Handling Post-Op Sensitivity

Sensitivity after dental treatment, such as a filling or a crown, can be very common. This often causes concerns to patients, since the tooth likely went a long duration of time without any symptoms or discomfort at all prior to the procedure. They may get frustrated, thinking that it’s only worse after treatment, or that something went wrong during their procedure. Postoperative sensitivity is completely normal, as well as temporary. 


But why does postoperative sensitivity occur? Well, this is because the steps that are used by dentists in order to restore tooth structure to damaged and decayed teeth create temporary irritation and sensitivity to the inside part of the tooth and the nerve inside of it. Even when the nerve is dead, in the case of a root canal, this rings true: the root canal space is a closed system, not getting much blood flow to it. This means that any trauma to the area will irritate it, and cause a toothache as the body heals and adjusts to the dental work that was finished. These are some of the most common examples of postoperative sensitivity. Everybody is different, but if a patient calls complaining about discomfort following a procedure, it will most likely be regarding one of the more common scenarios such as those listed above. 


Some patients are more prone to postoperative sensitivity than others. This may be true for those who:


  1. Have a chronic inflammatory medical condition. Patients with chronic inflammatory medical conditions or autoimmune conditions have an exaggerated inflammatory response and therefore may have more severe post-operative sensitivity due to higher levels of inflammatory markers in the blood. These patients are at a higher risk for complications and infections after receiving extensive dental treatment. 
  2. Grind their teeth. Patients who grind their teeth typically experience more post-operative sensitivity including aching and a bruised feeling around the roots of the teeth after dental treatment. Teeth grinding and clenching cause stress to the nerve. When the nerve is already stressed from dental treatment, this added stress from grinding or clenching increases the inflammation of the nerve even more. Patients should be educated that wearing a night guard after the treatment plan is completed will help reduce the amount of stress on the nerve, as well as prolong the life of the dental restorations. 


Keep in mind, pain isn’t enjoyable for anybody to experience, and patients are more likely to become upset or frustrated if they are in pain. Maintaining proper empathy when discussing these issues is a must. There are also many things that you can say to address their concerns and ease any worries or frustrations that they are having. 


Cavity Treatment 101: Why Does it Hurt Afterwards?

When a dentist removes a cavity, the following process happens: 


  1. The dentist drills out the cavity. 
  2. THe dentist applies a strong acid to clean out the remaining bacteria. 
  3. Then, he/she applies chemicals, which act as glue for the white fillings to adhere to the tooth. 
  4. Lastly, the dentist uses a UV light to light-cure the filling, making the softened material harden inside of the tooth. 


Even though you don’t do anything on the clinical end of dentistry, it’s extremely important to understand the basics of dental diseases and treatment methods. Therefore it’s a great idea to view the videos listed below – you can fast-forward to the main steps. 


WATCH: “Dental Cavities


WATCH: “Removing a Cavity


Understandably, these things cause sensitivity and irritation to the inside parts of the tooth, including the nerve space. This is what makes cavity treatment so frustrating for many patients, especially if they had not felt the physical symptoms of their decayed tooth prior to treatment. There is a reason for the sensitivity, of course, making it entirely normal – that reason lies in the basics of our oral anatomy. The root canal space is a closed system, meaning that it does not get any blood supply. Any trauma to the tooth, including fixing cavities, can irritate the tooth and lead to the development of a toothache. 


Helping Patients Who Suffer from Post-Op Sensitivity 

The reason that this topic is located in the conflict prevention module is because of how the patient might handle the unpleasant sensations following their dental procedure. In their mind, they spend money and time and maybe even stress by coming in to get their cavity treated, and yet the only result that they can feel is pain and discomfort. Sometimes, patients who are not properly warned in advance about post-operative sensitivity, can result in negative emotions or behavior. This could be tricky to navigate correctly – even if it might be frustrating to you, you must keep in mind that the patient does not know what you know, and that they are in pain. 


Additionally, it is extremely important to know how to navigate such a subject because you will need to be sure to extract enough information from the patient about their specific symptoms in order to gauge whether or not an abnormal reason is the cause of the pain and not just the normal healing process.


According to research, here are a few things that you can suggest to the patient to reduce normal postoperative sensitivity following a dental procedure: 


  1. Alternate Ibuprofen and Tylenol every four hours. This is the most effective way to control post-operative sensitivity following dental work.
  2. Use sensitivity strips by Crest. 
  3. The patient should check their bite to make sure that it feels right once they are no longer numb. When they are numb, they won’t be able to tell if the filling is properly leveled and contoured.
  4. Use sensitivity protection toothpaste. These toothpastes contain potassium nitrate, which helps the symptoms of irreversible pulpitis.


Of course, the chances of their sensitivity being caused by something other than the natural healing process is not to be discarded — while most sensitivity is normal, it is never recommended to discount the patient’s perspective or downplay the significance of what they are trying to describe. Not only will this possibly cause an issue to go overlooked, but it will also make the patient feel unheard, and belittled. Combine two of those things and you’d have a very (rightfully) upset patient, which is certainly not ideal. 


Conditions Which Cause Post-Op Sensitivity

Some conditions which cause post-operative sensitivity are urgent, while some are not so. If they are potentially experiencing something that could require urgency of treatment, you will then have an emergency appointment to schedule on your hands. Because of this, it’s a great idea to familiarize yourself with some of the common abnormal sensitivity causes and take note of the urgency of each possibility.



Commonly Asked Questions from Patients

“My tooth did not hurt before fixing cavities, but after my recent dental work, I now have a severe toothache.” Typically, small to medium-sized cavities do not hurt – after a tooth has been treated with a filling, the body will respond by creating short-term inflammation. This is the body’s effort to heal the area, and this will occur in any part of the body after you have any operation. If this discomfort does not subside after a period, the tooth may not have responded normally to the treatment. In cases where the tooth responds by creating chronic inflammation over a long period, it is possible that the tooth was unable to heal normally and will require a root canal. If this occurs, it is important to call us. We will examine the area and help determine if further treatment is necessary.  


“How long will my tooth hurt after a filling?” Every patient is different, and it can depend on the treatment performed. In most cases, symptoms will improve within a few days or weeks. It can take up to eight weeks for acute inflammation to subside. If you are still experiencing symptoms months after the treatment, it is possible that the tooth was unable to recover properly and chronic inflammation set in, requiring further treatment. Patients with inflammatory medical conditions or autoimmune diseases may experience prolonged healing time and increased symptoms during the healing phase. 


“What is the best sensitivity prevention toothpaste to stop toothaches after dental work?” Sensodyne is a great option, but any brand that contains fluoride and potassium nitrate is effective in reducing sensitivity. Crest Sensi-Stop Strips are also a great option. 


“My tooth did not hurt before I had my cavities fixed, but after my dental work, I now have a severe toothache.” Usually, small to medium-sized cavities do not hurt. After the tooth has been treated with a filling, the body responds by creating short-term inflammation. This is the body’s attempt to heal the area. This is true of any part of the body after an operation. If this discomfort does not eventually subside, the tooth may not have responded normally to the treatment. In cases where the tooth responds by creating chronic inflammation over a long period, it is possible that the tooth was unable to heal and will require a root canal. If this occurs, it is crucial to call us to examine the area and help you determine if further treatment is necessary.


“My teeth are very sensitive to cold and hot after recent fillings, is it normal?” Sensitivity is common after the placement of a filling. Sensitivity is the result of your tooth healing itself. The nerve inside the tooth will become irritated any time a tooth is treated. Eventually, this discomfort will subside. This is if everything is healing normally. Using sensitive toothpaste and taking ibuprofen can help ease these symptoms during the healing process. Patients with poorly-controlled chronic inflammatory medical conditions or patients with autoimmune diseases may experience more sensitivity than other patients due to their overreactive immune systems.


“My tooth is very sensitive to biting after recent dental work, is this normal?” When the filling is finished, and the dentist is making the final adjustments to the bite, it is often possible that patients are unable to bite and chew as they normally would due to the effects of the local anesthetic. This can lead to a bruised, sore feeling when patients bite or chew afterward. This is easily adjusted by your dentist and the best if done when the patient is not numb. If patients grind or clench their teeth, the sensitivity from the dental work can be made worse. Grinding teeth creates inflammation in the nerve and in the ligament that surrounds the teeth. This creates a bruised or painful sensation when patients chew. Patients who grind their teeth would benefit from a custom night guard to create a cushion between the teeth and reduce the amount of pressure exerted on the teeth that have had dental work performed on them.


“What can I do to ease a persistent toothache after my recent dental work?” Aching and temperature sensitivity are normal symptoms after receiving dental work. Your body is sending inflammatory cells to the area to help with the healing process. Aching can increase from clenching and grinding the teeth. This discomfort is temporary and should subside over time. Wearing a nightguard can help reduce the aching and tenderness for patients who clench and grind. During this time, it is advised that you take ibuprofen or Tylenol to help manage the inflammation, along with using sensitivity toothpaste. 


“I had a dental crown placed and now I have a toothache after getting my new crown. Is it normal?” There are three potential reasons this may be happening. One reason is that the nerve of the tooth is irritated from the procedure and needs some time to calm down and heal. This is a normal part of the healing process after dental work is performed on any tooth. Another reason is that your bite may need an adjustment. The third reason could be that the tooth was unable to heal itself and is now in a state of chronic inflammation. Which is a condition that will require a root canal. If you have inflammatory medical conditions like diabetes, high blood pressure, or rheumatoid arthritis, it is possible that you may need more time to heal after treatment. 


“I had a dental bridge placed, and now I have a sharp pain years later. Is it normal to have pain/toothache under my dental bridge?” It is typically not a good sign if there is pain around older dental restorations years after they were placed. The supporting teeth around the bridge may have decayed around the edges of the bridgework, reaching the nerve and causing infection. It is a good idea to call our Lincoln dentists and examine the area with x-rays to determine the cause of this pain.


“I have a toothache after a dental filling, do I need a root canal?” It is common to experience some discomfort for a few weeks or months after a filling. This is a normal part of the healing process. If this discomfort does not subside over time, it is possible that the nerve did not respond normally to the treatment and has developed chronic inflammation. When this happens, sometimes a root canal is the best option to save the tooth.


“Can I get a cavity under a new filling?” Unfortunately, very little of our dental work will last a lifetime. The mouth is exposed to strong chewing forces, temperature changes, bacteria, and acid from our diet. It is possible that cavities can form around the margins of fillings. To help your dental restorations last longer, it is a good idea to practice good oral hygiene, brushing at least twice daily, flossing, and using a mouth rinse. Avoiding sugary or acidic drinks, grinding or chewing ice can help prolong the life of your dental work as well. 


“How do I take care of a new dental filling?” The most common reason fillings need to be replaced more frequently is grinding, chewing ice, or not practicing good oral hygiene. It is a good idea to see your dentist regularly for checkups to examine the integrity of your restorations and help you identify any causes for abnormal wear and tear on your dental work.