I had a filling redone about 4 months ago and have had on and off pain ever since. It can get quite severe when it comes and recently it's been worse. It's like nerve pain mixed with an ache spreading through most of the teeth on that one side and even into my sinuses/eye/neck/jaw... I went to the dentist and got an x-ray of the tooth and he said the filling is NOt near the nerve but there is a dark shadow under the filling which could be an air space ... But I don't understand how this could be causing me all this pain... he recommmended replacing the filling before considering root canal...? Please give advice, im worried, thanks!
Pain for months, shadow under filling
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honestdoc
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Please provide x-ray image(s). Most likely the dentist placed a tooth colored filling called composites. Modern composites shrink about 1 percent during light curing. This shrinkage can create sensitivity, micro gaps, and bonded teeth micro fractures. On x-rays, there may be a dark line under the filling. We don't know if it is a gap, a cavity, or extra bond that pooled underneath.
Most dentist will disagree with me but I like the latest glass ionomer filling. It bonds naturally with no shrinkage and naturally desensitizes the nerve. Traditional Glass Ionomers do not have good wear strength but the latest Fuji Equia had shown similar wear strengths as flowable composites. An even better product is called Activa Bioactive restorative composites which is stronger and mimics natural teeth. Most dental clinics don't use this product because of its high costs. Many dentists in the US don't use amalgam "silver fillings" anymore. Amalgams have a longevity track record. I find them to be stronger than surrounding tooth structure and in larger fillings (less tooth remaining), the teeth tends to chip or fracture. I hope the bioactive restorative materials will be more available in the future.
Most dentist will disagree with me but I like the latest glass ionomer filling. It bonds naturally with no shrinkage and naturally desensitizes the nerve. Traditional Glass Ionomers do not have good wear strength but the latest Fuji Equia had shown similar wear strengths as flowable composites. An even better product is called Activa Bioactive restorative composites which is stronger and mimics natural teeth. Most dental clinics don't use this product because of its high costs. Many dentists in the US don't use amalgam "silver fillings" anymore. Amalgams have a longevity track record. I find them to be stronger than surrounding tooth structure and in larger fillings (less tooth remaining), the teeth tends to chip or fracture. I hope the bioactive restorative materials will be more available in the future.
honestdoc
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Pain may result from factors such as recent drilling, proximity of filling to nerve (pulp), possible gap or marginal seal deterioration, bite may be off, or isolated/routine grinding and clenching . Again, it is hard to determine if the black line is a gap or pooling of extra bond. I don't think it is a cavity since it was recently restored. I'm very conservative...less drilling the better. When fillings get replaced, there are more drilling on teeth involved. The best scenario would be to assess the filling and maybe not replace it if appropriate. The sensitivity most likely cold can lessen with time. I tell my patients that if the tooth feels cold, then the nerve of the teeth is working properly. Just don't overwhelm it with too much cold which can damage the nerve. If the pain gets too intense such as waking you at night, then the nerve is damaged and the tooth will need a root canal.