{"id":2347,"date":"2016-02-05T09:57:51","date_gmt":"2016-02-05T16:57:51","guid":{"rendered":"http:\/\/www.mynewsmile.com\/blog\/?p=2347"},"modified":"2016-02-05T09:57:51","modified_gmt":"2016-02-05T16:57:51","slug":"diagnosing-a-sensitive-tooth-after-a-new-filling","status":"publish","type":"post","link":"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/","title":{"rendered":"Diagnosing a sensitive tooth after a new filling"},"content":{"rendered":"<div id=\"fb-root\"><\/div>\n<p><script>\/\/ <![CDATA[\n(function(d, s, id) {\n  var js, fjs = d.getElementsByTagName(s)[0];\n  if (d.getElementById(id)) return;\n  js = d.createElement(s); js.id = id;\n  js.src = \"\/\/connect.facebook.net\/en_US\/all.js#xfbml=1\";\n  fjs.parentNode.insertBefore(js, fjs);\n}(document, 'script', 'facebook-jssdk'));\n\/\/ ]]><\/script><\/p>\n<table border=\"0\" width=\"100%\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"40%\">\n<div align=\"center\">\n<table style=\"border-collapse: collapse;\" border=\"0\" width=\"350\" cellpadding=\"0\" bgcolor=\"#A9C5A5\">\n<tbody>\n<tr>\n<td align=\"center\"><span style=\"font-family: Arial; font-size: small;\">We thank our advertisers who help fund this site.<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"center\"><script src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\" async=\"\"><\/script><!-- MyNewSmile sidebar tall --> <ins class=\"adsbygoogle\" style=\"display: inline-block; width: 300px; height: 600px;\" data-ad-client=\"ca-pub-4419877247826466\" data-ad-slot=\"6363395985\"><\/ins><script>\/\/ <![CDATA[\n(adsbygoogle = window.adsbygoogle || []).push({});\n\/\/ ]]><\/script><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/td>\n<td>.<\/p>\n<p>Dr. Hall,<br \/>\nI wanted to get your opinion on a pain I am having after the filling on my molar was replaced two weeks ago (a silver filling was replaced with composite filling) <\/p>\n<p>Here are my symptoms:<br \/>\n*moderate pain when chewing<br \/>\n*very mild sensitivity to cold<br \/>\ncontinuous moderate pain starting up in the evenings after dinner&#8230;<br \/>\n*I started taking 400mg Ibuprofen around midnight if I couldn&#8217;t sleep from the discomfort, and that really helps.<br \/>\n*In the mornings I have no pain.<br \/>\n(My wife, who is a doctor, suggested I take ibuprofen continuously to reduce possible inflammation. Started that today.)<br \/>\n*In the evenings, continuous mild pain and discomfort around my left jaw and tonsil.<br \/>\n*very slight tingling and numbness in my lower left jaw and chin, kind of like when anesthesia is almost completely worn off<\/p>\n<p>So my question: <\/p>\n<p>Do you think I should have the new filling replaced to address these symptoms? Or should I wait?<br \/>\n&#8211; Sergio from California<\/p>\n<p>Sergio,<br \/>\nAs thorough as you have been in describing your symptoms, I still haven&#8217;t got enough information to diagnose your pain. I don&#8217;t know how big your filling is. I don&#8217;t have an x-ray. I don&#8217;t know how deep the dentist had to go in doing your filling. Nevertheless, I think I can be helpful. Let&#8217;s examine your symptoms, point by point.<br \/>\n\u2022\tModerate <a href=\"https:\/\/www.mynewsmile.com\/sensitivetobiting.htm\" target=\"_blank\">pain when chewing<\/a>. A sharp pain when chewing when there are no other symptoms indicates this peculiar sensitivity that seems to come because of a bonding failure. If that happens then yes, you want to have the filling replaced with some changes in the bonding procedure. But that&#8217;s not the case with your filling. The pain is moderate and there are other symptoms. I would attribute your sensitivity to one of two possible causes. Either this is a larger filling that has changed your bite somewhat, or the ligament attaching your tooth to the jawbone has been traumatized slightly. I would expect this to get better over time.<br \/>\n\u2022\tVery mild <a href=\"https:\/\/www.mynewsmile.com\/sensitivetocold.htm\" target=\"_blank\">sensitivity to cold<\/a>. This would also happen if you had a large filling, or even one that was deep, where the pulp of the tooth was irritated because the dentist had to go close to the pulp to get the decay out. This type of sensitivity is routine for silver amalgam fillings but also happens with composite fillings when they are deep. As long as it gets gradually better, it is no cause for concern.<br \/>\n\u2022\tContinuous moderate pain in the evenings. This is a little puzzling and is of more concern. Spontaneous pain in a tooth can indicate an irreversible pulpitis, especially if it is more intense when you lie down. Again, this could have been a deep filling. But if there is spontaneous pain, it would tend to indicate that some bacteria have gotten into the pulp. This doesn&#8217;t mean that the dentist did anything wrong. The dentin of your tooth is porous, and in the process of removing deep decay, some bacteria are going to be pushed into the dentinal tubules of your tooth. If the pulp is close to the floor of the cavity, those bacteria will end up in the pulp. If it&#8217;s not too many bacteria, your tooth can recover. But if your tooth isn&#8217;t getting better by now, it&#8217;s not recovering.<br \/>\n\u2022\tPain in the jaw and tonsil. This wouldn&#8217;t have anything to do with the tooth. It might be related to stress on your jaw or mouth from the procedure.<br \/>\n\u2022\tTingling and a sense of numbness in your lower left jaw. You had an injection to numb the lower left jaw. Residual tingling would indicate that the dentist hit the bullseye with the injection &#8211; a direct hit on the nerve he or she was targeting to numb. He or she may have even nicked it slightly with the needle. The target nerve here goes to the teeth on that side of your lower jaw and also to the lip and chin. This is of no concern and will completely go away in time.<br \/>\nAnyway, I hope this is helpful. You have an interesting mix of symptoms, and I&#8217;m hoping it makes an interesting and helpful blog post for others. Bottom line&#8211;most of this is not of any concern. But the spontaneous pain in the evenings worries me. Pain intense enough that you have to take ibuprofen to sleep is a concern. If it has been two to four weeks and there is no improvement, I would have the tooth x-rayed by a dentist who has a high level of expertise in radiographic diagnosis&#8211;possibly an endodontist (root canal specialist)&#8211;who should look for a widened periodontal ligament space around the root tip of this tooth. If that is present, the tooth may <a href=\"https:\/\/www.mynewsmile.com\/dental\/need_root_canal.htm\" target=\"_blank\">need a root canal treatment<\/a>, and it would be better to have that done before the pain gets unbearable.<\/p>\n<p>&#8211; Dr. Hall<\/p>\n<p>Do you have a comment? We&#8217;d love to hear from you. Enter your comment below.<\/p>\n<p><iframe loading=\"lazy\" style=\"border: currentColor; width: 450px; height: 80px; overflow: hidden;\" src=\"https:\/\/www.facebook.com\/plugins\/like.php?href=http%3A%2F%2Fwww.mynewsmile.com&amp;layout=standard&amp;show_faces=true&amp;width=450&amp;action=like&amp;colorscheme=light&amp;height=80\" width=\"300\" height=\"150\" frameborder=\"0\" scrolling=\"no\"><\/iframe><\/p>\n<p>Click here to <a href=\"https:\/\/www.mynewsmile.com\/askdr.htm\">ask Dr. Hall<\/a> a question of your own.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>We thank our advertisers who help fund this site. . Dr. Hall, I wanted to get your opinion on a pain I am having after the filling on my molar was replaced two weeks ago (a silver filling was replaced with composite filling) Here are my symptoms: *moderate pain when chewing *very mild sensitivity to [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[46],"tags":[71,701,700,697,242,698,699,213,216],"class_list":["post-2347","post","type-post","status-publish","format-standard","category-fillings","tag-endodontist","tag-pain-when-chewing","tag-pulp-inflammation","tag-pulpitis","tag-root-canal-treatment","tag-spontaneous-pain","tag-tingling","tag-tooth-sensitive-after-filling","tag-tooth-sensitive-to-cold","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Diagnosing a sensitive tooth after a new filling - Cosmetic Dentistry Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Diagnosing a sensitive tooth after a new filling - Cosmetic Dentistry Blog\" \/>\n<meta property=\"og:description\" content=\"We thank our advertisers who help fund this site. . Dr. Hall, I wanted to get your opinion on a pain I am having after the filling on my molar was replaced two weeks ago (a silver filling was replaced with composite filling) Here are my symptoms: *moderate pain when chewing *very mild sensitivity to [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/\" \/>\n<meta property=\"og:site_name\" content=\"Cosmetic Dentistry Blog\" \/>\n<meta property=\"article:published_time\" content=\"2016-02-05T16:57:51+00:00\" \/>\n<meta name=\"author\" content=\"David A. Hall\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"David A. Hall\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Diagnosing a sensitive tooth after a new filling - Cosmetic Dentistry Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/","og_locale":"en_US","og_type":"article","og_title":"Diagnosing a sensitive tooth after a new filling - Cosmetic Dentistry Blog","og_description":"We thank our advertisers who help fund this site. . Dr. Hall, I wanted to get your opinion on a pain I am having after the filling on my molar was replaced two weeks ago (a silver filling was replaced with composite filling) Here are my symptoms: *moderate pain when chewing *very mild sensitivity to [&hellip;]","og_url":"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/","og_site_name":"Cosmetic Dentistry Blog","article_published_time":"2016-02-05T16:57:51+00:00","author":"David A. Hall","twitter_card":"summary_large_image","twitter_misc":{"Written by":"David A. Hall","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/#article","isPartOf":{"@id":"https:\/\/www.mynewsmile.com\/blog\/diagnosing-a-sensitive-tooth-after-a-new-filling\/"},"author":{"name":"David A. 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