Introduction
Anyone who has ever suffered from toothache knows this more than unpleasant feeling. An appointment at the dentist should be a way out to escape the pain. The dentist removes the caries and fills the tooth.
So everything is fine again, right? Unfortunately not. It still hurts, but it can’t be caries anymore – why does the tooth still hurt?
Toothache can be caused by many different things. Only a dentist can determine what exactly is the cause of the toothache. In most cases, a carious lesion (commonly known as tooth decay) is responsible.
Carious lesions can spread very far until they finally become noticeable. By then the damage is usually already very large and somewhat more difficult to repair. Regular check-ups at the dentist, which should be carried out once a year, help to detect caries in its early stages and prevent greater damage to the tooth.
The tooth is made up of the outer layer of enamel that surrounds the dentine core. Inside the dentine, the pulp is completely protected. Among other things, the pulp contains the nerve of the tooth.
From here, nerve fibers are sent into the dentine and pain stimuli are transmitted. The pulp also ensures the nutrition of the tooth. Blood vessels and different types of cells ensure that the tooth gets everything it needs to function well in the mouth.
Toothache is perceived through the nerve inside a tooth. If the nerve is irritated, it is perceived as pain. Toothache in the first days after a filling is relatively common.
Depending on the type of filling, toothache is more likely or less likely. The bigger and deeper the extent of the caries was, the closer it comes to the tooth nerve. During the removal of caries and especially during preparation with dental drills, mechanical irritation in the form of vibrations or heat may occur.
In the course of filling placement, acid is used during the preparation of the tooth enamel (enamel conditioning). Here a chemical irritation of the nerve is possible. The most commonly used plastic filling itself can also be the cause of the toothache.
The applied plastic consists of monomers, which are connected by UV light and thus hardened. Single remaining monomers can irritate the dental nerve and cause pain. A filling that is too high can also be a possible cause, as it can lead to overloading of the tooth.
Toothache after a filling must be distinguished from nerve inflammation (pulpitis/tooth marrow inflammation). The former is temporary and the tooth still has a sensation of cold, but the nerve inflammation is irreversible and the tooth here has no sensation of cold and is therefore dead. Pulpitis requires root canal treatment.
Toothache after a filling usually manifests itself as hypersensitivity, so that pain is mainly perceived when biting or when: biting. The pain itself is rather bright and stinging and can initially be permanent. Therapeutically one can cool the affected part of the jaw after a filling or take painkillers (e.g. Ibuprofen 400mg) in case of strong toothache.
It should be noted that toothache after a filling occurs after the anaesthetic has worn off, as it represents an intermediate hypersensitivity of the tooth nerve and that after a few days there should be an improvement. In case of a permanent or throbbing pain, which also often leads to waking up from sleep, a renewed visit to the dentist is recommended in order to rule out pulpitis (inflammation of the tooth root). In summary, the deeper the caries is and thus the closer the nerve is, the more likely subsequent pain is. However, they are only of a temporary nature.
- Sweets
- Acid
- Hot
- Cold