Toothache after filling

[Oli]

Hi

I have had toothache over the last week, since my dentist filled one of my bigger teeth at the back of my jaw. The tooth was not causing any pain at all and the toothache began after the filling was done and has gradually become worst.

I have been back to see my dentist today and he says that the filling was very deep and it may have hit the nerve and the tooth now needs root canal filling to stop the pain.

I would like to know if this is a common problem or has something gone wrong in my case. Could you also tell me if there are any alternatives to root canal treatment that cost less?

[Dr Vahid Motahar]

Hi,

Thank you for your question.

Your dentist is correct in saying that the cause of your pain is the depth of the filling that most likely has irritated the nerve of the tooth. This is very very common in dentistry and we, as dentist, try to explain this to our patients before such a treatment is carried out. Teeth that have deep fillings and are asymptomatic (painless), once the filling is replaced and a new one is put in, the patient returns with pain and then the dentist inform them that tooth needs a root canal treatemnt and a crown at extra cost.
At this stage patient usually are not over the moon because not only they paid for a flg, now there is going to be more substantial cost to sort the pain out (when there was no pain before until the tooth was touched by dentist)!

This is the nature of the dentistry and as mentioned is common with deeply restored dentition and dentist do not have any control over this matter. Simply due to the depth of the cavity and uts close peroximity to the nerve house, the nerve of the tooth becomes agitated and hence the pain and need for root canal treatment.

[Dr Ehsan J. Esfahani]

Hello Oli,

Thanks for your post.

Sometimes deep fillings can cause pain and severe sensitivity straight after they are placed. This is due to the proximity of the filling material to the nerve which causes irritation and inflammation of the nerve and hence toothache. It is a common occurrence and ways to minimise this problem are taken with deep fillings often with little success.

If it does occur then waiting for some weeks can result in subsidence of the toothache. If the toothache does not subside and is getting worse then the filling should be removed, medication placed over the nerve and a temporary filling placed. This might resolve the problem. After 6-12 months the temporary filling is replaced with a definitive filling.

However if the nerve irritation is such that the tooth can not recover by itself then root canal treatment is necessary. Antibiotics are given to relieve the toothache temporarily. The alternative option is removal of the tooth which is the cheapest option to relieve the toothache.

Sometimes despite all necessary precautions, root canal treatment can not be avoided after a deep filling is placed. Your dentist will inform you after treatment that this is the case. This is the nature of dentistry and patients are not too happy about it but its out of the dentist control.