Tooth pain after a filling: what is normal and what is not

Is it normal for a tooth to hurt after a filling?

Some discomfort is common. Removing decay and placing a filling is work on a living tooth, and the nerve inside can stay irritated for a while afterward. The deeper the decay went, the closer the work came to the nerve, and the more likely the tooth is to complain.

It usually eases over a few days to a few weeks. What matters is the direction: steadily better is normal, and worse, or no better at all, is worth a call. Normal usually looks like this:

• A twinge from cold, and sometimes from sweet things or cold air, that fades as soon as the cold is gone.
• Mild tenderness when you chew, for a few days, even though your bite feels normal.
• A sore gum next to the tooth, or a sore spot where the numbing injection went in, for a day or two.
• A vague ache in the teeth nearby, since an irritated tooth can make its neighbors feel sore too.

What if my bite feels high after a filling?

While your mouth is numb, it is hard to feel exactly how your teeth meet, so a filling that sits a fraction too high can go unnoticed until the numbness wears off. Then that tooth touches first when you close, and it can start to ache as if it were bruised.

A high spot does not wear down by itself, and every time you bite, that one tooth takes the force first, which keeps it sore. The fix is quick: we mark where your teeth touch and smooth the filling until your bite meets evenly again. Whether the filling was done here in Pearisburg or somewhere else, call rather than waiting it out.

When is pain after a filling a problem?

A different kind of pain can mean the nerve inside the tooth is more than irritated. Call if you notice any of these:

• Pain that lingers after the cold or heat has gone.
• Throbbing, or an ache that starts on its own with nothing setting it off.
• Pain that wakes you at night.
• Pain with hot food or drink, especially if something cold eases it.
• A sharp pain when you bite on one spot, which can be a high spot or a crack in the tooth.

Will I need a root canal?

Not necessarily. An irritated nerve often settles with time. Pain that lingers, throbs or wakes you can mean the decay came very close to the nerve, or had already reached it, before the filling went in.

Sometimes the nerve recovers. Sometimes it does not, and the tooth needs root canal therapy to clear out the inflamed nerve so you can keep the tooth. We test the tooth and take an X-ray to tell which, and we explain what we find before anything else is done.

How to ease sensitivity after a filling

While the tooth settles, these help. If the filling itself chips, feels rough or comes out, our page on a lost filling or crown covers what to do first.

• Wait until the numbness has worn off before you eat, so you do not bite your lip, cheek or tongue without noticing. Keep an eye on children, who tend to chew on a numb lip.
• Chew on the other side for a few days if the tooth is tender.
• Go easy on very cold or very hot food and drink for a while.
• Brush with a toothpaste for sensitive teeth, and keep brushing and flossing around the tooth gently.
• Take an over-the-counter pain reliever, exactly as the label directs, if it is safe for you to take.
• Do not hold an aspirin against the gum. It burns the gum and does nothing for the tooth.

When is tooth pain after a filling an emergency?

Pain after a filling is rarely an emergency. Call promptly, though, if the tooth throbs and you also have swelling in the gum or face, a bad taste, a bump on the gum near the tooth, or a fever. Those can mean an infection such as a dental abscess. Tell whoever answers what has happened and they will get you seen.

Go to an emergency room for swelling that is closing an eye or spreading down the neck, or for difficulty breathing or swallowing. Call us afterward and we will take care of the tooth.

Questions patients ask