Tooth hurts after root canal filling

It happens that after dental procedures, toothache does not go away. It may become smaller, less pronounced, and sometimes pain occurs only when you press on the tooth. Does this mean that the doctor did not complete the tooth treatment? What do pain sensations indicate immediately after treatment, how to respond to them?

After treatment of a tooth it hurts to press on it

Usually, a visit to the dentist solves the problem completely - the tooth is cured or, which is also sometimes necessary, removed. Almost always, the dentist warns you what sensations may appear soon: whether the tooth or gums will swell, how long they will last, and in what case you need to come back for an appointment.

If a tooth is removed, there may be slight pain at the extraction site throughout the day. This is normal, because the hole after removal is a living wound that needs time for tissue restoration. Roughly speaking, the wound should calm down and heal. But if the pain does not subside for several days, it is strong, throbbing, the swelling does not go away, you need to go to the doctor.

If the pain does not subside after treatment or removal, you should consult a doctor.

What can hurt after filling?

The pain associated with the installation of a filling directly depends on the structure of the tooth. It consists of a crown, neck and root. On top, all these structures are covered with hard dental tissues that do not have nerve endings. In the crown area it is dentin and enamel, in the root area it is cement. Inside, under the hard covering in the crown area, there is a dental cavity filled with pulp - a pulp that has many nerve endings and blood vessels. The cavity is connected to root canals, also filled with pulp. In the area of the apex (apex), the root is connected to the bone tissue of the jaw using a ligament - the periodontal ligament, which has excellent innervation.

Conclusion: a tooth can only hurt if the pulp and periodontium are diseased or injured during filling.

Canal cleaning and filling

The most common cause is caries - a pathological process accompanied by the destruction of hard dental tissues. This opens access to the dental cavity, root canals and periodontal tissue, inflammation or irritation of which causes severe pain.

Preparing a tooth for filling

Filling is a method of treating caries, but this process itself can cause mechanical irritation of soft tissues, accompanied by pain. Minor pain may be normal, but sometimes you cannot do without the help of a specialist.

In the superficial and middle stages of caries, the affected hard tissues are removed and a filling is placed on top, restoring the shape of the tooth. The dental cavity remains closed. This treatment is absolutely painless and does not require anesthesia. An even more effective way is to have your teeth professionally cleaned to remove plaque and tartar. Regular implementation of this procedure prevents the development of caries and allows you to keep all your teeth healthy for a long time.

Tooth preparation and depulpation

With deep caries, a hole forms in the hard tissues and an infection enters the dental cavity, causing intense pain. In such cases, before filling, preparation is carried out to remove damaged hard tissues and expand the cavity. If necessary, the old filling is also removed. Then the pulp is removed (depulping).

This is a painful procedure, but modern local anesthetics used in dentistry allow the patient to experience no pain at all. If deep caries has developed not so long ago, and the periodontal tissues are healthy, then it is possible to remove only the pulp from the dental cavity (amputation), after which a therapeutic lining is applied and a temporary filling is installed. If there is no pain, a permanent filling is placed after a few days.

In case of long-standing caries, the pulp is first completely removed from the dental cavity, and then from the root canals (extirpation). At the same time, the cost of filling increases.

It is very important to carefully remove the pulp (patients often call it the nerve) from the canal, making sure that no particles of destroyed hard tooth tissue remain in it. All this can support a long-term inflammatory process.

If a tooth hurts after canal filling, the infection can gradually reach the root apex, causing an inflammatory process in the periodontium, accompanied by fever and pain.

Why does a tooth hurt after filling?

If a tooth hurts under a filling, there are usually natural reasons for this - irritation and even a slight aseptic (without infection) inflammatory process. The tooth should hurt after filling. Pain appears after the anesthetic wears off and is associated with restoration of tissue sensitivity. Each patient’s pain sensitivity threshold is different: one feels almost no discomfort, while another perceives the same pain as severe.

Depending on the degree of destruction of the crown and the filling work performed, unpleasant painful sensations after the end of anesthesia can last from 5 days to several months. The doctor must warn the patient that he may be bothered by painful sensations for a certain time and how to cope with them.

There is no need to see a dentist if the pain:

has a moderate aching character, lasts no more than 5 days and its intensity gradually decreases; during root canal treatment, pain can last from a week to a month; if the filling was traumatic, it may last even longer;
appears or intensifies when pressing on the filling - biting on solid food;
associated with eating irritating foods - too cold or hot, as well as sour or sweet; after the effect of irritation ends, the intensity of painful sensations decreases;
associated with hypothermia;
is not accompanied by swelling of the cheeks, increased body temperature and a violation of the general condition.

Pain associated with filling errors

Common mistakes: root canal perforation and foreign body entry into the root canal

Post-filling pain syndrome can also be associated with medical errors. This:

Lack of x-ray examination at the very beginning, before filling . The tooth may have structural features: tortuous canals, the presence of additional canals, etc. Without X-rays, the doctor will not be able to properly process and seal it. This is where the answer to the question of why a tooth hurts after root canal filling lies.
Incorrect (insufficient or excessive) drying of the prepared cavity . Drying is necessary so that the application of a special solution promotes tight adhesion of the filling material to the dentin of the dental cavity. Insufficient drying leads to disruption of this adhesion, the filling will not fit tightly to the walls, infection will penetrate into the cavity, and inflammation will begin. Overdrying is also harmful, it increases the sensitivity of tissues and post-filling pain syndrome will persist for a long time.
Overheating of dental tissues. Most often, this complication occurs when the dentist works on old equipment. Tooth preparation is accompanied by strong heating of the bur. If you do not frequently cool the dental tissues, a burn of the pulp or dentin is possible, accompanied by severe pain. Tissue burns are also possible when filling using light-curing filling material and outdated ultraviolet lamps that have not been used for a long time. Modern halogen systems for light curing do not give rise to such complications.
Failure to comply with preparation rules. Leads to infection, the development of pulpitis and periodontitis and associated pain, which intensifies when biting hard food, perforation may occur: the walls or bottom of the dental cavity; this complication occurs when the walls of the carious cavity are excessively prepared; the bottom of the cavity is most often perforated due to insufficient preparation of the walls, the inability to see and properly process the mouths of the root canals;
walls of root canals - perforation is usually associated with instrumental treatment of difficult tortuous canals. To reduce pain, you will need to apply therapeutic bandages and completely re-treat the tooth.

Incomplete pulp removal. If after filling a tooth “the nerve hurts,” it means that the treatment was carried out poorly. An inflammatory process begins in the soft dental tissues, accompanied by severe pain. To prevent this from happening, the pulp is carefully removed, followed by treatment of the cavity and canals with an antiseptic.

Insufficient preparation of the carious cavity . Repeated tissue damage by caries usually develops when the affected hard and soft tissues are removed.

Entry of a foreign body into the root canal. It could be:

a fragment of a tool used to clean the canal;

dentin sawdust formed during the preparation of the dental cavity; they clog the mouth of the root canal, which interferes with its processing and contributes to the development of the inflammatory process.

Incorrect calculation of the shrinkage coefficient of the filling material . Shrinkage and depressurization of the filling can also cause tooth pain after filling. When curing (including light curing), filling material may slightly decrease in volume. This is called shrinkage; the dentist must take into account the shrinkage coefficient of the material used (how much and after what time it will lose volume). If this is not done, over time a gap will appear between the filling and the hard tissues, where infection can enter. This will lead to the development of pulpitis and periodontitis. If depressurization occurs, the old seal is replaced with a new one.

The filling is too high, leading to malocclusion. When it comes into contact with antagonist teeth on the opposite jaw after filling, tooth pain appears when biting. To eliminate pain, you need to carefully sand the new filling and remove excess filling material. If this is not done, the pain will be constant.

Excessive introduction of filling material into the root canal. This leads to its extrusion through the top of the tooth and injury to the periodontium. Periodontitis develops. To reduce pain, it is necessary to conduct x-ray diagnostics and eliminate the identified defect.

A cyst or granuloma of the root after poor-quality filling of the root canals and the development of an inflammatory process in them. Gradually, the inflammation becomes chronic and leads to the development of a granuloma (an overgrowth of loose granulation tissue) or a cyst (a sac filled with inflammatory exudate). The pain syndrome is a constant concern and is chronic in nature. It is impossible to do without surgical intervention - removal of tumors.

Allergic reaction to filling material. The onset of an allergy is manifested by pain and swelling of the periodontal tissues. This often causes a headache. Immediate removal of the filling is required.

To determine why a tooth hurts after filling, specialists at the YuliStom clinic first conduct diagnostics (thorough examination and x-rays) and only then treat.

What to do if your tooth hurts after filling?

If a tooth begins to hurt due to a filling being placed, but its condition does not require additional dental procedures to relieve severe pain, the doctor may prescribe:

painkillers ; most often these are drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs); Ketoprofen (Ketonal) has the best analgesic properties; in case of severe pain, it is enough to take a long-acting capsule of 150 mg - these will relieve pain for a day; instead of Ketonal, you can use the rectal suppository Diclofenac - 100 mg; both drugs are contraindicated in the presence of a gastrointestinal ulcer; in such cases, it is better to take a nimesulide tablet (Nise) - it has almost no negative effect on the gastrointestinal tract;
physiotherapeutic procedures - to reduce pain, electrophoresis with novocaine is prescribed; for swelling, it is better to use hydrocortisone instead of novocaine; Magnetic and laser therapy are also used; the number of procedures depends on the patient’s condition;
a one-time injection of an antibiotic solution into the periodontal tissues - for problematic traumatic treatment to prevent infectious inflammation and pain.

There are many folk recipes for relieving severe post-filling toothache:

rinsing the mouth with a decoction of oak bark; Pour 2 tablespoons of crushed bark into a glass of water, bring to a boil, boil for 15 minutes, add boiled water to the original volume, strain and rinse your mouth several times a day; when a tooth hurts, it relieves inflammation, swelling and associated pain well;
applying a small piece of salted (but not smoked) lard to the gum - this application is especially helpful for pain associated with tissue swelling: salt draws fluid from the tissue, swelling and pain go away;
a reflex method of pain relief (used in folk medicine for a very long time): grate a clove of garlic on a fine grater, place it in a thin napkin, apply it to the inside of the wrist of the hand opposite the painful tooth, fix it and leave it overnight.

When you can and when you can’t tolerate pain after filling

My tooth hurts under a filling, what should I do? First of all, do not panic, but calmly understand the situation. If a tooth hurts after a filling, the nature of the pain and the appearance of some other symptoms matter.

Tooth hurts under temporary filling

The intensity of pain under the temporary filling should gradually decrease

Can a tooth hurt under a temporary filling? Of course, it can, but natural pain is not severe, and its intensity gradually decreases. The tooth hurts after filling, mainly during the day, when it is subjected to one or another impact - pressure (chewing hard food), drinking hot, cold or sour drinks.

Possible reasons : most often, this is normal, the tooth begins to hurt for natural reasons. Painful sensations can also occur due to overheating of tissues during preparation, light-curing of fillings, problems with drying the dental cavity after preparation, or fillings that are excessive in height.
What is the best way to relieve pain : for natural pain and pain associated with minor violations of the therapeutic process, it is enough to rinse your mouth with an infusion of chamomile flowers and take an anesthetic (Analgin, Pentalgin, Nise).

Acute pain after filling

Very often, a tooth hurts after root canal cleaning and filling. The acute nature of the pain syndrome is associated with injury or inflammation of sensitive tissues - pulp or periodontium. Much also depends on the pain sensitivity of the patient himself.

Possible reasons : incomplete removal of pulp from the tooth cavity.
What is the best way to relieve pain : take a painkiller and see a dentist.

Read more about the causes and methods of eliminating acute pain in the teeth in this article.

Throbbing pain after filling

If the tooth hurts severely after filling, the pain has become throbbing, then this is a sign of inflammation of the pulp - pulpitis. A sharp headache often appears.

Possible causes : the cause of pulsating pain syndrome may be poor-quality treatment of the dental cavity and root canals, possibly perforation of the walls.
What is the best way to relieve pain : take any painkiller orally and immediately consult a dentist.

Only a dentist can relieve throbbing pain

Aching pain after filling

When a tooth aches after a filling is placed, this is normal. How long a tooth hurts after canal filling depends on the complexity of the manipulations performed. The intensity of the pain is important: if it increases, the pain intensifies sharply when pressed, then this is a symptom of incipient inflammation. A decrease in intensity is a favorable sign.

Possible reasons : this is natural pain in a filled tooth.
What is the best way to relieve pain : rinse with a decoction of oak bark or an infusion of chamomile flowers. If the pain seems too severe, take a pain reliever.

Read about how to eliminate aching toothache here.

Tooth hurts after filling when pressing

If a tooth hurts after a filling when you bite it, then most often it has natural causes and goes away in five to seven days.

Possible reasons : if after filling a tooth hurts when pressed, then most often this is a consequence of treatment and injury to dental tissues.
How best to relieve pain : temporarily avoid chewing food on the side of the filling, rinse your mouth with light antiseptics and herbal decoctions.

How to relieve post-filling pain

Most experts advise doing nothing. If the pain is normal, it will go away on its own in due time. But, if the pain is strong and interferes with the normal flow of life, you do not have to endure it. You can use folk remedies or official medicine.

By the way. The most famous “dental relievers” have long been considered soda and salt. They have several effects at once - antiseptic, relieves inflammation, removes tumors.

Soda and salt for preparing the solution

If your tooth hurts after permanent or temporary root canal filling, rinsing is effective.

Baking soda rinse procedure

A warm, but not hot solution is made in the proportion of 5 g of soda per 200 ml of water. Boil the water first. It is advisable to carry out up to four rinses per hour, that is, every quarter of an hour.

Preparation of the solution

Salt rinsing procedure

The proportions are the same as when preparing a soda solution. You can rinse five times an hour. It is preferable to use iodized salt. If the salt is ordinary table salt, add two drops (per 200 ml of solution) of pharmaceutical iodine, with a concentration of 5%.

Salt solution with iodine

Important! Iodine is used only by patients who do not have thyroid problems and who do not have an individual intolerance to this component.

Medicines

From your home first aid kit you can use the following drugs to relieve dental pain after root canal filling: Ketorol, Ketanov, Baralgin, Nise and others.

Painkiller "Ketorol" tablets

When you need to urgently go to the clinic

Occasionally, a filling can create serious problems that require immediate attention to your dentist:

gum pain after tooth filling; if the pain does not increase, then this is a variant of the norm; but often the pain syndrome is accompanied by redness and swelling of the mucous membrane, the appearance of pus when pressing on the gums, which indicates the presence of an inflammatory process; it could be a burn to the gum tissue, an allergy to the filling material, or an infection; in any case, you need to contact a specialist;
a toothache and a sharp rise in body temperature to high numbers or a slight increase lasts more than three days, a severe headache appears;
the cheek on the side of the filling became swollen and pain of any nature, increasing in intensity, appeared in the tooth or periodontal tissues.

Don't put off visiting the dentist if your cheek is swollen or you have a fever!

Treatment of post-filling pain

Home treatment for pain that occurs after filling is fraught with serious complications. If a surgical visit to the doctor has to be postponed for several days (when the pain catches you on vacation or on a business trip), you can temporarily suppress it with the help of:

rinsing with herbs (decoctions of chamomile, calendula, sage have a calming effect);
disinfection with antiseptics (rinsing, using spray).

Painkillers and anti-inflammatory drugs should be taken with caution, always in accordance with the instructions.

You should never put off going to the doctor. But in some cases this needs to be done immediately. Delay is dangerous when:

the pain has become unbearable;
the temperature has risen;
inflammation began (gums, cheeks);
lymph nodes have enlarged;
abscesses have formed.

Incomplete treatment can lead to serious complications: the development of pulpitis, tissue necrosis, tooth destruction and loss. Therefore, try not to lose contact with your doctor until the post-filling recovery period has passed.

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Prevention

The risk of tooth pain after a filling is installed can be reduced if you follow all the dentist’s recommendations for oral care.

What not to do before filling

When planning a visit to the dentist, you need to:

choose the most suitable time so that you can rest after the filling is placed;
eat, as you will not be able to eat immediately after treatment;
Do not drink alcoholic beverages under any circumstances, as they may have undesirable reactions with the painkillers used during treatment;
Brush your teeth thoroughly and rinse your mouth with an antiseptic solution, such as mouthwash.

You should not plan to place a filling during any acute illness or exacerbation of some chronic disease.

What not to do after filling

It is important to adhere to the following tips:

do not eat or drink for two hours;
try to avoid chewing on the affected side of solid food;
do not eat too hot or cold food for 5 – 7 days;
avoid coloring products that can change the color of the filling material (beets, red wine, etc.);
brush your teeth only with a new soft toothbrush twice a day;
use an alcohol-free mouth rinse;
do not use dental floss to remove food debris; it is better to replace them with a new product - an irrigator.

Poor cleaning of the cavity

In rare cases, when installing a tooth filling, a dentist may simply not notice microscopic areas of carious lesions in the tissues. Despite treating the area with antiseptic drugs, a small amount of pathogenic bacteria may still remain in the tissues of the carious cavity. This will lead to the fact that in a year or two, the enamel in this area will be destroyed and the tooth in which the filling will ache. Often, such processes can occur chronically, without showing any symptoms for years and without needing treatment, and then one day the tooth gives acute pain, indicating the onset of inflammation in the nerve tissues.