Why does my tooth still hurt after a filling?

By Jennifer Berry. Reviewed by Christine Frank, DDS, Curated by Doctor Jerry Krape.

When a person has a cavity in their tooth, a dentist will probably recommend a filling. Fillings are safe and effective, but some people might experience discomfort or tooth sensitivity afterward.

Most of the time, this sensitivity is normal and will resolve within a few days or weeks.

A person should call their dentist right away if they have extreme pain, or if discomfort occurs with other symptoms, such as fever, redness, or swelling.

In this article, we look at the reasons why a person may have tooth sensitivity after a filling, how to treat it, and when to see a doctor or dentist. We also look at other possible causes of tooth sensitivity.

What should I expect after a filling?

The dentist will numb the area around the affected tooth.

A filling is a dental procedure that involves a dentist cleaning away any decay from the tooth and then filling the space with a new material.

After injecting a numbing agent around the tooth, the dentist will then clean out the decayed area of the tooth, usually with a dental drill. They will then fill the space with gold, silver amalgam, a composite, or porcelain.

For several hours after having a filling, a person’s face may still feel numb, tingly, itchy, or puffy. They may have difficulty eating, swallowing, talking, or moving their face.

Sometimes, dentists recommend that people avoid eating or drinking for a few hours, as this may result in a person accidentally biting their tongue or cheek.

Once the numbing agent has worn off, these feelings will go away. But, in the following days and weeks, a person may notice some new sensations as they adjust to the new filling.

Sensitivity in the filled tooth or area around it is one of the most common occurrences during this time.

What does sensitivity after a filling feel like?

When a person has a sensitive tooth, they may notice that certain triggers cause a temporary, uncomfortable sensation in the filled tooth or surrounding area. It may feel like a shock of cold or sudden pain that comes on quickly and goes away.

Factors that can trigger tooth sensitivity after a filling include:

  • cold foods or drinks, such as ice cream, popsicles, or beverages with ice
  • hot drinks, such as coffee or tea
  • air hitting the tooth, such as when breathing through the mouth, which may be worse with cold air
  • sugary foods, such as candy
  • acidic foods and drinks, including fruit, juice, and coffee
  • biting down when eating

Why do fillings cause tooth sensitivity?

Some sensitivity after a tooth filling is normal and temporary. Sometimes, however, sensitivity after a filling is due to other causes that need treatment or repair.

Below, we discuss possible reasons for this symptom and when to see a dentist.

An irritated nerve

woman experiencing toothache

The nerve inside the tooth may take a few days to heal.

Short-term tooth sensitivity after a filling usually occurs because the filling procedure has aggravated or caused inflammation in the nerve inside the tooth.

Usually, the tooth’s outer layers — the enamel and cementum — protect the nerve from exposure. But fillings, especially deep ones, can get close to the nerve endings and cause irritation and uncomfortable sensations.

As the nerve heals, the sensitivity will go away. This may take a few days or weeks. Once the nerve has healed fully, a person should feel no difference between the filled tooth and the other teeth.

Incorrect bite alignment

A dentist must ensure that the filling lines up with the other teeth in the mouth. If the filling is too tall, it can cause extra pressure as a person bites down. This can cause pain and sensitivity that is often more severe than normal post-filling sensitivity.

It is quite normal for a person to experience some minor sensitivity when biting down in the days following the procedure. Typically, the bite will correct itself within a few weeks.

However, if a person experiences severe sensitivity, or they have difficulty eating or putting their teeth together, they should ask their dentist to check the bite. The dentist may decide to smooth down the high point of the filling to properly fit the bite and eliminate discomfort.

Pulpitis

Pulpitis is inflammation of the pulp deep within the tooth. It can cause tooth sensitivity and pain.

Pulpitis does not regularly occur with minor fillings, but it might happen if:

  • the tooth has had trauma, such as from an accident that resulted in a cracked or broken tooth
  • the cavity was very deep, reaching the inner pulp layer
  • the tooth has undergone multiple fillings or procedures

There are two types of pulpitis:

  • reversible pulpitis refers to mild inflammation where the pulp remains healthy, and the tooth will heal on its own
  • irreversible pulpitis is when there is a damaged nerve that starts to die, in which case a person will need a root canal to save the tooth

A dentist can usually resolve pulpitis with a new filling or a restorative procedure, such as a root canal. A person may also need to take antibiotics to clear any bacterial infection.

How to treat a sensitive tooth

When a person experiences normal, post-filling sensitivity, a dentist may recommend that they use a desensitizing toothpaste.

These products contain an ingredient called potassium nitrate that helps stop the sensations on the surface of the tooth from reaching the nerve endings inside.

These products do not work immediately, but a person should notice relief within several days if they use the toothpaste twice a day.

A person may also try the following methods at home to help relieve tooth sensitivity:

  • Over-the-counter pain relievers, such as acetaminophen or ibuprofen.
  • Topical numbing ointment designed for the mouth.
  • A toothbrush labeled for sensitive teeth. These are softer than standard toothbrushes and will be less harsh on the tooth enamel.
  • Brush with gentle, circular strokes on the teeth and gums. Avoid scrubbing back and forth or aggressive pushing of the brush on the teeth.
  • Floss once a day, taking care to be gentle on the gums and teeth.
  • Take note of which foods or drinks cause sensitivity and avoid them if possible.
  • Avoid whitening toothpaste and products, which can make sensitivity worse.
  • Rinse the mouth out with water after consuming acidic foods or drinks, such as coffee and fruit. Acidic foods and beverages can wear away the tooth enamel.
  • Avoid brushing the teeth immediately after eating acidic foods, as it may remove more of the enamel.

If tooth sensitivity does not improve in the days following a filling, talk to a dentist. It is essential that the dentist rules out other potential causes of sensitivity that may not be related to the filling.

What else can cause tooth sensitivity?

Sometimes a tooth may be sensitive for reasons other than the filling procedure. If the sensitivity develops later, such as within a few weeks or months after a dental procedure, it could be due to one of the following issues:

Tooth abscess

tooth abscess is an infection in the nerve of the tooth. A very deep cavity, gum disease, or a cracked tooth usually causes an abscess.

Symptoms of a tooth abscess include:

  • a severe toothache
  • sensitivity
  • redness on the gums
  • a bad taste in the mouth
  • a pimple- or boil-like bump on the gums
  • fever

A tooth abscess requires medical care. A person who notices these symptoms should see a doctor or dentist right away.

Loose or broken older fillings

Dental fillings generally last for years, but they do not last forever. If an older filling becomes loose or breaks, it can cause sensitivity and pain as it gets closer to the nerve in the tooth.

Even if the loose or broken filling does not cause discomfort, a person should get a replacement to prevent further damage or decay to the tooth.

Gum disease

man flossing teeth

If the gums bleed during flossing, it may be a sign of gum disease.

Periodontal disease, or gum disease, can cause tooth sensitivity.

This is because it causes the gums to recede, or pull away from the tooth. This exposes part of the tooth near the root and can make it feel sensitive. The root of the tooth does not have enamel to protect it.

Other symptoms of gum disease include:

  • red or bleeding gums, especially while brushing or flossing
  • gums that look different than usual
  • teeth that appear to be separating
  • loose teeth in adults
  • sores or pus in the mouth

Gum disease often causes no symptoms in its early stages. This is why it is important that people see their dentist regularly to check for problems before they become serious.

When to see a dentist

People should not be alarmed if a tooth is mildly sensitive in the days following a filling. Using home remedies and desensitizing toothpaste should help relieve the discomfort.

A person should see a dentist right away if the sensitivity worsens, makes it difficult for them to eat, or they experience other symptoms, such as a toothache or fever.

Outlook

Fillings are a safe and effective way to treat dental cavities. Most fillings will last many years. Taking good care of teeth with daily brushing and flossing, as well as regular dental checkups, can help prevent future cavities.

Some sensitivity after getting a filling is normal. But, see a dentist for severe sensitivity or pain or if other problems, such as fever or redness, develop.


Diabetes causes shift in oral microbiome that fosters periodontitis, Penn study finds.

Doctor Krape Cosmetic & Specialized Dentistry continues to keep you informed as to the new studies, trending techniques and medical advances that can affect or change the way Dentistry is practiced, which can affect the overall health of not just your teeth but your entire body! Diabetes continues to have ill effects on much more than previously understood. Please read!

A new study led by University of Pennsylvania researchers has found that the oral microbiome is affected by diabetes, causing a shift to increase its pathogenicity. The research, published in the journal Cell Host & Microbe, not only showed that the oral microbiome of mice with diabetes shifted but that the change was associated with increased inflammation and bone loss.

“Up until now, there had been no concrete evidence that diabetes affects the oral microbiome,” said Dana Graves, senior author on the new study and vice dean of scholarship and research at Penn’s School of Dental Medicine. “But the studies that had been done were not rigorous.”

Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome. But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes.

“My argument was that the appropriate studies just hadn’t been done, so I decided, We’ll do the appropriate study,” Graves said.

Graves co-authored the study with Kyle Bittinger of the Children’s Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet’s Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases.

Graves co-authored the study with Kyle Bittinger of the Children’s Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet’s Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases.

“We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome,” said Graves.

With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice.

The findings “demonstrate unequivocally” that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.

Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene.

“Diabetes is one of the systemic disease that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control,” he said. “And good oral hygiene can take the risk even further down.”

The study was supported by grants from the National Institute of Dental and Craniofacial Research (DE017732 and DE021921) with assistance from Penn Vet’s Center for Host-Microbioal Interactions and the Penn Center for Musculoskeletal Disorders.

Article: Diabetes Enhances IL-17 Expression and Alters the Oral Microbiome to Increase Its Pathogenicity, Dana T. Graves et al., Cell Host & Microbe, doi: 10.1016/j.chom.2017.06.014, published 12 July 2017.