Fillings FAQ

Content provided by Cleveland Clinic.

Will I experience sensitivity around the filling following the procedure?
Tooth sensitivity following placement of a filling is fairly common. A tooth may be sensitive to pressure, air, sweet foods, or temperature. Usually, the sensitivity resolves on its own within a few weeks. During this time, you should avoid those things that are causing the sensitivity. Pain relievers are generally not required.

Contact your dentist if the sensitivity does not subside within 2 to 4 weeks or if your tooth is extremely sensitive. He or she may recommend you use a desensitizing toothpaste. Your dentist may apply a desensitizing agent to the tooth or possibly suggest a root canal procedure.

Rather than "sensitivity" around my new filling, I'd call the sensation I feel "pain." What's the cause of this pain?
There are several explanations for this pain, each resulting from a different cause.

• Pain when you bite With this type of pain, the pain occurs when you bite down. The pain is noticed soon after the anesthesia wears off and continues over time. In this case, the filling is interfering with your bite. You will need to return to your dentist and have the filling reshaped.
• Pain when your teeth touch This is a very sharp pain that occurs only when your teeth touch. The pain is likely caused by the touching of two different metal surfaces (for example, the silver amalgam in a newly filled tooth and a gold crown on another tooth with which it comes into contact). This pain should resolve on its own within a short period of time.
• "Toothache-type" pain If the decay was very deep to the pulp of the tooth, this "toothache" response may indicate this tissue is no longer healthy. If this is the case, root canal treatment will be required.
• Referred pain With this type of pain, you experience pain or sensitivity in other teeth besides the one that received the filling. In this situation, there is likely nothing wrong with your teeth. The filled tooth is simply passing along "pain signals" it's receiving to other teeth. This pain should decrease on its own over 1 to 2 weeks.

Is it possible to have an allergic reaction to amalgam?
It is possible, but fewer than 100 cases have ever been reported, according to the American Dental Association. In these rare circumstances, mercury or one of the metals used in an amalgam restoration is thought to trigger the allergic response. Symptoms of amalgam allergy are similar to those experienced in a typical skin allergy and include skin rashes and itching. Patients who suffer amalgam allergies typically have a medical or family history of allergies to metals. Once an allergy is confirmed, another restorative material can be used.

My dentist told me that I need to have a filling replaced. If my tooth doesn't hurt and my filling is still in place, why would the filling need to be replaced?
Constant pressure from chewing, grinding, or clenching can cause dental fillings to wear away, chip, or crack. Although you may not be able to tell that your filling is wearing down, your dentist can identify weaknesses in your restorations during a regular checkup.

If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscess.

If the filling is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.

What causes a filling to simply fall out?
New restorations that fall out are probably the result of improper cavity preparation, contamination of the preparation prior to placement of the restoration, or a fracture of the restoration from bite or chewing trauma. Older restorations will generally be lost due to decay or fracturing of the remaining tooth.