Persistent Tooth Sensitivity After Multiple Fillings: What to Do?

A tooth that has been filled four times experiences sensitivity and pain whenever pressure is applied while biting?

Hello Doctor, about a month ago I had a dental filling done at Clinic A for a shallow cavity that was only on the surface.
After the filling, I experienced some sensitivity when biting into slightly hard foods.
When I inquired about it, the doctor asked me to return for a follow-up, and he re-filled the tooth.
After that, I had no issues eating, and everything felt normal.
However, one day I accidentally bit into something hard, and afterwards, I started experiencing sensitivity and pain, even when rinsing my mouth or sucking in air.
Unfortunately, due to a typhoon, I had to visit Clinic B.
The doctor there informed me that the filling had come out.
He mentioned that the cavity wasn't deep, but since there was a base material used during the filling at Clinic A, it was thinner and more prone to coming out.
The doctor at Clinic B refilled it, but within a week, I was unable to bite down at all; biting into food felt like an electric shock, which was unbearable, although it would subside after a while.
I had no sensitivity when drinking cold water or when my tongue touched the area, but I just couldn't bite down.
The doctor at Clinic B examined my teeth, tapping them without causing pain, but there was some dull sensitivity when he applied pressure.
He explained that the cavity was located between the teeth, which made it more sensitive due to insufficient support, and he noted that it was deeper than he initially stated.
However, he reassured me that if it wasn't painful when not being touched, I wouldn't need a root canal; I just needed to eat soft foods and manage the discomfort.

Later, I returned to Clinic A, and the doctor suggested that I might have irritated the nerve during the filling process.
He first adjusted the height of the filling, and if I still couldn't bite down that evening, I might need a root canal the next day.
Unfortunately, I still couldn't bite, so I went back to him.
He tapped my teeth again, which didn't hurt, and he adjusted the filling.
He asked if it was still sensitive, and I confirmed it was.
He said that the nerve should be fine and offered to give it another chance with another filling.
He advised me to observe it for a few days, and if it didn't improve, I would need a root canal.
Now, it's the day after the new filling, and I still feel sensitivity when biting, but it's not as painful as it was after the filling from Clinic B, making it more bearable.
However, drinking water, especially cold, gives me a strange sensation, and even using sensitive toothpaste still elicits some feeling.
My question is, since I currently reside abroad and will likely return in a week or two, could this situation be due to postoperative sensitivity that will resolve with time, or is a root canal inevitable? I understand that teeth can become weaker after root canal treatment, which could lead to more serious issues in the future, especially since it may be difficult to manage abroad.
Should I proceed directly with a root canal, or does this tooth just need time to heal? I would appreciate your opinion, thank you.

Sally, 20~29 year old female. Ask Date: 2017/09/13

Dr. Zeng Guanghui reply Dentistry

If repeated fillings still result in pain when biting, it is likely that the dental pulp is already inflamed.
If there is spontaneous pain, it is recommended to perform a root canal treatment.
If there is sensitivity to hot and cold, consider performing pulp capping treatment first and monitor for improvement.
If symptoms persist, then consider root canal treatment.

Reply Date: 2017/09/13

More Info

Tooth sensitivity after dental fillings can be a frustrating and uncomfortable experience. It seems that you have undergone multiple dental procedures, and your symptoms have persisted despite the interventions. Let's break down the potential causes of your sensitivity and explore possible solutions.

Understanding Tooth Sensitivity
Tooth sensitivity can arise from various factors, especially after dental work. When a tooth is filled, the procedure can sometimes irritate the nerve inside the tooth, leading to temporary sensitivity. This is particularly common if the cavity was deep or if the filling material is in contact with the nerve. Additionally, if the filling is not properly sealed, it can allow bacteria to enter, potentially leading to further decay or infection.

In your case, it appears that the sensitivity worsened after biting down on hard food, which could have caused trauma to the tooth or the filling itself. The fact that you experienced a sharp, electric-like pain when biting suggests that the nerve may be reacting to pressure or temperature changes.

Possible Causes of Your Symptoms
1. Nerve Irritation: The sensitivity you are experiencing could be due to irritation of the dental pulp (the nerve inside the tooth). This can happen if the filling is too close to the nerve or if the procedure caused inflammation.

2. Inadequate Seal: If the filling was not adequately sealed, it might allow for microleakage, leading to sensitivity and potential decay beneath the filling.

3. Material Reaction: Different filling materials can react differently in the mouth. If you have multiple types of materials, there could be a galvanic reaction, causing discomfort.

4. Underlying Decay: If there was deeper decay than initially assessed, it could lead to ongoing sensitivity and pain.

Recommendations for Management
1. Observation: Since you are currently abroad and may not have immediate access to your original dentist, it might be wise to monitor your symptoms closely. If the sensitivity decreases over time, it could indicate that the nerve is healing.

2. Soft Diet: Continue to eat a soft diet to minimize pressure on the affected tooth. Avoid hard, crunchy, or sticky foods that could exacerbate your symptoms.

3. Desensitizing Toothpaste: Using a toothpaste designed for sensitive teeth may help alleviate some discomfort. These products contain compounds that help block the transmission of pain signals from the tooth surface to the nerve.

4. Follow-Up with Your Dentist: Once you return home, it is crucial to follow up with your dentist. They may recommend further evaluation, including X-rays, to assess the health of the tooth and surrounding structures.

5. Consider Root Canal Treatment: If your symptoms persist or worsen, your dentist may suggest a root canal treatment. This procedure involves removing the affected nerve and pulp tissue, which can alleviate pain and sensitivity. While it may seem daunting, root canal treatment can save the tooth and prevent further complications.

6. Seek a Second Opinion: If you are uncertain about the recommendations from your current dentist, consider seeking a second opinion from another dental professional. This can provide you with more information and options for treatment.

Conclusion
Tooth sensitivity after fillings can be a complex issue, and while it may resolve on its own, it is essential to remain vigilant about your symptoms. If the discomfort continues, it is crucial to seek professional dental care to prevent further complications. Remember, maintaining good oral hygiene and regular dental check-ups are vital for long-term dental health.

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