Tooth Pain After Filling: Causes and Solutions

Q: Tooth Pain After Filling: Causes and Solutions

Dear Ms. <br>Christine： Hello! As mentioned, the tooth may have nerve inflammation or may even be necrotic. <br>Root canal therapy is needed, and if there are any issues, you should consult an endodontist.

Tooth decay led to pulpitis, and after a few months of treatment, the pain returned?

I'm sorry, but it seems that the message was not sent, so I will resend the question.
The tooth number 16 has a deep cavity, close to the nerve.
It was filled a few years ago, and then in November of last year, the tooth suddenly started to hurt.
Drinking cold water only provided temporary relief, especially at night when lying down, the pain was severe enough to prevent sleep.
After taking migraine pain relief medication, I went to see a dentist.
The doctor diagnosed it as pulpitis, stating that it might be due to the previous filling being too close to the nerve.
The doctor removed the previous filling and placed a temporary filling, then mentioned that if it hurt again, I would need a root canal treatment, noting that my tooth roots were difficult to access.
If there was no pain after a week, they would proceed to fill the tooth without root canal treatment.
After that, my tooth no longer hurt, and the doctor filled it without performing a root canal.
Since then, I have been afraid to bite food on the filled side and have been using the other side to chew.
In April of this year, I suddenly experienced mild pain again, and biting on the filled side caused discomfort.
After 1-2 days, the sensation disappeared.
Today, May 1st, I suddenly started to feel mild pain again, and biting on the filled side is painful, with soreness felt when touching the bone on my cheek.

1) Is it abnormal for a filled tooth to hurt again, even though it’s not as painful as before requiring medication? Why is it hurting again?
2) Is it bad that I am afraid to bite food on the filled tooth, fearing that pressure on the filling might affect the nerve, and only using the other side to eat? What negative effects could this have?
3) Are these symptoms indicative of a recurrence of pulpitis?
4) If tooth number 16 cannot undergo root canal treatment and needs to be extracted, is it necessary to get a prosthetic tooth or crown? What would happen if I don’t get one (would the gum be left empty without a tooth)? Thank you for your response.

Christine, 20~29 year old female. Ask Date: 2020/05/02

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Christine: Hello! As mentioned, the tooth may have nerve inflammation or may even be necrotic.
Root canal therapy is needed, and if there are any issues, you should consult an endodontist.

Reply Date: 2020/05/02

More Info

Tooth pain after a filling can be a complex issue, especially when the filling is deep and close to the nerve. Based on your description, it seems you have experienced a series of dental challenges that may indicate underlying issues with the tooth and surrounding structures. Let's address your questions one by one.

1. Is it abnormal for a filled tooth to hurt again? Why does it hurt?
It is not uncommon for a tooth that has been filled, especially one that was previously close to the nerve, to experience discomfort or pain after treatment. This can happen for several reasons:
- Residual Inflammation: After a filling, the tooth and surrounding tissues may still be inflamed, which can cause sensitivity, especially to temperature changes or pressure.

- Deep Decay: If the decay was extensive, the nerve may still be irritated, leading to intermittent pain.

- Microleakage: Sometimes, the filling material may not completely seal the tooth, allowing bacteria to enter and cause further decay or inflammation.

- Pulpitis: If the nerve is still irritated, it may lead to a condition known as pulpitis, which can cause pain that varies in intensity.

2. Is it bad to avoid using the filled tooth for chewing?
While it is understandable to be cautious about using the filled tooth, consistently avoiding it can lead to other issues:
- Uneven Wear: Over time, the teeth on the opposite side may wear down more quickly due to the extra pressure from chewing.

- Jaw Issues: Avoiding one side can lead to jaw discomfort or temporomandibular joint (TMJ) issues due to uneven pressure distribution.

- Nutritional Concerns: If you are avoiding certain foods because of discomfort, it may affect your overall nutrition.

3. Are these symptoms indicative of a recurrence of pulpitis?
Yes, the symptoms you describe—intermittent pain, sensitivity to biting, and discomfort in the surrounding area—could suggest that pulpitis is recurring or that there is another underlying issue. It is crucial to monitor these symptoms closely. If the pain persists or worsens, it is advisable to return to your dentist for a thorough examination, which may include X-rays to assess the health of the tooth and surrounding bone.

4. What if the tooth cannot undergo root canal treatment?
If the tooth is deemed non-restorable and requires extraction, there are several considerations:
- Replacement Options: After extraction, you may need to consider options like dental implants, bridges, or dentures to restore function and aesthetics. Not replacing a missing tooth can lead to:
- Shifting Teeth: Adjacent teeth may shift into the gap, leading to misalignment.

- Bone Loss: The jawbone may resorb over time where the tooth was, leading to changes in facial structure and potential issues with neighboring teeth.

- Functional Impairment: Missing teeth can affect chewing and speaking.

In conclusion, it is essential to maintain open communication with your dentist regarding your symptoms and concerns. Regular check-ups and prompt attention to any changes in your dental health can help manage pain and prevent further complications. If you experience persistent pain, it is crucial to seek further evaluation to determine the best course of action for your dental health.

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