You had a filling done, the numbness wore off, and now the tooth is sensitive. Most of the time that’s normal and it settles on its own. Here’s what’s normal, the two most common reasons it doesn’t settle, and when it’s worth a call.
Key points
- Some sensitivity for a few days after a filling is normal, especially to cold, and especially after a deep one.
- If it’s still bothering you after a few weeks, or it’s getting worse instead of better, call.
- The two usual reasons are a filling that sits a little high, or a nerve that’s irritated because the decay came close to it.
- A high filling is usually sore when you bite and is a quick fix. Sometimes the two are hard to tell apart.
- When a filling is deep, we tell you beforehand what’s possible, and we treat the tooth to help it settle.
What’s normal
A filling means removing decay and bonding new material to what’s left. The tooth notices. For a few days afterward it’s common for it to be sensitive to cold, and a little tender when you chew. The deeper the cavity was, the more likely that is.
Usually it fades over a few days. If it’s lasting longer than a few weeks, it’s worth a call. The same goes for sensitivity that’s getting worse instead of better.
The two usual reasons it keeps hurting
The filling sits a little high. When you’re numb, it’s hard to feel exactly how your teeth meet. If the new filling is a hair too tall, that tooth hits first every time you close. A high filling is usually sore to bite on, and it can make the tooth sensitive to cold too. We can usually find the high spot and adjust it in a few minutes. More on why a tooth hurts when you bite.
The nerve is irritated. The biggest clue here is how close the decay, and so the filling, came to the nerve. The closer it was, the more likely the nerve is inflamed. Most irritated nerves calm down over time. Some don’t.
Sometimes it’s hard to tell the two apart, because a high filling and an irritated nerve can both make a tooth sore and sensitive to cold. That’s one reason to come in rather than wait it out: checking the bite takes a few minutes, and it rules one of them out.
| Filling sits high | Irritated nerve | |
|---|---|---|
| Biggest clue | Sore when you bite down on it | The filling was deep, close to the nerve |
| Cold | Can be sensitive | Sensitive, sometimes lingering |
| What fixes it | Adjusting the high spot, usually in minutes | Often time. Sometimes a root canal |
When it’s more than an irritated nerve
Most sensitivity after a filling fades. These are the signs that the nerve may not recover:
- Cold that keeps aching for thirty seconds or more after it’s gone.
- Pain that starts on its own, with nothing cold or sweet near it.
- A tooth that wakes you up at night.
Those usually point to a nerve that’s inflamed beyond recovery, and the tooth may need a root canal to keep it. That’s not a sign the filling was done wrong. It usually means the decay had already reached close to the nerve before it was found. Tooth pain that comes and goes, or hurts at night. Signs you may need a root canal.
Why we warn you when a filling is deep
When a cavity is deep, we tell you before we start what’s possible afterward: that the tooth may be sensitive for longer than usual, and that a deep filling can sometimes end in a root canal. You shouldn’t find that out for the first time from a toothache.
What we do to help a deep filling settle
Once the decay is removed, there are still bacteria left in the dentin, the layer of tooth under the enamel. Before the filling goes in, we treat the tooth with a series of antimicrobials and desensitizers to clean them up: 4% chlorhexidine, then bleach (sodium hypochlorite), then glutaraldehyde, rinsing well between each one.
If the decay reached all the way to the nerve and left it exposed, we place a bandage over the exposed nerve before the filling goes on. Dentists call it a pulp cap.
What helps in the meantime
- Ibuprofen, if it’s safe for you to take. An anti-inflammatory usually helps dental pain more than acetaminophen (Tylenol).
- Skip very cold drinks on that side for a few days if they set it off.
- Don’t wait out a high bite. If it hurts every time you close, that’s a quick adjustment, not something to get used to.
Call us if
- it’s still sensitive after a few weeks, or getting worse
- it hurts when you bite down, or your bite feels off
- cold keeps aching long after it’s gone
- it hurts on its own or wakes you at night
- there’s swelling, or a bump on the gum
Had the filling done somewhere else? Call anyway. Checking the bite and testing the tooth doesn’t depend on who placed the filling. More on fillings. Crown or filling? How we decide.
Call 702-734-0776 or tell us what’s going on.
General education, and not a substitute for an exam.