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Pain after Filling

I recently had a silver filling replaced with a composite filling. I was careful to go to a mercury-free dentist so they would know how to safely remove the silver filling. It’s been a couple of weeks and I am still having some weird sensitivity and pain. Here are my specific symptoms:

  1. Medium pain when chewing
  2. Mild sensitivity to cold
  3. Tingling in lower right jaw where the filling was replaced

Does this mean there is something wrong with the filling or is this normal?

Luke H.

Dear Luke,

Man holding his jaw in pain

I appreciate how thorough you were in listing your symptoms. The only additional thing I wish I knew was how large and/or deep the filling was. Additionally, I wanted to add that it was wise of you to go to a mercury-free dentist for this filling replacement. Too many patients think any dentist can remove their amalgam (silver) fillings and end up swallowing or inhaling a lot of mercury. Going to a dentist who knows how to do a sanitary amalgam removal is imperative.

Now, onto your question. I’ll go through your symptoms one by one and do my best to point you in the right direction with this filling.

Pain When Chewing

Because your pain is moderate, there are two possible causes that come to mind. The first is if the filling was large, it could have changed your bite somewhat. A second possibility is trauma to the ligament. Our teeth have ligaments attached to help them. The filling process could have caused some aggravation or trauma to that ligament. This should get better over time. I would take some ibuprofen to help with the pain and give it some more time.

Let me differentiate this from sharp pain, for the benefit of others reading this. Sharp pain when chewing is indicative of bonding failure. In that case, you’d want to have the filling replaced.

Sensitivity to Cold

While this is a routine problem with silver amalgam fillings, it also can happen with composite fillings if the decay was deep. This is because the dentist has to get close to the pulp and it can irritate it making it sensitive.

As long as this is getting better over time, then this is a normal issue and nothing to worry about. If it does not get better or worsens, then further diagnostics are needed.

Tingling in Jaw

This seems to indicate to me that your dentist used some numbing medication and hit the sweet spot directly. The nerve he or she was aiming for goes to the teeth, lip, and chin. Some residual tingling is normal when the dentist was so close. (A good thing for you during the procedure). This will gradually wear away and be of no concern.

If you get to four weeks and there is no improvement or the pain increases, I would see an endodontist and have them x-ray the tooth. They are great at radiographic diagnosis. They can let you know if a root canal treatment is necessary.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.