Why does the tooth ache under a temporary seal when pressing and what should I do?

Modern dentistry is today a rather advanced and effective branch of medicine. However, even the most reliable system sometimes fails. For example, after stamping a person may get a toothache. This may occur the next day after sealing or manifest itself a few years after the restoration. It all depends on the specific situation. However, this problem exists and it needs to be understood.   

Why the seal is sore: the main reasons

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

The first reason is the hypersensitivity of the tooth after professional hygiene. The fact that before the treatment is always done cleaning teeth. Ideally, the hygiene should be directed to the entire oral cavity. However, in view of the fact that this procedure entails additional financial costs for the patient, many dentists purge only the causative tooth. It should be noted that careful conduct of this procedure in some patients causes hypersensitivity of the dental tissues. Those. Acidic and cold foods provoke toothache and, thus, cause great discomfort when eating. A person, remembering that this tooth has recently been treated, thinks that the reason for poor-quality treatment and improper filling of the seal. However, this is not so, the dentist could perform his work at the highest level. And his only mistake could be that he did not tell the patient about this side effect and the methods of its elimination.

The second reason is the effect of photopolymers on pulp tissues (nerve, vascular bundle). Many people who visited the dentist, heard the concepts of "photopolymer seal", "photopolymer" and "photocomposite." This material, which in its composition contains a polymer matrix, filler and binder. The binding of all these components to an integral system (solidification of the seal) occurs by absorbing photons directed from the light source, which is also seen at the doctor's reception. It looks like an ordinary lamp that emits blue light. But, in addition to cyan light, the lamp is also a source of ultraviolet and infrared radiation, which generates heat. And this heat flow adversely affects the neurovascular bundle. To put it briefly, in the pulp there is stagnation of blood, swelling of the cells and vasodilation. In a complex, these processes can lead to post-pilling pain.

It is not worth to be afraid of this, since this is quite ordinary phenomenon, and in most cases it passes by itself. Exceptions are only those situations when patients without evidence begin to use various drugs, incorrect concentrations of solutions and alternative methods of medicine for relief of pain in the tooth.

The third reason is post-reflex pain due to dentine overdrying. The fact is that when preparing the tooth for sealing it must be carefully dried. However, carefully - this does not mean "maximally" and "as much as possible". Drying should be carried out in such a way that there is no liquid on the surface of the dentin, and in the interior, the optimum moisture level remains. If it does not exist, the pulp cells will intensively isolate the liquid to compensate for its deficiency. This causes post-pilling hypersensitivity, which manifests itself as a pain in the tooth with the use of cold, hot, sour, spicy food after the installation of a new seal. When there is a normalization of the pulp (after 1-2 weeks), the pain completely passes.

The fourth reason is pain under the seal as a result of non-observance of the dentine etching technique. Etching is one of the stages in preparing the tooth for sealing. Since dentin has a tubular structure, when preparing burs dentinal tubules are clogged with sawdust and other foreign substances. In order to release these channels on the tooth, etching gels based on orthophosphoric acid are applied. It is important to strictly observe the duration of this process, because excessive exposure to the gel promotes deeper etching. As a result, the photocomposite or cement penetrates too deeply into the dentinal tubules when sealed, irritating the tissues of the pulp. Typically, this exposure is not so toxic and powerful to cause pulpitis. Most often it manifests itself in the form of weak constant pain and within 1-2 weeks passes. 

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

The seventh reason is the microcracks between the filling material and the walls of the tooth cavity. In case of poor quality of treatment between the filling and its bed, microspaces can remain. Thus, if a cold, acidic, sweet liquid enters these cracks, 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 the child is sealing fissures and the sealant is applied to the carious tooth. Such inattention leads to the fact that the material undergoes the development of a carious process, which is not visually determined by external examination. After the microtracks appear between the sealant and the tooth tissues, the child begins to complain of pain in the tooth.

The eighth reason is poor-quality filling in the cervical region. Mucous gums are very tender and supple. It does not tolerate the effects of aggressive mechanical and chemical factors. When the treatment is completed with restoration in the cervical area, it is very important to use the highest quality material and thoroughly polish the seal. If the seal is made of a stitched or poor-quality material, then there is a probability of a negative effect of the non-hardened particles on the gingival tissue. And if you do not polish the restoration, it will remain rough and fine-grained. Such a relief will inevitably lead to damage to the gums. It is also worth noting the poor recovery of contact points (contacts between a number of standing teeth). If this manipulation is carried out without taking into account the location of the gingival papillae (gum triangles between the teeth), the filling will put pressure on the papillary (papillate) part of the gum. This will inevitably lead to papillitis and can provoke localized periodontitis.    

The ninth reason is arsenic under a temporary filling in the treatment of pulpitis. One of the ways to devitalize is the use of arsenic paste. The method implies that the tooth is dissected, a small amount of arsenic is left in it and covered with a temporary filling. After a certain time, this leads to toxic necrosis of the pulp. Since arsenic is inherently a poison, the pulp at the beginning of devitalization attempts to activate all the mechanisms of protection against its effects, and in the final stages it decomposes. All these processes are accompanied by a toothache.

The tenth reason is an exacerbation of chronic periodontitis at the stages of its treatment. If a person goes to the clinic and has one of the chronic forms of periodontitis, then he will be instrumental and medicamentous treatment of the root canals. After the channels are cleaned, they will be left with medications to eliminate the inflammatory process. After that, the tooth will be closed with a temporary filling until the next visit. It is possible that in the interval between visits the tooth will start to bother, it will feel like a temporary filling hurts when biting into the tooth. This phenomenon is quite typical, although quite unpleasant. In any case, you need to continue the course of treatment, after which not only pain will disappear, but also the inflammatory process in periodontics.

The eleventh reason is the treatment of deep caries without an insulating pad. Since the composite material has a toxic effect on the pulp, it is necessary to separate the photopolymer seal from the nerve. To do this, glass-ionomer cement is used most often, which has optimal insulating properties. If the doctor has neglected the rules of treatment of deep caries, then the development of pulpitis and its complications is possible.

The twelfth cause is the overheating of the pulp. If the dentist worked without cooling or prepared a tooth without breaks, then the high-temperature effect would be exerted on the vascular bundle. Earlier it was already mentioned about the unfavorable thermal effect of the photopolymer lamp. However, the temperature to which the pulp is heated when the metal tool is rubbed against hard tooth tissues is significantly higher than the temperature when the photopolymer lamp is used. Therefore, in this case, we can talk not only about the pain under the seal, but also about the development of pulpitis.

The twelfth cause is residual pulpitis. In order to clearly demonstrate the meaning of this concept, we can imagine the following situation. A patient with pulpitis turned to the doctor, he was anesthetized, the nerve was removed, the canals sealed, a seal was put, and the next day the tooth hurts. This is the residual inflammation of the pulp. It could have happened for various reasons. In some situations, the doctor could not completely remove the nerve (not enough experience, heavily curved channels, lateral branches of the channel, etc.). At the same time, a part of the inflamed pulp remains in the tooth. Since manipulation is often performed under local anesthesia, the patient does not feel pain during dental treatment. But when he comes home, the action of the anesthetic drug begins to subside, and the person realizes that they have put a seal on him, and the nerve hurts. Often children with unformed roots are subjected to a vital pulp amputation. At the same time part of the nerve is removed, and some remain in the tooth. It is worth saying that this form of treatment, though sparing, but at the same time quite unpredictable. After all, at any time, the remaining part of the neurovascular bundle can become inflamed. It depends more on the immunological properties of the body and the qualifications of the doctor.       

The thirteenth reason is residual periodontitis. The essence of this problem differs little from the residual pulpitis. As a result of the course of treatment of periodontitis, the patient is cleaned with canals, carries out anti-inflammatory therapy and restores the tooth. After a while, the seal begins to bother, there is a constant pain, which increases with nibbling and chewing. In this case, it is an incomplete treatment of the disease. In the focus of inflammation, a pathogenic flora could remain, which, with a decrease in the reactive properties of the body, could cause inflammation.

The fourteenth cause is the toxic effect of the filling material on the periodontal ligament. To date, dentists are trying to work as accurately as possible in the root canals. To do this, they use X-ray diagnostics, various apex locators (sensors for determining the length of the root canal), endodontic microscopes, etc. But, such equipment is not available in all dental institutions. And, if the lack of additional visualization tools to add insufficient experience of the dentist, there may be a situation in which the filling material will be outside the apex of the root canal. Those. The material will be removed into the periodontal gap, while having a toxic effect on the ligamentous apparatus of the tooth. Thus, with a qualitative restoration, but the irrational sealing of the root canals, the tooth may begin to disturb. And although there is a new seal in it, unwanted localization of the filling material causes unpleasant sensations.

The fifteenth reason is pain in the nearby tooth. Probably, it may seem that this theory sounds quite absurd and unrealistic. However, very often patients come to the dentist with complaints of acute, unbearable pain. At the same time, most of them point to the tooth, which was recently treated. After the diagnosis in a clinical setting, it turns out that another tooth was sick, most often the next one. When the pain is fairly strong, it has the property of spreading to the rest of the teeth. Therefore, it is practically impossible to pinpoint the patient tooth. But, the patient recalls that recently he was treated with a tooth and put a seal. Therefore, in his opinion, this tooth has more chances of getting sick than the rest. After such conclusions, a person begins to believe in his theory and concentrates only on pain in a certain tooth. Moreover, many people, feeling the ineffectiveness of tooth treatment, lost money and time, go directly to the surgeon to remove the suspected tooth. Just as confidently they show the tooth with a seal and insistently ask the surgeon to remove it. If the surgeon has a basic experience, he refuses to carry out the removal, determines the true source of pain and directs the patient to appropriate treatment.

Risk factors

A large number of factors can contribute to the onset of pain after filling. Often a predisposing factor is the non-observance of the doctor's recommendations during the treatment course. Many patients believe that dental treatment is the task of a purely dentist, for he receives financial payment for this. However, complex therapy involves the participation of both the dentist and the patient. And, if one of these people does not fulfill their tasks, the achievement of the expected result can become doubtful. Often, patients tend to constantly change dentists. This is to some extent reasonable, because each person seeks to find the most experienced and honest specialist. However, if this occurs during the course of treatment of any disease, then each dentist has to re-diagnose, assess the clinical situation and make up his therapeutic algorithm.

The risk factor is any situation that provokes an imbalance in the blood supply, innervation and metabolism of the tooth. The fact is that after the filling the tooth is in a state of rehabilitation. After all, all the manipulations that were performed during treatment are a huge stress for the dental system. Foreign chemical solutions, cutting tools, filling cements and composites impact the teeth with a powerful blow. Therefore, the body needs some time to adapt to new conditions. If at this point the fragile system is disturbed, there may be a violation of its operation. For example, during the hypersensitivity period after filling, the pulp is in an irritated state. And if at this time to use too hot or cold foods, then the development of the inflammatory process in this tooth is not ruled out. One of the main risk factors is reduced immunity, hypovitaminosis and emotional stress. These are common causes that can trigger the onset of inflammatory diseases. Also, not the least role in this is played by genetic factors that determine the threshold of pain sensitivity for each individual. The role of heredity should not be underestimated, since two people with the same way of life, age and physique can perceive the effects of unfavorable factors differently. And often the difference in perception is connected with hereditary features. Therefore, for someone, genetics is a risk factor, and for someone - a factor of protection.

Symptoms

Symptoms of post-pilling pain may be manifested to varying degrees depending on the reasons for which they arose. If the pain is associated with post-pilling hypersensitivity, then its first symptoms will be unobtrusive, weak, aching pain in the tooth, which can intensify with the use of cold and hot food. In simple terms, a person has a tooth under the seal. The increase in symptoms when eating high and low temperatures is due to the fact that an additional stress agent acts on the irritated pulp. Therefore, the nerve reacts more sharply to it than in the normal state. As a rule, such pain passes in 1-2 weeks.

If the carious process began to progress under the filling, the complex of symptoms will differ from hypersensitivity. The pain will appear only with the use of provoking products: cold, hot acidic and sweet food. This will create the feeling that something is going into the tooth. Such pain can appear both after the installation of a new seal, and a year after restoration.

With increased load on the seal, pain will appear during eating, when biting and pressing on the tooth. If the tooth does not "disturb" and does not direct the chewing pressure on it, then the pain will be absent. In such a situation, it is important to provide rest to the problem tooth to prevent the development of traumatic periodontitis.

After applying arsenic paste, the tooth is restored with temporary cement. When arsenic starts to act, you can feel the pain under a temporary seal. Each person's degree and duration of pain may be different, but, more often than not, people feel constant aching pain in a sealed tooth. As a rule, this pain passes in some hours after imposing devitalizirujushchego a preparation. This is due to the fact that the devitalizing pastes include an anesthetic, which blocks pain sensitivity. But, not all people have anesthetic pain relief, many people have a very low sensitivity threshold and the dose of anesthetic in this case will be too small for this organism.

If in a dental clinic a person underwent caries treatment in the cervical (near-lingual) part of the tooth, then the inflammatory process in the tissues of the gum may develop. The first signs of inflammation in the prisideshnoy area is redness of the gums, itching, burning and insignificant soreness. If the process progresses, the pain in the gums will become more pronounced, and swelling and bleeding will be added to it.

In the treatment of chronic forms of periodontitis, the inflammation may worsen. Thus there is a strong, constant, nojushchaja a pain which amplifies at pressing on a tooth with a time seal. Also, pain intensifies when a person eats, especially hard food. If the treatment continues, these symptoms will gradually disappear after 1-2 days. In this case, the chronic process will also cease to progress. But, some patients, feeling a pain in the tooth, do not trust the therapeutic plan of their doctor. This is somewhat logical, because the medicine is left under the seal, and the tooth hurts. But, it is worth noting that such a reaction of the body is observed not only with dental pathologies. At the initial stages of treatment of many sluggish diseases, there is a certain exacerbation of the inflammatory process, and after the completion of therapy, chronic inflammation disappears, the disease turns into persistent remission. Therefore, a positive result in treatment is possible only if the person will fulfill all the conditions of the doctor and in no case change the treatment plan at his discretion.

The residual periodontitis after the installation of a permanent seal is a rather unpleasant phenomenon. This is due to the fact that the course of treatment is over, a permanent seal 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, strengthen with chewing. A person often doubts whether to go to the dentist or not. After all, the pain is not so strong as to run to the doctor, but not so weak as to not pay attention to it. However, it is worth mentioning that it is necessary to inform the dentist of such problems. Even if a few days will just have to watch the condition of the tooth, even better it is under the supervision of a specialist. If the pain does not pass, then the question of further tactics of treatment will be decided.

The development of chronic periodontitis is accompanied by some specific processes. The pulp stops its life activity and turns into necrotic masses. This leads to the fact that the tooth externally acquires a grayish hue and on its background the seal looks more contrast (due to the fact that its color does not change). However, no other symptoms may be observed.

If after the filling the pulpitis started, then immediately it is necessary to contact the dentist who conducted the treatment. This is necessary to find out the reason that triggered the development of the inflammatory process. In case the pulpitis developed due to caries under the seal, then in the tooth you can see the gray areas of enamel and dentin. In this case, the seal can also acquire a similar shade and, as a result, most of the tooth looks black. Symptoms in acute pulpitis are often bright: the tooth with a seal hurts from hot, from cold, and pain can 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 wave out and amplify, but not completely disappear.

Some of these symptoms go away on their own, and some require the intervention of a doctor. However, in case of any suspicious phenomena and sensations, consult with a specialist. Asking a question is simple and quick, and treating caries complications is a long and unpleasant process.

Diagnostics

It is quite dangerous to independently diagnose your illnesses. 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 his health, can not objectively assess his condition. It is associated with emotions, experiences about the consequences of the disease and other psychological moments. Paradoxically, even a doctor who suddenly becomes ill immediately becomes a patient. And it 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, record data on the onset, duration, degree of pain and make some assumptions about the condition of the tooth. But, for the final diagnosis should go only to the dentist. He has not only 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 for conducting various clinical trials that will help determine what triggered the painful attack.

Treatment or what to do if the tooth is sick under the filling

To prescribe and conduct a tooth treatment without consulting a specialist is highly discouraged. After all, at home, even the diagnosis is almost impossible to put. And about treatment, even speech can not go. But what if the filling has a pain? There are some methods that help cope with toothache before going to the dentist. Just note one point - do not experiment with your health! You can not apply garlic, lemon, and smear it with balm "Golden star" to the tooth. Also, do not rinse your mouth with vinegar, alcohol and other aggressive solutions. This definitely will not lead to an improvement in the condition. From the alternative methods only the use of phytotherapy is allowed. Some solutions based on herbs inhibit the work of nerve endings and thus reduce the sensitivity of the teeth. The first recipe: 5 drops of eucalyptus oil diluted in 100 ml of water. Heat to a temperature of about 30 °, rinse 3 times daily after meals. The second recipe: cook the infusion of chamomile, rinse 3 times a day after eating. This solution will also be effective in inflammation of the gum after sealing. The third recipe: 3 drops of tea tree oil diluted in 100 ml of water. Use by analogy with previous solutions. But, if you are pregnant, then even phytotherapy you are not recommended to practice without the permission of a doctor.

If you suspect a hypersensitivity after sealing, then to reduce it you can use desensitizers. This is a group of drugs that reduce the sensitivity of dentin. They can be part of 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 hardly differs from the use of other pastes. The only thing that the manufacturer strongly recommends is to rinse your mouth before brushing your teeth. Also worth noting that this paste contains fluoride in its composition. If you live in a region where the amount of fluoride in the water is higher than normal, then such a paste is contraindicated for you. In addition, there are pastes and other popular brands (Sensodyne, Lacalut, Blend-a-med, etc.). Among the rinsers that reduce the sensitivity of teeth on sale is Listerine. The method of its application is quite simple - to collect 4 teaspoons of liquid, rinse your mouth for 30 seconds, spit out the contents. Also, there are special gels for reducing the sensitivity of teeth, for example, President sensitive plus. It should be applied twice a day immediately after cleansing by applying a gel to the teeth. Additional methods that help to get rid of dental hypersensitivity quickly include: the use of a soft toothbrush, the refusal to use too hot or too cold foods, regular oral hygiene.

The pain in the tooth, which is caused by the hypersensitivity of the tooth, lacks a specific and vivid symptomatology. Therefore, most often the method of observation is proposed. Thus every day the patient marks dynamics of pain under a seal. If discomfort with everyone becomes softer and weaker, then no intervention is required. The body will independently stabilize its condition and the tooth will continue to function normally. If the pain becomes stronger every day, then it is a question of the progression of the pathological process and immediate therapeutic intervention is required. If the symptom complex corresponds to tooth decay, the inserted seal should be removed and the tooth cleaned of the affected hard tissues. After that, the doctor will perform a second restoration. If the dentist diagnosed pulpitis, then the treatment will be more radical. The doctor will remove all the carious tissues, extract the nerve, clean the canals, seal them and perform the restoration. With periodontitis, the situation is more complicated. If the process is chronic, the treatment can occur in several visits until the inflammatory process is completely eliminated. In the case where the material was taken out beyond the apex of the root and against this background there is pain in the tooth, the necessary physiotherapy procedures, for example, fluxing, will be prescribed. If the pain persists for 2 weeks, then surgical treatment will be indicated.

Any disease with a non-serious attitude towards it can give complications. Therefore, it is necessary at once to provide for this and not to give reasons for the development of more severe pathologies. If you have a normal hypersensitivity, then the probability of its complications is very small. Even if you do not use desensitizers, the likelihood of pulpitis or periodontitis is very low. However, with the development of the carious process, the situation is different. Caries can be complicated by inflammation of the pulp, and inflammation of the periodontal disease. And this can entail the removal of the tooth and a long process of prosthetics. In order to avoid this, you need to clearly understand what is happening to your body. And you can get this information only after a thorough clinical examination.

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Prevention

Factors of the risk of pain after sealing are quite a lot. But, we can exclude only some of them, and for this there are certain recommendations. The first rule is always to follow the recommendations of your doctor. If you come 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 prone to inflammatory processes. Therefore, the normalization of diet and sleep, the rejection of bad habits can contribute to the fact that inflammatory processes will not develop. Also, you should always tell your doctor about your feelings and suspicious dental disorders. 

Forecast

Hypersensitivity after sealing is not a diagnosis, it's just a symptom. And the cause that causes these feelings, can be any disease. If you take into account the usual hypersensitivity after the filling, then its forecast is quite favorable. It will disappear without a trace in a short time. The outcome of other diseases, the symptom of which is the hypersensitivity of hard tissues, depends on human consciousness and responsibility. If a person has turned in time for specialized care, then the probability of a complete restoration of the dental system is much higher. If he preferred to engage in self-medication, using grandmother's methods of healing, the result can be the most unpredictable. Also a great role is played by the doctor who is engaged in treatment. If he takes seriously the complaints of patients, carefully evaluates them, then even pulpitis and periodontitis does not become an obstacle to the normal functioning of the tooth.

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