Toothache after a filling

Pain often occurs after a tooth filling. The causes have already been described above.In most cases the restoration is too high after the treatment. This results in early contact and the tooth meets its opponent before all others in the jaw closure.

This is less disturbing at the beginning. However, if this condition persists for a long time, pain will occur. The reason for this is the chronic overloading of the tooth.

The dentist should remove the excessive amount of pain so that the tooth contacts evenly afterwards. If this does not relieve the pain, replacing the filling can help. A leaking filling margin or a shrunken filling can also trigger these sensations.

Pain intensification takes place mainly at night. This is due to the lying position and a warming of the cheek when lying on it. The warmth leads to an increased release of inflammatory mediators, which increases the perception of the pain stimulus.

A similar effect can be felt with increased outside temperatures. If very deep drilling is carried out due to an extensive carious lesion, the cavity is located in the dentin (dentin) covered by the dental enamel, i.e. very close to the tooth cavity (pulp) and thus to the dental nerve. This can be problematic if caries is still present there.

For a long-lasting restoration, the drilled cavity must be free of caries. Otherwise, secondary caries can form underneath and attack the dental nerve. The dentist must now decide which type of treatment is best.

The treatment of choice is called capping. A distinction is made between direct and indirect capping. The indirect method is used when there is a thin layer of dentin directly above the pulp.

A drug in the form of a cement containing calcium hydroxide is then applied and the cavity is closed. This stimulates new dentin formation (tertiary dentin). Sometimes, after several weeks, the tooth must be reopened and the residual caries removed before the definitive closure follows.

If, however, the pulp is opened punctually during drilling, a direct capping must be performed immediately. This is done by stopping the bleeding with hydrogen peroxide and then placing a medication over it. This is followed by the definitive filling.

This method is the more promising, the younger the patient and the smaller the affected area. It is also advantageous if there is no more caries at the opening. In the best case there is no pain after the treatment.

If the pain does not subside or if it worsens, the dentist should be consulted again and a root canal treatment should be performed. Some patients insist on going through a dental treatment without anesthesia. This can be useful in certain situations.

For example, if the caries is only very superficial in the enamel. However, as soon as the dentin is affected by the caries, living and therefore pain-sensitive tissue is affected. Pain may then occur during drilling.

Initially, the pain is felt more strongly after the treatment than if you had an anesthetic. This can be due to the stress caused by the drilling during the treatment. It is therefore more a subjective sensation than an actual increase in pain. However, the unpleasant feeling disappears just as quickly as the pain after drilling with anesthesia.