Installing a filling is a standard procedure that every person faces sooner or later. Using special material, the doctor restores part of the dental tissue that was lost due to therapeutic or restorative measures. Most often, filling is used during the fight against caries and pulpitis. In the latter case, it is assumed that the channels are cleaned and then filled with a composite solution.
These measures are aimed at eliminating physical and pain factors. During the rehabilitation process, the patient may feel discomfort for some time.
Pain is observed in 80% of people, which is considered a normal reaction of the body to aggressive intervention. They take place within 3-14 days, depending on the complexity of the procedure and the physiological characteristics of the individual patient.
What to do if the pain does not subside when pressing hard on the tooth after filling? What could this be connected with, why does this happen?
These measures are aimed at eliminating physical and pain factors. During the rehabilitation process, the patient may feel discomfort for some time. Pain is observed in 80% of people, which is considered a normal reaction of the body to aggressive intervention. They take place within 3-14 days, depending on the complexity of the procedure and the physiological characteristics of the individual patient. What to do if the pain does not subside when pressing hard on the tooth after filling? What could this be connected with, why does this happen?
Symptoms of periodontitis
Let's start with the fact that in the initial stages the disease occurs without symptoms, and it can only be detected at a dentist's appointment; this will require an x-ray. Symptoms appear in the stage of acute periodontitis or as a result of exacerbation of the chronic form. Among the signs of the disease:
- sharp or aching pain;
- swelling of the gums in the affected area;
- feeling as if the tooth has become taller;
- temperature increase;
- sleep disturbance;
- tooth mobility;
- tissue redness;
- pain when touching a tooth or chewing food.
If at least two symptoms occur, contact your dentist.
Causes
Before you begin to eliminate the problem, it is necessary to determine the cause of the occurrence, depending on which the diseases are distinguished:
- Traumatic - occurs when there is a mechanical action on the jaw, such as a blow, bruise, or even getting hit by a bone when eating food. Also with regular small impacts, such as biting off threads.
- Medication - in case of non-compliance with the doctor’s visit schedule: sometimes a strong medicine is placed in the root canal, and the next appointment time is not just prescribed. Ignoring it leads to acute periodontitis.
- Infectious - the culprit is streptococcus, which accumulates in the affected tissues and provokes inflammation.
Among the ways of “infection” there are:
- intradental - or canal, that is, toxins and bacteria move through the root canal, infect the pulp and lead to death in the periodontal tissues;
- extradental - less common - inflammation spreads from surrounding tissues not directly related to the dentition - sinusitis, osteitis, etc.
Even less often, the transition occurs through blood and lymph.
Pulpitis and periodontitis are often confused, but:
- first - inflammation, which occurs due to the penetration of microbial organisms, affects the pulp - the inner part of the tooth, where the nerve endings and blood vessels are located; characteristic symptoms are acute throbbing pain, which sometimes spreads to the ear, jaw, head (causing migraine), and intensifies in the evening and with a sharp change in temperature;
- second, the inflammatory process affects the deep bone tissues surrounding the tooth and is a complication after pulpitis.
That is, the second is a consequence of the first.
Classification of periodontitis
The pathogenesis of the disease distinguishes several types:
- Apical periodontitis is considered a mild form, localized at the very apex of the root, with symptoms: acute pain, swelling, high body temperature and malaise. The causes are untreated pulpitis or carious disease, an error when installing a prosthesis, and even tartar. This type accounts for thirty percent of requests.
This disease is typical for an undistributed load on the teeth, which take on the role of removed molars or fillings, and also occurs due to therapeutic errors.
- Granulating periodontitis - characterized by pain when pressing, a feeling of swelling of the tooth, as well as skin fistulas - a purulent formation opens in the epithelium under the tooth, through which a variety of formed bacteria tries to find a way out. It can be effectively treated if you visit a dental clinic in a timely manner.
- Granulomatous (purulent) periodontitis is a dangerous pathology, which is characterized by the absence of pain symptoms that prompt the patient to see a dentist, since this is how the body protects itself from harmful microorganisms entering the blood. In this case, tooth and bone destruction occurs, and the tissues are filled with granulomas. Ultimately, this leads to tooth extraction without the possibility of restoration.
Additional information: A granuloma is a neoplasm formed from granulation tissue that isolates the affected, inflamed areas from the rest of the body. This is a kind of pouch filled with decaying cells. The capsule is usually attached to the root of the tooth and causes its loosening and destruction.
- Fibrous periodontitis - like the purulent form, cannot be diagnosed in the early stages, as it is almost asymptomatic. This is a constant inflammation of the periodontium (that is, the connective tissue that surrounds the tooth surface). In this case, the ligaments that hold the tooth in the gum are disrupted, which can lead to loss of teeth.
At the same time, this form of the disease can be caused by both independent factors, for example, problems with the heart and vascular system, and single causes:
- infection of periodontal tissues;
- deep advanced caries;
- mechanical impact and injury;
- low quality filling or prosthesis;
- chronic granulating or granulomatous periodontitis;
- penetration of foreign substances into the gums (pin, instrument defect).
Complications
Exacerbation of periodontitis, depending on the form of tooth damage, the stage of the disease and the location of the affected tooth, leads to complications:
- periostitis - inflammation of the periosteum or jaw;
- abscess - the development of an abscess due to the destruction of mucous, skin and fascial tissue, while neoplasms are characterized in soft tissues;
- phlegmon - abscess rupture;
- sinusitis - transition of the inflammatory process to the maxillary sinus;
- lymphadenitis - enlargement of the lymph nodes located closest to the affected area of the jaw;
- osteomyelitis - spread of infection to the bone, periosteum, soft tissue.
In addition to inflammatory processes, secondary adentia can occur - when, due to delamination of bone tissue, the tooth simply stops receiving nutrition and functioning and falls out.
Exacerbation of chronic periodontitis, as a rule, does not manifest itself symptomatically in the early stages of the disease, so it can only be detected during a preventive examination using x-ray diagnostics. Teeth that have previously undergone treatment for pulpitis or complex caries must undergo this type of examination.
Early diagnosis
An important role in making a diagnosis is an accurate, complete anamnesis - a survey (questionnaire) of the patient regarding complaints, the nature of pain, medical history and previous surgical interventions in the oral cavity.
Absolute indications for electroodontodiagnostics and x-ray examination:
- pain in a tooth that has previously been treated;
- state of intoxication of the body - high temperature, weakness, lack of appetite;
- the presence of asymmetry of the oval of the face, neck, change in skin color, enlargement of the lymph nodes closest to the jaw;
- external changes in the oral mucosa;
- the presence of a deep periodontal pocket;
- an extensive filling, under which the development of caries disease is observed (“a bad” filling can be easily identified by color, even if it is not photopolymer; as a rule, the affected materials have a gray color, under which darkening of caries is observed);
- tooth mobility.
Important! A diagnostic method based on the use of electric current allows one to determine the pain threshold of the dental pulp to determine its viability and the level of damage.
Light mechanical manipulations are also used to make a diagnosis - tapping in several positions (allows you to accurately determine the affected canal). It is also possible to use a cold test.
If at least one of the signs of periodontitis is detected, the diagnosis moves to the X-ray level. For accuracy, modern dentistry uses computed tomography, where each tooth is visible in great detail.
The exact type of disease can be determined directly during surgery, so contact a professional clinic where there will be specialists and tools to eliminate and treat this disease. .
Stages and forms of the disease
Periodontitis is divided according to the general principle into chronic and acute. Chronic cannot be completely cured. It is only possible to eliminate local inflammation and stop further exacerbation of the disease. Chronic periodontitis is asymptomatic and does not bother the carrier, but in case of exacerbation of the disease, symptoms begin to appear. In a calm state, a small fistula may appear on the gum from time to time, and slight discomfort may occur when chewing food or mechanical impact on the area of inflammation. If left untreated for a long time, the risk of tooth loss is high.
Treatment of acute periodontitis has an end result. But even after complete recovery, control over the oral cavity is necessary to avoid re-inflammation. In acute periodontitis, all of the listed symptoms are characteristic, only 2-3 of them may appear, and this is already a signal to visit the dentist. Purulent periodontitis is especially pronounced. In this case, the pain is acute, body temperature rises, and gumboil formation is possible.
Forms of periodontitis:
- Fibrous. In this case, periodontal tissue is replaced by fibrous tissue. It is often asymptomatic and can be detected by external signs: changes in enamel color, bad breath, pulp death.
- Granulating. It leaks quickly and destroys bone tissue. It is characterized by painful sensations when pressing on the gums or chewing food. A pulling or bursting pain may be observed without mechanical impact on the tooth.
- Granulomatous. This is a dangerous type of disease because it is asymptomatic, while destructive processes take place inside the periodontium, which are accompanied by the appearance of cysts and granulomas. If left untreated, the tooth may simply fall out. An infection locked in a granuloma or cyst can “explode” under the influence of the slightest irritant: provoke inflammation (for example, sepsis).
- Apical. The simplest form, easy to treat. It occurs as a result of untreated pulpitis and is localized in one place near the root.
Another treatment
Unfortunately, no one is immune from such situations, and therefore most modern clinics provide secondary services free of charge. If negative manifestations are associated with improper fitting of the filling, then the situation can be corrected by mechanical grinding of the surface in literally 10 minutes. Problems arising from the presence of voids, remnants of damaged tissue and instrument fragments require a whole range of measures. The doctor removes the old material, eliminates the cause, treats it with medication, and installs a new filling. In case of incorrect diagnosis of caries in the presence of pulpitis, the canal is cleaned according to the standard procedure.
Our clinic initially conducts a consultation and visual examination to identify both obvious and hidden causes of secondary pain. The use of modern equipment allows us to minimize the risks of incorrect diagnosis and incorrect treatment of a particular disease. X-rays are taken before and after the procedure, which is a guarantee of providing dental services at the highest level!
General recommendations
As a rule, the teething period takes from 2 days to a week. And at this time, parents should be especially patient and affectionate towards the child. The best way to distract your baby is to try to redirect his attention.
It is necessary to pay enough attention to the child in order to distract him from pain and discomfort during teething.
You need to pick him up more often, offer him interesting toys, take walks (if the child feels normal). Now, during the quarantine period, try to ventilate the room as often as possible and go out to the balcony with your child. When walking, it is better to avoid crowded places and try to limit visits to the houses of strangers.
Babies who are breastfed are more likely to ask for the breast at this time. There is no need to refuse a child, as this calms him down. It is also not recommended to change the feeding regimen and introduce new types of complementary foods.
Many children put their toys in their mouths when teething begins. Therefore, it is necessary to monitor their cleanliness. The desire to chew something relieves discomfort. You can give the baby a special rubber ring, after thoroughly treating it with a soda-soap solution and keeping it in the refrigerator for some time to cool. Many kids willingly nibble on crackers, biscuits or cookies.
It is also important to remember:
You should not ask the dentist to “cut down” the filling too much in advance to avoid possible overestimation. The upper and lower teeth must be in contact with each other to ensure proper chewing of food. In addition, the removal of teeth from the bite (a special reduction in their height) can lead to a decrease in the distance between the upper and lower jaws. This will inevitably lead to the same diseases of the temporomandibular joint. Therefore, the height of the fillings should be optimal, comfortable for the patient, and at the same time, not reducing the height of the bite.
Remember!
If after installing the filling (coming home, the next day or some time later) you notice that the filling is bothering you and you feel uncomfortable closing your mouth, then if possible, contact your dentist. He will once again check the contact points of the teeth using a carbon copy, find out your subjective sensations (where, in your opinion, it is interfering) and adjust the filling. It will take literally 5-10 minutes and will save you from further problems.
In addition, if you feel that the edge of the filling is sharp and injures the surrounding tissues (tongue, cheek, gum), that the filling is not polished enough, that there is a gap, gap, step, etc. between the filling and the tooth. – also consult a doctor for correction. If there are undercuts, gaps and roughness, there is a risk that plaque and microbes will accumulate under the filling or on it, and a relapse of caries may develop in this place over time. The dentist will quickly and painlessly polish the problem area and thereby prevent possible consequences.
What to do if your teeth itch?
Of course, consult a doctor immediately. Don't try to diagnose it yourself or dismiss the problem as insignificant. Often itching is the first sign, followed by more serious ones: pain, inflammation, bleeding. Only a specialist can prevent negative consequences and relieve you of unpleasant sensations. Well, as a relief, before you get to the dental chair, you can suck on an ice cube or rinse your mouth with a soda solution.
What is the temporomandibular joint - TMJ
We use this joint while talking, chewing, yawning, laughing - very often. Around it are muscles and tendons that allow the jaw to move in different directions for different purposes.
TMJ problems occur for many reasons:
- violation of the dental system, for example, congenital anomalies of teeth, gums or bone tissue, malocclusions, injuries, poor-quality prosthetics;
- congenital anatomical abnormalities of this joint;
- increased or decreased tone of muscle fibers around the TMJ;
- active conversational load, for example, among actors, singers, speakers;
- central nervous system problems;
- disruptions in the functioning of the endocrine system;
- excessive tension of the jaw muscles, for example, due to the bad habit of biting nails.
What is the temporomandibular joint and why do problems arise with it? Detailed and clear - in the video:
Actors and singers with active oratorical articulation are at risk for TMJ arthrosis
What to do when a filling interferes
Sometimes a filling can get in the way just because you’re not used to it, especially if there was deep caries, pulpitis or periodontitis in its place. That is, it is simply unusual for the patient to feel a filling instead of a cavity. But this feeling passes very quickly, and in just a few days the patient gets used to the healed tooth.
If the feeling of discomfort does not go away, you should consult a doctor. It is important that the treatment is carried out by a qualified dentist.
The first thing the specialist will do is take an impression of the jaws using a copy cloth. After strong clenching of the jaws, an imprint will remain on the surface of the napkin, from which the doctor will be able to determine the area that brings discomfort to the patient. If the area is small, the filling will simply be sanded and the imprinting procedure will be carried out again.
If the cause of discomfort lies in problems with the gums, a periodontist is involved in the treatment.
In some situations, removal of the filling material may be indicated. The tooth is prepared, medications are placed into the cavity, and an insulating gasket is installed. Afterwards, the tooth is closed with a temporary filling and the patient is sent home. If there is no discomfort when you visit the doctor again, a permanent filling is installed.
How long does pain last after dental implant placement?
Let's consider the normal postoperative course of the condition.
1-5 day
. The pain may increase during the first few days, starting from the moment the anesthetic administered before implantation wears off. It can be aching, throbbing, and worsened by tilting the head. While this does not indicate a complication, this is the body’s natural response to intervention. As well as swelling of the tissues in the area of the implant.
5-10 day
. By the 5th day the pain subsides. The swelling subsides completely. The question remains for the patient: how much does the gum hurt after installing the implant, since it is still sensitive. By the 10th day, as a rule, everything goes away.
After 2-6 months
. There are times when everything goes fine, but after a few months or even a year a person complains that the tooth implant around it hurts. Possible reasons:
- loosening
of the plug, adaptation crown on the abutment. They rub the soft gum tissue. The situation is not critical. The dentist will adjust, carry out the necessary manipulations and you don’t have to worry about the safety of the implant;
implant rejection An unfavorable outcome of the entire implantation is unsuccessful osseointegration. The body did not accept the artificial tooth root. Fortunately, the rejection rate is close to 1%;- inflammatory
gum diseases. This is often due to poor hygiene and violation of the doctor’s postoperative recommendations; - injury
to the jaw nerve, then the jaw hurts after implantation.
If your gums, jaw, or ear hurt for more than 10 days after dental implantation, do not put off visiting the doctor who performed the operation. Early diagnosis and initiation of treatment will avoid complications. Calling after two weeks or more with such symptoms may delay treatment for a longer period.
