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Why Does My Tooth Hurt After the Dentist?

By Nicholas S. Baumann, DDS
If a toothache after seeing the dentist remains for more than a few days, it’s time to return.

A trip to the dentist is supposed to help us keep our teeth healthy and take care of dental problems, but what if after a visit that includes something as simple as a filling, we start to experience sensitivity or pain? What are the possible reasons for this, and what can be done to solve the issue?

The first most likely cause of tooth sensitivity is if the bite is high, say from a filling or crown. Having even a small excess force on the tooth can lead to inflammation in the ligament around the tooth. This can lead to sensitivity while biting, as well as to hot and cold. A bite being high by as little as a few microns can lead to this. Think about if you get something as small as a hair stuck between your teeth. It is very easy to tell, and a hair is only about 50 microns thick. Luckily, it is very easy for your dentist to adjust the bite which usually eliminates the sensitivity. Even if the bite feels ok when you bite down, it still may need to be adjusted. Our teeth don’t always come down in the same position and there may be areas that hit high when different bites are performed, such as chewing, or grinding. All of these different bites need to be checked and adjusted if symptoms persist.

If bite adjustments do not alleviate the problem, another possibility would be that the restoration did not adhere to the tooth fully. If this is the case, there can be microscopic movement between the restoration and the tooth, leading to sensitivity. This is hard to determine as you would not be able to see this at all on an X-ray. Moreover, we must focus on symptoms after other solutions have been attempted. If this is the case, the only way to resolve the issue is to replace the restoration. Composite, tooth-colored fillings are the restorations most likely to have this issue. It can also occurs in other types of restorations like crowns, although this is less common.

If all other things do not result in relief of symptoms, there may be a problem with the nerve of the tooth. If there is deep decay or a fracture of the tooth before a filling or crown is done, there may already be damage done to the nerve. The closer to the nerve, the more likely this can occur, but it may even occur in a simple filling. Preparing a tooth for a filling or crown is a trauma to the tooth. Sometimes it can just take time for sensitivity to calm down, but if the nerve reacts unfavorably to the filling process, this can lead to sensitivity ranging from minor to extreme. If the sensitivity is due to nerve irritation, the only solution is to have a root canal.

Tooth sensitivity after seeing the dentist can be frustrating; however, it can occur for a number of reasons. If you have sensitivity for longer than a few days after a filling or crown, be sure to see your dentist. Luckily, most of these cases are easy to fix either with a small adjustment or a little time, and long term it should feel just like your natural tooth.

Dr. Nick is with Palm Desert Smiles and can be reached at (760) 568.3602.

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