I’ve been waiting almost a month to get my teeth whitened because my dentist replaced silver fillings with composite in four teeth, and one bottom molar tooth is super sensitive. My dentist wants me to wait because he says the bleaching gel might make the sensitivity worse.

The is sensitive to cold, and I feel a little pain when I chew. And I feel mild discomfort around my jaw and tonsil and slight tingling in my lower jaw and chin. After dinner, the pain is continuous, but I take ibuprofen for it. In the morning, I don’t have any pain.

Should I ask my dentist to replace the filling or wait to see what he recommends? Thanks. Charlie from CT

 

Charlie,

Although you thoroughly described your symptoms, Dr. Szarek would need additional information for an accurate diagnosis, including:

• The size of your filling
• The depth of the filling
• What an x-ray shows

But we can provide some insight into what may be causing your discomfort.

What Causes Pain and Sensitivity in White Fillings?

Some factors that cause pain and

• Moderate pain when chewing. Moderate pain and sensitivity are common if you have a large filling that has changed your bite. Another cause for mild pain is trauma to the ligament that attaches your tooth to the jawbone. In either case, mild pain should gradually decrease
• Minimal sensitivity to cold. When a dentist gets close to the tooth pulp to remove decay before placing a large or deep filling, it can irritate the tooth. Mild sensitivity to cold is common for amalgam (silver) fillings, but it can occur with deep composite fillings. If the sensitivity gradually improves, you don’t need additional treatment.
• Evening moderate, but continuous pain. Spontaneous, lingering pain can occur with pulpitis. Pain increases when you lie down. Although a deep filling can cause sudden pain, bacteria might have infected the pulp. But this doesn’t mean that your dentist is at fault. As decay is removed, some bacteria enter the tooth’s dentinal tubules. A tooth can recover from minimal bacteria. But if your discomfort is not improving, you need further treatment.
• Pain in your jaw and tonsil. Although jaw and tonsil pain are not related to your filling, the procedure might have stressed your muscles and tissue.
• Lower jaw tingling and numbness. While numbing your lower left jaw, your dentist probably directly hit a nerve or even nicked it. The nerve runs on the side of your tooth, jaw, and chin, and the sensation will go away in time.

Allow some time for the sensitivity to go away before you get teeth whitening. If your discomfort doesn’t improve, you can get a second opinion from a dentist with advanced training in root canal treatment or an endodontist (root canal specialist). If the root tip has a wide periodontal ligament space, you may need root canal treatment. Get it done before your pain and discomfort get worse—and before getting your teeth whitened.

Michael Szarek, DMD, of Lowell, MA, sponsors this post.