Pain After White Composite Filling
Question: Why does my tooth hurt after it just received a new white filling? It did not hurt before!
Answer: Your tooth should obviously not hurt after the filling, especially if it did not hurt before. In this practice I do not have patients complaining of pain after white fillings are placed. If you are experiencing pain, here are some reasons why:
- Polymerization Shrinkage: Composites (white fillings) shrink a little when they harden. Generally the dentist will place the material into the cavity in a liquid to pasty form and then use a strong light (LED or Halogen) to instantly harden the material. If the composite material is placed incorrectly or in bulk then the composite will shrink enough to either allow a little gap to form around the filling, or it will actually pull the tooth together. Either way the tooth will become sensitive to hot and cold.
- Too Large Composite: Composite is a great material, in small fillings. Once the filling reaches a certain size (1/3 the distance between the cusps or more than 2 surfaces) then it generally is not strong enough to function correctly. Composite material is not strong enough to function exactly like tooth structure. The tooth will bend, the composite will wear or fracture, and eventually failure is inevitable. When the filling fails it will then require a much larger restoration or worse.
- Fractures in Tooth: Often old silver mercury fillings, amalgams, are removed and replaced with white fillings for various reasons. These amalgams have too many issues to list here (let’s see if any ADA dentists complain), but the main one is that the expansion and contraction as well as compression over time results in tooth fractures. Removing these fillings and not recognizing the fractures (visually) will result in trouble. A fractured tooth should not receive a white composite filling!
- Other Issues: The two scenarios above are fairly common. Often I see patients that have super large composite fillings (patches), and that is usually a warning sign to the quality of dentistry found in all the other teeth. Composite material is great if used correctly. It is not a cure-all. It can have bubbles in it, fail to bond correctly, not cure all the way, etc. Composite is very technique sensitive and is often placed without enough care. This is where experience becomes important!
So, to answer this persons’ question – Your tooth could hurt for many reasons, none are good. Talk to your dentist about this problem and see what they say. If the answer is “wait and it will get better”, then seek out a second opinion. Unfortunately Kentucky is not known for its quality dentistry (we are 49th and 50th in the US when it comes to number of teeth in adult mouths and oral health), so do your research and find a top dentist. I suggest you look at the AACD (American Academy Of Cosmetic Dentistry) as one of your sources. Select a member as they have gone through some of the most rigorous training in the world and must live up to their reputation.