Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Dr. Amanda Rizner
Dental restorations such as fillings, crowns and root canals are common treatments for dental caries commonly known as “cavities.”
They restore the structure and function of teeth damaged by decay. While these procedures are generally effective in preventing further decay and preserving tooth integrity, some patients may experience sensitivity after the tooth is restored or fixed. This sensitivity is not abnormal and can range from mild discomfort to sharp pain and can occur immediately after or develop over time. Understanding why teeth can be sensitive is essential for both patients and dental professionals to address and manage this common issue effectively.
Nerve Irritation
One of the primary reasons for sensitivity after a dental work is irritation to the tooth’s nerves. During the process of fixing the tooth, the dentist removes decayed tissue and prepares the enamel or dentin for its restoration. This causes movement of the fluid within the dentinal tubules inside the tooth, which causes stimulation of the nerve and can lead to sensitivity. Some decay can be located very close to the tooth’s nerve and can cause the nerve to immediately or eventually die. This will lead the tooth to become infected over time and a root canal or extraction will be necessary. Dentists can place medication near the nerve to help lessen the chance of this from occurring but it cannot always be prevented. The patient’s age, size of the decay lesion, and size of the pulp (nerve) can all contribute to why a tooth may be sensitive after placement.
Temperature Sensitivity
Dental restorations, particularly those made of metal amalgam or composite resin, can conduct temperature changes more efficiently than natural tooth enamel. As a result, patients may experience increased sensitivity to hot or cold foods and beverages. This sensitivity is often temporary and should subside as the tooth adjusts to the presence of the restoration. Dentists will normally tell patients that the temperature sensitivity, even if intense, should go away quickly within ten seconds. This type of discomfort should subside weeks after the tooth is fixed. Patients should use sensitive based toothpaste, and eliminate any whitening products to help expedite this process.
Post-Operative Inflammation
After the procedure, it is not uncommon for the surrounding tissues to become inflamed as part of the body’s natural healing response. This inflammation can cause temporary sensitivity and discomfort in the treated tooth. Inflammation typically resolves on its own within a few days, but patients may experience sensitivity during this healing period. We recommend using warm salt water rinses in order to provide relief from this type of discomfort.
High Restorations
If the material is not properly contoured or if it extends too far above the surface of the tooth, it can create an uneven bite. This can cause excessive pressure on the tooth when chewing or biting down, leading to sensitivity or discomfort. In such cases, adjustments may be necessary to ensure a proper fit and alignment of the restoration with the surrounding teeth. The sensitivity normally will subside after such adjustments are made.
Jaw Pain
Some patients may experience jaw discomfort after the procedure that can be due to many reasons. The injection technique used to anesthetize certain teeth requires that dentists place a needle near or through larger chewing muscles. This can cause minor trauma to surrounding blood vessels and can, in return, leave the patient with some discomfort opening or closing their jaw for a few weeks after the procedure. Patients who have had previous issues with their temporal mandibular joint (TMJ) may also have difficulty keeping their jaw open for longer procedures, which can lead to muscle tension. Dentists can provide “bite blocks” for the patient to rest their jaw on, in order to help reduce this tension.
Microleakage
Some dental restorations, such as clear fillings, will not always create a perfect seal. This could be because the filling material does not adequately bond to the tooth or if there are gaps between the filling and the tooth surface. Bacteria and debris can infiltrate the area, leading to irritation and sensitivity. This phenomenon, known as microleakage, can compromise the integrity of the filling and increase the risk of recurrent decay. For this reason, dentist aim to keep the tooth very dry during its placement, and sometimes will use a rubber dam over the tooth in order to provide ultimate isolation. There also other biocompatible materials that can be used in order to try to eliminate this leakage during filling placement.
Managing Sensitivity After Dental Procedures
Use Desensitizing Toothpaste or Prescription toothpaste
Specialized desensitizing toothpaste containing ingredients such as potassium nitrate or fluoride can help alleviate tooth sensitivity by blocking nerve impulses and strengthening tooth enamel. For patients who wish to avoid fluoride, there are alternative options such as hydroxyapetite or calcium phosphate. Patients should use desensitizing toothpaste regularly as part of their oral hygiene routine to minimize sensitivity over time. They should also avoid any whitening products, as these can worsen symptoms. Dentists can also prescribe toothpastes with a higher concentration of fluoride.
Avoid Extreme Temperatures
Patients with sensitive teeth should avoid consuming excessively hot or cold foods and beverages, as these can exacerbate sensitivity. Instead, opt for lukewarm or room temperature items and use a straw to minimize contact with sensitive teeth. Minimizing food concentrated with sugar will also provide benefit.
Follow-Up with Your Dentist
If sensitivity persists or worsens after receiving dental treatment, it is essential to follow up with your dentist for evaluation. Your dentist can assess the restoration’s integrity, address any issues such as high spots or leakage, and recommend appropriate treatment options to alleviate sensitivity. There are also some desensitizing agents the dentist can place on the filling in order to provide relief. However, if sensitivity persists due to a very large cavity or crack present, further evaluation and treatment may be warranted.
Conclusion
Sensitivity after dental work is not uncommon and can arise from various factors, including nerve irritation, temperature changes, inflammation, and filling defects. Understanding the underlying causes of sensitivity is crucial for implementing effective management strategies and ensuring optimal outcomes for patients. By addressing sensitivity promptly and proactively, dental professionals can help patients achieve lasting comfort and maintain healthy smiles for years to come.
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