Why Does My Tooth Still Hurt After Filling? Common Dental Issues Explained

Even after getting a dental filling, it can still hurt?

Doctor, I would like to ask about my second-to-last tooth on the lower right side.
I previously visited a dentist due to tooth pain, and they diagnosed it as a cavity, which was subsequently filled.
However, it has been almost two months, and I am still experiencing pain.
A few days ago, I was waking up in pain every night and had to get up to take painkillers, which were completely ineffective.
Yesterday, I returned to my original dentist, who took new X-rays and confirmed that the cavity had not reached the nerve.
The dentist also excavated and refilled the tooth.
I had no pain yesterday, but it started again today.
What could be the reason for this?

vivian, 20~29 year old female. Ask Date: 2016/05/29

Dr. Zeng Guanghui reply Dentistry

The above situation may indicate that the previously filled cavity is deep and close to the dental pulp, or that the tooth itself may have cracks in addition to the decay.
It is advisable to consult a dentist for further evaluation and treatment.

Reply Date: 2016/05/29

More Info

Tooth pain after a filling can be a frustrating and concerning issue, especially when it persists despite treatment. There are several potential reasons why your tooth may still be hurting after a filling, and understanding these can help you and your dentist determine the best course of action.

1. Incomplete Removal of Decay: One common reason for ongoing pain is that not all of the decay was removed during the initial treatment. If any decay remains, it can continue to irritate the tooth and surrounding tissues, leading to pain. This is particularly relevant if the cavity was deep or close to the nerve.

2. Pulpitis: After a filling, the tooth may experience inflammation of the pulp, known as pulpitis. This can occur even if the decay was completely removed. Pulpitis can be reversible or irreversible. Reversible pulpitis may cause temporary sensitivity, while irreversible pulpitis often leads to more severe pain and may require root canal treatment.

3. High Filling: Sometimes, a filling can be too high, meaning it interferes with your bite. When you bite down, the pressure can cause discomfort or pain. If your dentist has not adjusted the filling to ensure it is level with the surrounding teeth, this could be a source of your pain.

4. Cracked Tooth Syndrome: If the tooth has a crack, it may not be visible on an X-ray. Cracked tooth syndrome can cause intermittent pain, especially when chewing or when the tooth is exposed to temperature changes. This condition often requires further evaluation and possibly a crown or other treatment.

5. Gum Issues: Sometimes, pain may not originate from the tooth itself but rather from the surrounding gum tissue. If there is inflammation or infection in the gums (gingivitis or periodontitis), it can cause discomfort that feels like tooth pain. Proper oral hygiene and possibly a professional cleaning may be necessary to address this.

6. Nerve Damage: In rare cases, the dental procedure itself can irritate or damage the nerve, leading to persistent pain. This may require further intervention, such as a root canal, to alleviate the discomfort.

7. Referred Pain: Sometimes, pain in one tooth can be referred from another area in the mouth or even from the jaw. Issues with the temporomandibular joint (TMJ) or other teeth can manifest as pain in the area of the filled tooth.

Given that you have already seen your dentist and had an X-ray taken, it is essential to communicate your ongoing symptoms clearly. If the pain persists despite the recent treatment, you may want to consider seeking a second opinion from another dentist or a specialist, such as an endodontist, who focuses on issues related to the dental pulp and root canals.

In the meantime, keep track of when the pain occurs, any specific triggers (like temperature changes or chewing), and any other symptoms you may experience. This information can be invaluable for your dentist in diagnosing the issue accurately.

In summary, persistent tooth pain after a filling can arise from various factors, including incomplete decay removal, pulpitis, high fillings, cracks, gum issues, nerve damage, or referred pain. It's crucial to follow up with your dentist and possibly seek further evaluation to address the underlying cause of your discomfort effectively.

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