Why does my tooth hurt after a filling?

A tooth that has just been filled has been drilled, dried, etched and rebuilt in the space of half an hour, so a few days of sensitivity are ordinary: a short twinge with cold drinks, tenderness when you bite on that side, a dull ache for an hour after eating. As a rule that fades within one to two weeks and improves a little every day. Pain that gets worse instead of better, wakes you at night, or throbs on for a minute after something cold has gone is a different signal, and needs an appointment rather than patience. The single most common fixable cause is boringly simple: the filling sits a fraction of a millimetre too high, and every bite hammers that one spot.

Enamel has no feeling. The layer beneath it, the dentine (Dentin), is riddled with microscopic tubules that run inwards towards the nerve and carry fluid. Anything that moves that fluid — cold, air, pressure, sweetness — registers as a short, sharp sensation.

Removing decay exposes that dentine, which is then dried, treated with an adhesive and sealed under the filling. The nerve reacts the way any tissue reacts to being disturbed: it becomes temporarily irritable. Dentists call this reversible pulpitis, and reversible is the important word — in most teeth the irritation quietens down over days to a few weeks.

Two things add to the picture without involving the nerve at all. The local anaesthetic (Betäubung) wears off over two to four hours, and the injection site can stay tender for a day or two. And the gum beside a filling that reached close to the gum line is often bruised by the band used to shape the filling.

The first three hours. Numb lip, numb tongue, a clumsy smile. Do not test the numb side by chewing — you cannot feel a cheek bite coming, and hot drinks are risky simply because you cannot judge the temperature.

Day 1 to day 3. Usually the peak. Cold registers sharply and briefly, biting on that tooth feels different from biting elsewhere, the gum may be sore. Many people take nothing at all.

Day 4 to day 14. A steady downward trend. The cold twinge shortens, then stops appearing every time, and chewing becomes unremarkable. By the end of the second week most people have forgotten which tooth it was.

Week 3 to week 6. Deep fillings — where the cavity reached close to the nerve — can take this long to go completely quiet. What matters is the direction of travel, not the calendar.

Your bite is accurate to a few hundredths of a millimetre. A filling that sits marginally proud takes the full force of every clench, and the ligament suspending the tooth in its socket becomes inflamed. That does not resolve by itself — but the fix is one of the quickest things in dentistry: we mark the contact with coloured foil, polish away the high point, and the pressure comes off immediately. Do not wait a fortnight on this one.

This is the classic post-filling picture and the one that needs nothing but time.

When decay reaches close to the pulp, we place a protective liner and fill over the top to give the nerve a chance to recover — an approach German dental associations support wherever the nerve still shows signs of health. In most cases it works; in a minority the nerve does not recover and the tooth then needs root canal treatment (Wurzelbehandlung). We say so before we start when a tooth falls into this category, so later symptoms are not a surprise.

Tooth-coloured composite (Komposit) is glued to the tooth; where the seal at one edge is not perfect, tiny fluid movements reach the dentine. Sometimes that settles as the surface remineralises, sometimes the margin needs polishing or a small repair.

Teeth are poor at telling the brain exactly where a problem is. A crack, gum inflammation, an old problem in the neighbouring tooth or grinding at night can all announce themselves in the week after a filling purely by coincidence — which is why we examine rather than assume.

• Chew on the other side for two or three days — long enough for the tooth to calm down, not for weeks.
• Skip the extremes. Ice water, hot soup, hard nuts and sticky sweets all provoke a freshly filled tooth.
• Use a toothpaste for sensitive teeth. Potassium nitrate or stannous fluoride formulations damp the nerve response; give them a fortnight of proper brushing.
• Keep brushing the tooth. People avoid the sore spot, plaque builds at the margin, and the gum adds its own soreness to the mix.
• Painkillers, sparingly. An ordinary over-the-counter analgesic for the first evening or two is reasonable; needing them daily for a week is a reason to be seen. Never place a tablet against the gum — it burns the tissue.

Swelling, fever or pain you cannot control at home should be seen the same day. Outside our opening hours the dental out-of-hours service (zahnärztlicher Notdienst) covers Wuppertal and the surrounding towns.

If you grind your teeth. Bruxism (Bruxismus) loads a new filling far harder than chewing does, and a high spot is punished all night. Tell us if you wake with a tight jaw — a night guard (Knirscherschiene) protects the filling and the tooth around it.

If you are an anxious patient. Fear does not make pain imaginary; it makes it louder and harder to sit with. We work with local anaesthetic as standard and offer sedation and laughing gas (Lachgas) where someone needs it — say so when you book and we plan more time, not less.

Pregnancy and children. Fillings can be placed during pregnancy, and gums are more reactive then, so some post-filling gum soreness is hormonal rather than technical. Children rarely say “sensitive to cold”; they say the tooth feels funny or stop chewing on that side. The commonest problem after a child’s filling is a bitten cheek while still numb, so keep an eye on them for the first hour.

If you are new to Germany, or your German is limited. Describing pain precisely is exactly where a second language fails people — and “it hurts when I bite” versus “it hurts with cold” points to two completely different causes. We treat and explain in English, and our team also works in German, Russian, Turkish, Ukrainian, Arabic, Kurdish and French. If you are still looking for a practice where language is not the obstacle: English-Speaking Dentist in NRW.

Very little, and often nothing. In statutory health insurance (gesetzliche Krankenversicherung, GKV), examinations and the filling itself are covered as standard care (Regelversorgung). Since amalgam was banned across the EU in 2025, that standard means a tooth-coloured filling in front teeth and back teeth alike, provided as a benefit in kind with nothing to pay at the desk. Extra costs arise only if you choose something beyond that standard, and only under a written extra-cost agreement (Mehrkostenvereinbarung) signed before treatment. Adjusting the bite on a filling we placed is routine follow-up, not a new plan. More on coverage: Does the statutory fund pay for fillings? (EN).

If a painful tooth needs deeper investigation we can take a 3D X-ray (DVT), which costs 178 € in our practice — but that is the exception; everyday checks use a normal X-ray and a look under the microscope. How we work: Fillings and caries treatment – service page (EN).