A trip to the dentist is not on everyone’s fun things to do list. Whilst dentistry has come a long way in terms of comfort and a focus on the patient as whole, there are still people who are apprehensive when it comes to dental work.
When you have a check-up and clean it is possible that your dentist may identify areas of decay or damage that will require dental fillings. A common question is do dental fillings hurt? The answer is usually not. Whilst this is not a completely reassuring response, it is an honest one, and covers many of the situations when tooth fillings are performed.
Let’s backtrack to the reason why dental fillings would be required in the first place. The outer layer of your tooth is called enamel and it is the hardest substance in the human body. The middle layer is called the dentine and the inner layer is called the pulp, commonly known as the nerve. Despite being very tough, the enamel layer can be breached by tooth decay, chipped and damaged by trauma, acidic erosion or cracking. Once this breach has occurred it is common for a tooth filling to be recommended. The reason this is important, is that the middle layer of dentine is softer, allowing the problem to spread more rapidly causing more destruction to precious tooth structure. In some cases, but not all, the tooth can become sensitive once the problem reaches this point. If the pulp/nerve becomes involved as the issue spreads then a more acute pain or toothache and infection is likely. At this stage the tooth may need extensive root canal treatment or be removed altogether.
Dental fillings are designed to remove decayed tooth, replace lost or missing tooth structure, seal over the tooth surface and protect the nerve of the tooth from future damage. They can also be performed for aesthetic reasons.
Do tooth fillings hurt while having them done? 
There are a number of things that contribute to this scenario. What is important to consider is that no dentist wants you to suffer or be unnecessarily uncomfortable during dental fillings and can offer local anesthetic that is very effective.
Very small, shallow or superficial dental fillings can be done painlessly. The process of cleaning back the surface and applying the tooth filling in these situations involves subtle vibration and rinsing with water which can feel slightly cold. For the most part these can be done without anesthetic and you avoid a few hours of numb lip afterwards.
Smoking can significantly slow down the healing process and will increase your risk of getting a dry socket or an infection. It is important to follow recommendations advised by your dentist regarding how long you should wait after extraction to start smoking to reduce the risks of healing issues.
If the decay is deeper and into the dentine or close to the nerve, then the process of doing a tooth filling will usually require an anesthetic injection if it is to be comfortable. The dentine layer has small pathways that will transmit the vibration and the feeling of water spray towards the nerve. The majority of the time, the dentist will recommend having the anesthetic as it is preferable to experiencing the pain or discomfort. Some patients will choose to have deeper dental fillings without anesthetic, but remember there is no prize for being tough and suffering through it.
Local anesthetic injections work by blocking the pain signal to the brain. It is very effective and reliable in most cases, but there are situations where additional anesthetic is needed to completely eliminate sensation during tooth fillings. The down side to anesthetic is that the numb feeling extends to other areas such as the cheeks, lips and tongue and can last for several hours. It is important to be careful and not bite your lips while you can’t feel them.
Do tooth fillings hurt after they are completed?
Most of the time there will be no issues with pain after dental fillings are performed. Occasionally there is some sensitivity or mild discomfort after a filling, and the deeper the filling, the more likely this is. The majority of cases will settle within a few days, but there are rare situations where this can last for weeks or even months. If you have any concerns following your treatment it is important you ask, as some things may be able to be resolved. The most common cause of pain or discomfort is if the tooth needs to have the filling trimmed back slightly if you are hitting too hard on it. Some sensitivity to cold is also possible but this usually resolves itself. Your dentist will typically advise you if they suspect the tooth will have ongoing issues or including the risk of issues with the nerve.
Your comfort is of great importance when it comes to having dental work performed, and it is essential you find a dentist that is caring, and you can communicate well with. There is no need to suffer during dental fillings but please talk with your dentist if you have any concerns.
