rule, this effect is not so toxic and powerful as to cause pulpitis. Most often, it manifests itself as mild, constant pain and passes within 1-2 weeks.

The sixth reason is increased load on the filled tooth. This may occur due to overestimation of the filling level or for other reasons. Often, with pathological forms of bite, disorders of the masticatory muscles, diseases of the temporomandibular joint, filling becomes a rather complex manipulation. The fact is that with the listed pathologies, a person can close his teeth in different positions. And all the occlusion (closure) options can be simultaneously convenient for the patient or inconvenient. Therefore, the doctor can make an ideal restoration of the tooth in the optimal occlusion of the teeth, but the patient will close his teeth in a different position. And this can cause overload of the treated tooth. As a result, a pain syndrome will be provoked, which can lead to the development of pulpitis or periodontitis.

The seventh reason is micro-gaps between the filling material and the walls of the tooth cavity. If the treatment is of poor quality, micro-spaces may remain between the filling and its bed. Thus, if cold, sour, sweet liquid gets into these gaps, short-term pain may occur. Also, such gaps can form due to the development of secondary caries under a new or old filling. There are situations when a child undergoes fissure sealing and the sealant is applied to a carious tooth. Such inattention leads to the fact that a carious process develops under the material, which is not visually determined during an external examination. After micro-gaps appear between the sealant and the tooth tissues, the child will begin to complain of toothache.

The eighth reason is poor quality filling in the cervical area. The mucous membrane of the gum is very tender and pliable. It does not tolerate the effects of aggressive mechanical and chemical factors. When the treatment ends with restoration in the cervical area, it is very important to use the highest quality material and carefully polish the filling. If the filling is made of stitched or low-quality material, there is a risk of negative impact of unhardened particles on the gum tissue. And if you do not polish the restoration, it will remain rough and fine-grained. Such relief will inevitably lead to damage to the gum. It is also worth noting the poor quality restoration of contact points (contacts between adjacent teeth). If you perform this manipulation without taking into account the location of the gingival papillae (triangular shaped gingival protrusions between the teeth), the filling will put pressure on the papillary (papillary) part of the gum. This will inevitably lead to papillitis and may provoke localized periodontitis.

The ninth reason is arsenic under a temporary filling during pulpitis treatment. One of the methods of devitalization is the use of arsenic paste. The method involves preparing the tooth, leaving a small amount of arsenic in it and covering it with a temporary filling. After a certain time, this leads to toxic necrosis of the pulp. Since arsenic is essentially a poison, the pulp at the beginning of devitalization tries to activate all mechanisms of protection against its effects, and at the final stages it is subject to decay. All these processes are accompanied by toothache.

The tenth reason is the exacerbation of chronic periodontitis at the stages of its treatment. If a person has contacted a clinic and one of the chronic forms of periodontitis has been detected, then he will undergo instrumental and medicinal treatment of the root canals. After the canals are cleaned, medications will be left in them to eliminate the inflammatory process. After this, the tooth will be closed with a temporary filling until the next visit. It is possible that in the period between visits the tooth will begin to bother, there will be a feeling as if the temporary filling hurts when biting on the tooth. This phenomenon is quite typical, although quite unpleasant. In any case, it is necessary to continue the course of treatment, after which not only the pain will disappear, but also the inflammatory process in the periodontium.

The eleventh reason is the treatment of deep caries without an insulating lining. Since the composite material has a toxic effect on the pulp, it is necessary to separate the photopolymer filling from the nerve. For this, glass ionomer cement is most often used, which has optimal insulating properties. If the doctor neglects the rules for treating deep caries, pulpitis and its complications may develop.

The twelfth reason is pulp overheating. If the dentist worked without cooling or prepared the tooth without breaks, then the vascular-nerve bundle will be exposed to high temperatures. The unfavorable thermal effect of the photopolymer lamp has already been discussed. However, the temperature to which the pulp heats up when the metal instrument rubs against the hard tissues of the tooth is significantly higher than the temperature when the photopolymer lamp is in operation. Therefore, in this case, we can talk not only about pain under the filling, but also about the development of pulpitis.

The twelfth reason is residual pulpitis. In order to clearly demonstrate the meaning of this concept, we can imagine the following situation. A patient with pulpitis came to the doctor, they gave him anesthesia, removed the nerve, filled the canals, put in a filling, and the next day the tooth hurts. This is residual inflammation of the pulp. This could happen for various reasons. In some situations, the doctor might not have completely removed the nerve (insufficient experience, strongly curved canals, lateral branches of the canal, etc.). In this case, part of the inflamed pulp remains in the tooth. Since manipulations are often carried out under local anesthesia, the patient does not feel pain during the dental appointment. But when he comes home, the effect of the anesthetic begins to subside, and the person realizes that he has been filled, and the nerve hurts. Often, children with unformed roots undergo vital amputation of the pulp. In this case, part of the nerve is removed, and part remains in the tooth. It is worth saying that this form of treatment, although gentle, is also quite unpredictable. After all, at any moment the remaining part of the vascular-nerve bundle can become inflamed. It depends to a greater extent on the immunological properties of the body and the qualifications of the doctor.

The thirteenth reason is residual periodontitis. The essence of this problem is not much different from residual pulpitis. As a result of the course of treatment for periodontitis, the patient's canals are cleaned, anti-inflammatory therapy is carried out, and the tooth is restored. After some time, the filling begins to bother, constant pain occurs, which intensifies when biting and chewing. In this case, we are talking about incomplete treatment of the disease. Pathogenic flora could remain in the inflammation site, which, with a decrease in the reactive properties of the body, could cause inflammation.

The fourteenth reason is the toxic effect of the filling material on the periodontal ligament. Today, dentists try to work in root canals as accurately as possible. To do this, they use X-ray diagnostics, various apex locators (sensors for determining the length of the root canal), endodontic microscopes, etc. However, not all dental institutions have such equipment. And if we add the lack of additional visualization tools to the dentist's insufficient experience, a situation may arise in which the filling material ends up outside the apical opening of the root canal. That is, the material will be brought out into the periodontal gap, thereby having a toxic effect on the ligamentous apparatus of the tooth. Thus, with high-quality restoration, but irrational filling of the root canals, the tooth may begin to bother. And although there is a new filling in it, the unwanted localization of the filling material causes unpleasant sensations.

The fifteenth reason is pain in a nearby tooth. It may seem that this theory sounds quite absurd and unrealistic. However, very often patients come to the dentist complaining of acute, unbearable pain. Most of them point to a tooth that was recently treated. After diagnostics in a clinical setting, it turns out that a completely different tooth was hurting, most often the neighboring one. When the pain is quite severe, it tends to spread to other teeth. Therefore, it is almost impossible to pinpoint the exact tooth that is hurting. However, the patient remembers that he recently had a tooth treated and a filling put in. Therefore, in his opinion, this tooth has a higher chance of getting sick than the others. After such conclusions, a person begins to believe in his theory and concentrates only on the pain in a certain tooth. Moreover, many people, feeling the ineffectiveness of tooth treatment, lost money and time, go straight to the surgeon to remove the suspected tooth. They confidently point to the tooth with the filling and persistently ask the surgeon to remove it. If the surgeon has basic experience, he will refuse to perform the removal, determine the true source of the pain and refer the patient for appropriate treatment.

Risk factors

There are many factors that can contribute to the occurrence of pain after filling. Often, a predisposing factor is failure to follow the doctor's recommendations during the course of treatment. Many patients believe that dental treatment is the task of the dentist alone, because he receives financial payment for it. However, complex therapy involves both the dentist and the patient. And if one of these people does not fulfill their tasks, then achieving the expected result may become questionable. Often, patients tend to constantly change dentists. This is reasonable to some extent, because each person strives to find the most experienced and honest specialist. However, if this happens during the course of treatment for any disease, then each dentist has to re-diagnose, assess the clinical situation and create his own therapeutic algorithm.

A risk factor is any situation that provokes an imbalance in the blood supply, innervation and metabolism of the tooth. The fact is that after filling, the tooth is in a state of rehabilitation. After all, all the manipulations that were carried out during treatment are a huge stress for the dental system. Foreign chemical solutions, cutting instruments, filling cements and composites have a powerful impact on the teeth. Therefore, the body needs a certain time to adapt to new conditions. If at this moment the fragile system is disturbed, its work may be disrupted. For example, during the period of hypersensitivity after filling, the pulp is in an irritated state. And if at this time you eat too hot or cold foods, then the development of an inflammatory process in this tooth is possible. One of the main risk factors is decreased immunity, hypovitaminosis and emotional stress. These are common causes that can provoke the occurrence of inflammatory diseases. Also, genetic factors play an important role in this, which determine the threshold of pain sensitivity for each individual. The role of heredity should not be underestimated, as two people with the same lifestyle, age and body type may perceive the effects of unfavorable factors differently. And often the difference in perception is associated with hereditary features. Therefore, for some, genetics is a risk factor, and for others, a protective factor.

Symptoms

Symptoms of post-filling pain may manifest themselves to varying degrees depending on the reasons for their occurrence. If the pain is associated with post-filling hypersensitivity, then its first symptoms will be an unobtrusive, weak, aching pain in the tooth, which may intensify when eating cold and hot food. In simple terms, a person has a toothache under a filling. The intensification of symptoms when eating food of high and low temperatures is due to the fact that an additional stress agent acts on the irritated pulp. Therefore, the nerve reacts to it more acutely than in a normal state. As a rule, such pain goes away on its own in 1-2 weeks.

If the carious process has begun to progress under the filling, the complex of symptoms will differ from hypersensitivity. The pain will appear only when eating provoking foods: cold, hot, sour and sweet food. At the same time, it will feel as if something is entering the tooth. Such pain can appear both after installing a new filling and a year after restoration.

With increased load on the filling, pain will appear during eating, biting and pressing on the tooth. If the tooth is not "disturbed" and chewing pressure is not directed at it, then there will be no pain. In such a situation, it is important to provide rest to the problem tooth to prevent the development of traumatic periodontitis.

After applying the arsenic paste, the tooth is restored with temporary cement. When the arsenic starts to act, you can feel pain under the temporary filling. The degree and duration of pain may be different for each person, but most often people feel a constant aching pain in the filled tooth. As a rule, this pain goes away a few hours after applying the devitalizing drug. This is due to the fact that the devitalizing pastes contain an anesthetic that blocks pain sensitivity. However, not all people are able to stop the pain attack with an anesthetic; many people have a very low sensitivity threshold and the dose of the painkiller in this case will be too small for the given organism.

If a person has undergone caries treatment in the cervical (near-gingival) part of the tooth in a dental clinic, then an inflammatory process may develop in the gum tissue. The first signs of inflammation in the gingival area are redness of the gum, itching, burning and slight pain. If the process progresses, the pain in the gum will become more pronounced, and swelling and bleeding will be added to it.

When treating chronic forms of periodontitis, an exacerbation of the inflammatory process is possible. In this case, a strong, constant, aching pain appears, which intensifies when pressing on the tooth with a temporary filling. Also, the pain intensifies when a person eats, especially hard food. If the course of treatment is continued, these symptoms will gradually disappear in 1-2 days. In this case, the chronic process will also stop progressing. However, some patients, feeling pain in the tooth, stop trusting the therapeutic plan of their doctor. This is logical to some extent, because the medicine is left under the filling, and the tooth hurts. But it is worth noting that such a reaction of the body is observed not only in dental pathologies. At the initial stages of treatment of many sluggish diseases, some exacerbation of the inflammatory process occurs, and after the completion of therapy, chronic inflammation disappears - the disease goes into stable remission. Therefore, a positive result in treatment is possible only if a person follows all the doctor’s instructions and in no case changes the treatment plan at his own discretion.

Residual periodontitis after a permanent filling is a rather unpleasant phenomenon. This is due to the fact that the course of treatment is over, a permanent filling is installed (possibly even with a pin), and the tooth hurts. Most often, the pain is not acute, but weak and unobtrusive. It can appear and disappear at any time of the day, and intensify when chewing. A person often doubts whether to go to the dentist or not. After all, the pain is not so strong that you run to the doctor, but not so weak that you ignore it. However, it is worth saying that you should definitely tell the dentist about such problems. Even if you just have to observe the condition of the tooth for a few days, it is better to do this under the supervision of a specialist. If the pain does not go away, then the question of further treatment tactics will be decided.

The development of chronic periodontitis is accompanied by some specific processes. The pulp ceases its vital activity and turns into necrotic masses. This leads to the tooth acquiring a grayish tint externally and the filling looks more contrasting against its background (due to the fact that its color does not change). In this case, no other symptoms may be observed.

If pulpitis develops after filling, you should immediately contact the dentist who performed the treatment. This is necessary to determine the cause that provoked the development of the inflammatory process. If pulpitis developed as a result of caries under the filling, you can see gray areas of enamel and dentin in the tooth. In this case, the filling can also acquire a similar shade and, as a result, most of the tooth looks black. Symptoms of acute pulpitis are most often bright: a tooth with a filling hurts from hot, from cold, and pain can also appear spontaneously. The duration of attacks can vary from 1 minute to several hours, depending on the stage. Often the pain does not go away for a whole day. It can decrease and intensify in waves, but not disappear completely.

Some of the listed symptoms go away on their own, while others require medical intervention. However, if you experience any suspicious phenomena or sensations, consult a specialist. Asking a question is simple and quick, but treating complications of caries is a long and unpleasant process.

Diagnostics

Self-diagnosis of your diseases is quite a dangerous thing. The reason for this is not even that you do not have a special education for this. The problem is that any person who is sensitive to their health cannot objectively assess their condition. This is due to emotions, worries about the consequences of the disease and other psychological moments. Paradoxically, even a doctor who suddenly falls ill immediately becomes a patient. And he must be treated by another doctor. This is correct from the point of view of medical rationalism. Therefore, you can examine the problem tooth, note all complaints, write down data on the onset, duration, degree of pain and make some assumptions about the condition of the tooth. But, for a final diagnosis, you should go only to a dentist. He has not only a higher education, a license and experience, but also expensive diagnostic equipment, which is only available in specialized medical institutions (various tomographs, radiovisiographs, etc.). Also, the doctor has the conditions to conduct various clinical tests that will allow determining what caused the pain attack.

Treatment or what to do if a tooth under a filling hurts

It is highly recommended not to prescribe and carry out dental treatment without consulting a specialist. After all, it is almost impossible to even make a diagnosis at home. And there can be no talk of treatment. But what to do if a filling hurts? There are some methods that help cope with toothache before visiting a dentist. Let's note one thing right away - do not experiment with your health! You cannot apply garlic or lemon to the tooth, or smear it with "Golden Star" balm. Also, you should not rinse your mouth with vinegar, alcohol or other aggressive solutions. This will definitely not improve the condition. Of the folk methods, only herbal medicine is allowed. Some solutions based on medicinal herbs inhibit the work of nerve endings and thus reduce tooth sensitivity. The first recipe: dilute 5 drops of eucalyptus oil in 100 ml of water. Heat to a temperature of about 30 °, rinse 3 times a day after meals. The second recipe: prepare an infusion of chamomile, rinse 3 times a day after meals. This solution will also be effective for gum inflammation after filling. Third recipe: dilute 3 drops of tea tree oil in 100 ml of water. Use in the same way as the previous solutions. But if you are pregnant, even herbal medicine is not recommended for you without your doctor's permission.

If you suspect that you have hypersensitivity after filling, you can use desensitizers to reduce it. This is a group of drugs that reduce the sensitivity of dentin. They can be included in toothpastes, gels, rinses and other dental hygiene products. An example of a toothpaste with a desensitizer is DESENSIN gel-paste. The method of its use is almost no different from the use of other pastes. The only thing that the manufacturer strongly recommends doing is rinsing the mouth before brushing your teeth. It is also worth noting that this paste contains fluoride. If you live in a region where the amount of fluoride in the water is higher than normal, then this paste is contraindicated for you. In addition, there are pastes of other popular brands (Sensodyne, Lacalut, Blend-a-med, etc.). Listerine is available among rinses that reduce tooth sensitivity. The method of its application is quite simple – take 4 teaspoons of liquid, rinse your mouth for 30 seconds, spit out the contents. There are also special gels to reduce tooth sensitivity, for example, President sensitive plus. It should be used twice a day immediately after brushing by applying the gel to the teeth. Additional methods that will help to get rid of dental hypersensitivity faster include: using a soft toothbrush, avoiding eating too hot or too cold foods, regular oral hygiene.

Toothache caused by tooth hypersensitivity has insufficiently specific and vivid symptoms. Therefore, the observation method is most often suggested. In this case, every day the patient notes the dynamics of pain under the filling. If the unpleasant sensations become softer and weaker with each passing day, then no intervention is required. The body will stabilize its condition on its own and the tooth will continue to function normally. If the pain becomes stronger every day, then we are talking about the progression of the pathological process and immediate therapeutic intervention is required. If the symptom complex corresponds to caries, then the installed filling must be removed and the tooth must be cleaned of affected hard tissues. After this, the doctor will perform a repeat restoration. If the dentist has diagnosed pulpitis, then the treatment will be more radical. The doctor will remove all carious tissues, extract the nerve, clean the canals, fill them and perform the restoration. With periodontitis, the situation is more complicated. If the process is chronic, then the treatment can take place in several visits until the inflammatory process is completely eliminated. In the case where the material was removed beyond the root apex and against this background there is pain in the tooth, the necessary physiotherapy procedures will be prescribed, for example, fluctuation. If the pain persists for 2 weeks, then surgical treatment will be indicated.

Any disease, if not taken seriously, can cause complications. Therefore, it is necessary to immediately foresee this and not give reasons for the development of more severe pathologies. If you have normal hypersensitivity, then the probability of its complications is very insignificant. Even if you do not use desensitizers, the probability of pulpitis or periodontitis is very low. However, with the development of the carious process, things are different. Caries can be complicated by both pulp inflammation and periodontal inflammation. And this can entail tooth extraction and a long process of prosthetics. In order to avoid this, you need to clearly understand what is happening to your body. And such information can only be obtained after a thorough clinical examination.

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Prevention

There are quite a few risk factors for pain after filling. However, we can only exclude some of them, and there are certain recommendations for this. The first rule is to always follow the recommendations of your doctor. If you came to the dentist to get the expected result, then you must fulfill your obligations as a patient. It is also necessary to understand that an organism with strong immunity and stable metabolism is less susceptible to inflammatory processes. Therefore, normalizing diet and sleep patterns, giving up bad habits can help prevent inflammatory processes from developing. Also, you must always inform your doctor about your feelings and suspicious dental disorders.

Forecast

Increased sensitivity after filling is not a diagnosis, it is only a symptom. And the reason that causes these sensations can be any disease. If we take into account the usual hypersensitivity after filling, then its prognosis is quite favorable. It will disappear without a trace in a short period of time. The outcome of other diseases, the symptom of which is hypersensitivity of hard tissues, depends on human awareness and responsibility. If a person seeks specialized help in time, then the probability of complete restoration of the dental system is much higher. If he prefers to self-medicate, use grandmother's methods of healing, then the result can be the most unpredictable. The doctor who is engaged in treatment also plays a big role. If he takes patients' complaints seriously, carefully evaluates them, then even pulpitis and periodontitis do not become an obstacle to the normal functioning of the tooth.

Many diseases begin quite "quietly" and unnoticed. And it is not always easy to understand whether this is a normal reaction to a photopolymer lamp or pulpitis. But if you solve this problem in a team with a dentist, the end result will please you. Be healthy and take care of yourself!