Pain and sensitivity after filling replacement - normal or not?

[CS_]

Hello, I had an old amalgalm filling removed and replaced with a white composite one 3 weeks ago. Second to last left lower back tooth. It is a large filling. I had zero issues with the tooth previously but my dentist said the old filling was very old and was starting to leak. He recommended replacing with a white filling. He did say a crown is likely in the future.

I am still having niggly achy pain, avoiding eating on that side, and mild sensitivity to hot/cold. The pain is not horrible, it is more of an awareness/dull ache. I have taken the odd painkiller but do not feel the need to take regularly (perhaps I should - would regular ibuprofen help calm any inflammation?).

Is this normal? How long should I give it to settle / is it likely to settle? It took a lot to work up the courage to get this done and I am terrified that more work will be needed. I am losing sleep and lack of appetite for worrying . Also complicated by the fact I’m due to go on holiday (flying longhaul) in two weeks…

 

[night_natter]

Hi,

I’m not a dentist, but have been having some replacement composite fillings for amalgam fillings for the same reasons as you. I had a weird slightly achy feeling in one of mine three weeks ago. It turned out that it was slightly high and needed some follow up polishing to get my bite right. Same thing then happened with my crown (that has been put in on a molar that had an amalgam that was old, big and had a tooth crack underneath). Dentist polished it back a bit and now it’s fine.

It might be worth a visit back to the dentist. The polishing is done easily and without numbing. And if it’s anything to do with the filling beyond that, it’s probably best you let your dentist know anyway. I’m sure it will be totally fine. My fillings have settled within a few days of being in the chair.

 

[CS_]

Thank you very much for your reply with your own experience, that’s really helpful.

I went back to my dentist yesterday and he used the paper thing to identify and file down some high points. It’s hard to tell whether that has helped because I could always bite my teeth together ok, the pain was on attempting to chew food.

It was a little sore at points when he was filing it down but he said when a tooth is really inflamed they can barely touch it, so the fact I tolerated it well is a potentially good sign?

He said to give it a few days to heal and see if it settles down. If it doesn’t, then I will need a root canal and a crown

 

[night_natter]

@CS_ fingers crossed it all settles down for you!!

 

[CS_]

Hi, I posted previously about a filling I’d had replaced 3.5 weeks ago. It’s a second to last lower tooth, old amalgam which dentist said was beginning to leak (I had zero issues with it) replaced with composite. Large filling.

I’ve been having general mild aches, occasional zaps, hot/cold sensitivity, and pain on attempting to chew food. I went back to my dentist this week and he filed down some high points (this hurt in places - is that normal or should I have felt nothing?). The pain is not severe nor waking me at night (but my anxiety is, I’m on edge and all I can think about!) although I’m taking ibuprofen at bedtime.

I am flying long haul on holiday in 2 weeks (Scotland to USA) and terrified of it getting worse!

My dentist said whilst it should normally have settled by now he might have advocated ‘watch and wait’ a bit longer to see if the nerve settles, but the timing of my holiday complicates things (and here was me thinking I was being good facing up to my fear and getting it done, with an over 5 week gap, I had no idea this could happen). If it doesn’t settle it’s root canal and crown.

My options are to:

1. Keep waiting to see if it settles, and risk a flare up flying and whilst on holiday.

2. My dentist said there would be no time for a root canal pre holiday but he could ‘put on a special medicine’. He said this would get rid of any pain, and it would be a very quick appointment, but once done it definitely means root canal on my return from holiday. Does this sound like he’s suggesting a medicated filling, or is there something else? I’m worried if I go this route any temporary measure might fail / fall out whilst away. And obviously anxiety about a definite root canal.

I would be really grateful if any dentists on here could give an opinion on whether this all sounds reasonable, and what would be the best option / any other ideas. Thank you so much

 

[Gordon]

It sounds like the only viable options TBH, number 2 means putting in a medication which will effectively kill off the pulp (painlessly!) but yes it means a root treatment is essential afterwards.
Flying isn't a big risk of making things worse, usually only a problem with an actual abscess due to air pressure differences.

 

[CS_]

Thank you so much @Gordon for taking the time to reply, it is very much appreciated.

If you don’t mind me asking, if it was your tooth - or if I was your patient - what would you do? My first instinct is to wait and hope it settles but I know that is likely coming from a place of fear rather than logic. Am I kidding myself after 3.5weeks that it may settle on its own?

Another question if you don’t mind - option two, would that involve removing the existing filling to place medicine and would it then be sealed / what with? Is it safe and solid enough to last several weeks? I am having fears that if I do choose this option that a temporary solution may fall out / risk of infection etc? And would it completely kill pain?

Thank you so much

 

[Gordon]

If you don’t mind me asking, if it was your tooth - or if I was your patient - what would you do? My first instinct is to wait and hope it settles but I know that is likely coming from a place of fear rather than logic. Am I kidding myself after 3.5weeks that it may settle on its own?

I'm always a bit wary of big composite fillings. If it were my tooth I'd probably take the whole filling out and replace with a sedative dressing, then if it settled I'd get a crown or inlay done instead of a big composite.

Another question if you don’t mind - option two, would that involve removing the existing filling to place medicine and would it then be sealed / what with? Is it safe and solid enough to last several weeks? I am having fears that if I do choose this option that a temporary solution may fall out / risk of infection etc? And would it completely kill pain?

It'd be sealed up with something like a glass ionomer, perfectly able to last for months if required.

 

[CS_]

Thank you @Gordon. I really regret getting the composite now. I didn’t know about the complications so many people seem to have. Do you think after almost 4 weeks, that if it was going to settle it would have done by now?

I’m loathe to kill the tooth if there’s still a chance, but the holiday deadline is forcing a decision. If it weren’t for the holiday I probably would decide to give it a few more weeks.

Would antibiotics help to tide me over? Wondering if I could ask my dentist for a prescription and take the risk of going on holiday, with those as back up if things get worse. But I know antibiotics are not a panacea and maybe not appropriate/wouldn’t help. I’d hate to be on holiday in worsening pain and in need of emergency help.

Thanks again for all your help.

 

[Gordon]

Do you think after almost 4 weeks, that if it was going to settle it would have done by now?

Probably but it's not a definite. Depends why it's grumbling in the first place I'm afraid.

Would antibiotics help to tide me over? Wondering if I could ask my dentist for a prescription and take the risk of going on holiday, with those as back up if things get worse.

It probably wouldn't help, but I'd take some antibiotics with me if it were me. Depends where you're going, some places like Spain you can buy Penicillin without prescription...

 

[CS_]

USA @Gordon . My dentist has only given me the option of killing the pulp and planning a root canal once back. I wonder whether I should ask him for antibiotics and take the risk on holiday hoping it settles down - or at least that the antibiotics keep me pain free until I am home and don’t feel so rushed into a decision. I don’t know if that is an option / if the antibiotics would relieve the pain. Maybe I should just go ahead with the kill now before holiday (is that a guarantee of pain free!) if a root canal and crown is looking likely in my future anyway.

Wish I had never had the replacement filling, or at least postponed it (l had already postponed it twice since Christmas and thought I was being good facing my fears and getting it done!). I’m a 41 year old professional (solicitor) woman and should know better. Benefits of hindsight! I had no idea fillings could cause this much trouble.

 

[Gordon]

Unfortunately antibiotics may not help. The pain may be from the pulp dying, which antibiotics won't help at all. However, I'd still have some with me just in case.
Pulp kill is more likely to stop it hurting but with all biological processes, there's no certainties, sorry!

If you'd postponed it though it was even more likely to need RCT/Crown than not.

 

[CS_]

Thanks @Gordon . I contacted my dentist. He has booked me in next week (2 days before I fly! ) to give it a little more time to see if it settles, and if not, treat there and then (to kill it I presume). By the time of next weeks appointment it will have been over 5 weeks since the replacement filling.

He seems to think that as it is not getting worse, that there is still a chance. I badly WANT to believe this and for this to be the case…… we’ll see. I am still having intermittent spontaneous mild pain, and sensitivity to cold and chewing, but nothing terrible. Ibuprofen helps and it doesn’t wake me in the night.

I am praying it resolves itself by next week so that no scary time-pressured decisions have to be made…

 

[Gordon]

Fingers crossed for you

 

[CS_]

So 5 weeks today since the filling replacement, 1 week since adjustment, and little change. No worse, but no better. Still having random (mild) pain which resolves with ibuprofen, cold sensitivity, can’t chew food on that side. Dentist appointment tomorrow and I’m scared. Flying to USA two days later on Thursday, for two week holiday. I will follow dentist’s guidance, but if he leaves the decision to me I really don’t know what I’ll do in the chair. Leave it as it is with the mild pain, take ibuprofen, and hope and pray it doesn’t flare up or get worse whilst away - VERSUS doing further temporary treatment which may keep things comfortable, if I have understood it right (but will definitely require root canal and crown once back) but also potentially could make it worse . I know he cannot provide guarantees either way. Dilemma. Wishing I could turn back time…

 

[CS_]

Well I was so anxious but made it to the dentist today.

X-ray and visual exam = no visible issues. Filling looks fine. No visible cracks. Filling is large/deep, but when compared to previous x-ray it is no nearer to the pulp than before.

Dentist thinks perhaps hairline crack(s) invisible to the naked eye may be contributing to the sensitivity and causing the pulp to be irritated.

He advised usually if endo/RCT is going to be required it would usually make itself known by about the 3 week mark. And that symptoms would worsen (I am at the 5 week mark with not much change).

He said my tooth is not behaving predictably and it is therefore on the fence. He said he would do ‘the nuclear option’ of a pulpotomy today if I requested it, but his instinct is to ‘watch and see’. He acknowledged it is not ideal with my upcoming holiday as we are only going to know in hindsight what the correct course of action is….

I hope I have made the right choice. I do trust my dentist so I was guided by his instinct, but as he rightly explained, no guarantees either way.

I have been prescribed diclofenac to take with me. He did not think antibiotics would be helpful as no sign of infection today and said any risk of future infection would take a while to establish so a pre-emptive ‘just in case’ antibiotic prescription not needed.

Apologies for the long message. I always think it’s helpful when reading threads myself when the poster updates.

 

[Gordon]

I always think it’s helpful when reading threads myself when the poster updates.

I agree. I hope you have a great holiday.

 

[CS_]

Thank you Gordon Do you think this all sounds reasonable? My dentist did say that he leans to the conservative side whereas others may advocate for action straightaway. I guess theres no right or wrong and only time will tell.

 

[MumOfBoys1985]

Hopefully it'll behave. Have a fabulous holiday

 

[Gordon]

Do you think this all sounds reasonable?

Yes. Totally reasonable.