Guides · Restorative
Is pain or sensitivity after a filling normal, and how long does it last?
Why hot-cold sensitivity, pain on biting and throbbing occur after a filling; which is normal and which calls for a return visit; high fillings and when a root canal becomes necessary.
Mild cold sensitivity after a filling is normal and usually fades within 1–3 weeks; with deep fillings it can extend to 4–6 weeks. Sharp pain on biting usually means the filling is high and is fixed with a few minutes of adjustment. Pain that starts on its own, wakes you at night, throbs or steadily worsens indicates that the nerve is affected; in that case root canal treatment may be needed.
Why is there sensitivity?
When decay is removed, hard tissue is taken away and the dentinal tubules remain permeable for a while. As the filling material bonds to the tooth (in composite, during light-curing) there is slight shrinkage; the tooth's nerve-and-vessel tissue (the pulp) reacts to the heat, vibration and chemical stimuli of the procedure. In most teeth this reaction is temporary: the nerve recovers, the tubules close and the sensitivity fades.
Which pain is normal and which is not?
| Symptom | Likely cause | What to do |
|---|---|---|
| A twinge lasting a few seconds with cold | Expected dentine sensitivity | Wait; eases in 1–3 weeks |
| Sharp, stabbing pain on biting | The filling is high (bite contact) | See the dentist; a 5-minute adjustment |
| A twinge with sweets, food packing between the teeth | Open contact with the neighbouring tooth or an overhang | Dental check; the filling is corrected |
| Prolonged, throbbing pain with heat, night pain | Pulpitis (irreversible) | Root canal treatment may be needed |
| Pain only when pressing one particular spot | A crack in the tooth | Examination; a crown may be needed |
How long does it last?
With shallow fillings, sensitivity usually passes within a few days. With deep fillings close to the nerve the dentist usually places a protective liner; these teeth may have mild sensitivity for 4–6 weeks. The rule: if sensitivity is decreasing, healing is under way; if it stays the same or increases, a check is needed.
Why does a high filling matter?
When the filling is finished, the bite cannot be felt properly because of the numbness; even with an articulating-paper check, a spot that "touches first" may be noticed a few days later. A high filling strains the tooth with every chew; it leads to pain, sensitivity and, in time, jaw-joint complaints. The fix is simple: the dentist finds the contact with articulating paper and balances it with a few seconds of grinding. Don't put it off thinking "I'll get used to it".
What can you do at home?
- Avoid very cold and very hot foods in the first days; don't bite hard things on the side of the filling.
- Use a desensitising (potassium-nitrate) toothpaste regularly for 2–4 weeks.
- Don't brush hard; a soft brush, circular strokes.
- If you clench, tell your dentist; a night guard also extends the life of the filling.
When to go back to the dentist
Book an appointment if biting pain has not gone within 2–3 days, if sensitivity lasts more than 3 weeks or increases, or if there is spontaneous throbbing, swelling, a bad taste or a feeling that a piece of the filling has broken off. Early intervention usually saves the tooth from needing a root canal.
What does "going on to a root canal" mean?
If the decay was very close to the nerve, the nerve may not recover after the procedure. This does not mean the filling was "done wrong"; with deep decay it is a possibility foreseen and explained to the patient beforehand. In that case root canal treatment is done through the filling and the tooth is usually kept. More: Root canal treatment, Pain after a root canal.
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
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