Educate Yourself
Post-Op Sensitivity
What to expect after a filling, and how we help prevent it
Postoperative tooth sensitivity with composite restorations is a common, yet unpredictable, part of dentistry. Sensitivity that occurs on teeth that were not sensitive before treatment can be unsettling — but it is important to note that this is far preferable to the more extensive and expensive treatment that results from postponing necessary dental care.
Decay and existing fillings act as insulation over the nerve and dentin. Removing this insulation during treatment — combined with the mechanical and chemical trauma of the procedure — can result in temporary post-op hypersensitivity. As the tooth heals, sensitivity should become less frequent and less severe; this can take days to weeks, and occasionally months.
Understanding Tooth Anatomy
Enamel is the hardest tissue in the body, forming the tooth's outer layer and protecting it from pressure, bacteria, and temperature changes. Dentin lies beneath the enamel and contains microscopic fluid-filled channels connected to the nerve. Hot, cold, and sweet foods move this fluid, which can trigger a twinge of discomfort or a short, sharp pain.
Crown / Enamel
Hardest tissue in the body; the visible outer layer.
Dentin
Beneath enamel; fluid-filled channels connect to the nerve.
Pulp / Root Canal
Contains nerves and blood supply running through the root.
Gum / Alveolar Bone
Soft tissue and bone that support and anchor the root.
Progression of Caries
1. Incipient Lesion
Decay limited to the outermost layer of the tooth (enamel).
2. Moderate Lesion
Decay penetrates through enamel and reaches the dentin layer.
3. Advanced Lesion
Decay is within the dentin layer but has not yet reached the pulp.
4. Pulpitis
Decay reaches the pulp — see reversible vs. irreversible pulpitis below.
Why a Tooth May Become Sensitive
High Bite
A filling that sits slightly high can make a tooth sore over a few days. A quick chairside adjustment usually resolves this completely — don't hesitate to return to the office.
Reversible Pulpitis
Inflammation of the pulp that is expected to resolve and heal over time, much like a bruise. Manifests as pain on hot/cold stimulation that does not persist, and typically settles within days to weeks.
Irreversible Pulpitis
With deep decay, the pulp can become irritated beyond recovery. Symptoms include intense or throbbing pain, pain that persists after stimulus is removed, pain that wakes you at night, or spontaneous pain — root canal therapy is the treatment needed to save the tooth.
Things You Can Do to Reduce Sensitivity
Any time you have sensitivity or questions about your symptoms, call or email us — communication is key.
- —Anti-inflammatory medication: 400mg Ibuprofen every 8 hours for a few days post-op, combined with Tylenol 500 every 6 hours as needed. Take with food.
- —Sensodyne use: After brushing, flossing, and rinsing with a fluoridated rinse, apply a small amount of Sensodyne along the gum line of the affected tooth with a Q-tip.
- —Soft & temperate diet: Avoid hard or sticky foods and chewing directly on the filled tooth; avoid extreme temperatures on the affected side.
- —Good oral hygiene: Continue brushing, flossing, and rinsing as usual. Warm salt water rinses speed gum healing.
Preventive Measures We Take
- —Use of self-etching primer
- —Applying tooth-desensitizing (GLUMA) solutions before filling placement
- —Laying a thin resin-reinforced glass ionomer liner on the deepest cavity surfaces
- —Inserting a layer of flowable composite between the tooth and final filling
- —Layering of filling material