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Bridging the Gap Between Patient Experience and Dental Practice

If you’ve ever experienced lingering pain after dental treatment, you may find yourself asking – Did my dentist do something wrong? Perhaps your tooth was asymptomatic before treatment and now there is pain. As a dentist, this is a conversation we have often. People believe that dental pain after treatment must be caused by the dentist, which results in a loss of trust in their provider. 

While these conversations are difficult, they are necessary to correct common misconceptions. In this blog, we’ll discuss what patients think is causing the pain, what is likely to be causing pain, and how to better communicate with your dentist to ensure a comfortable experience. 

Misconceptions About Tooth Pain After Dental Treatment 

Tooth pain after a dental procedure can be concerning. Particularly if it was not there before. From the patient’s perspective, many worry that: 

• The dentist drilled too deep, causing discomfort or damage. 
• The crown isn’t properly sealed, leading to sensitivity or pain. 
• A nerve is exposed, which is often described as feeling like a “live wire” or as if something vital is left open to the elements. 

These concerns are frequently expressed by patients trying to make sense of their pain. And while it is possible that the dentist has done something wrong, it’s not common. To better understand, let’s look at two common treatments as examples. 

The first example, which is quite common, is a filling. In this scenario, the patient may think the pain is a result of the dentist drilling too deep to clean out the decay. However, it’s not in our nature to drill too deep. If anything, we don’t drill deep enough in the beginning and must continue drilling to ensure we remove all the decay before filling the tooth. 

During this process, we use x-rays and caries detecting stain to determine how deep to drill. We also communicate with the patient before and during the procedure, so they know what to expect. A lot of times, we find the decay is about the same or better than we expected based on the x-ray. Meaning there are not usually surprises. 

Another good example of this is a dental crown. In this scenario, the patient may think the pain is being caused by the crown not being sealed properly causing sensitivity and pain. To ensure that this does not happen, we take x-rays to make sure that the fit is precise. We also tactically feel that the crown is sealed all the way and seated on the tooth properly. In the rare case that the crown is not done properly, it would not cause any pain.  

In both scenarios, it’s important to remember that most dental issues do not cause pain. If you are in pain, you are likely in need of emergency dentistry. 

Causes of Tooth Pain After Dental Treatment

So, if the pain is not a result of the dental treatment – what is causing the pain? In most cases, pain after dental treatment has to do with the prognosis of the tooth and the timing of treatment. A dental prognosis can be defined as the likelihood of a tooth’s survival, or the overall viability of a tooth and its risk of requiring removal. We use a classification system that rates your tooth as either: good, fair, guarded, poor or hopeless. 

When a patient comes in with pain after dental treatment, the first thing we look at is the original prognosis of the tooth. If it is guarded or poor, we know that the tooth already had a high-risk or questionable-risk profile and there is a chance that more invasive treatment – like a root canal – may be needed. 

We also look at how long the patient may have delayed treatment. If this was going to be a simple treatment a year ago and they are just receiving treatment now, there’s a good chance the situation has worsened. 

The pain, then, is not the fault of the dentist. It’s the body telling us that the tooth may need additional treatment, or additional time to heal. 

In these scenarios, we recommend one of the following options based on the dental prognosis and other factors, such as the patient’s risk profile and dental history: 

• We wait and see if things improve. Sometimes, a tooth just needs more time to heal. 
• We recommend an anti-inflammatory protocol such as a non-steroidal anti-inflammatory medication. This can give the tooth a better chance at healing. 
• If neither of these options work, we may recommend a root canal to treat an infected or necrotic tooth. 

Talking to Your Dentist: Know Your Risk

In most cases, we know going into a filling or crown if a root canal may be needed down the road. However, we always recommend the least invasive treatment first to give the tooth a better chance at survival. 

Think of your tooth like a cat with nine lives, there are only so many times we can treat a tooth before it needs to be removed. To give you the best chance at keeping your teeth until you’re 100, we will recommend the least invasive treatment, keeping in mind your dental risk profile and dental history. 

In our dental office, we always have these conversations with patients ahead of time, so we are all on the same page. Then, if there is pain after a filling or crown, the patient will know what this means. 

For a more detailed conversation about dental pain and additional treatment options, be sure to watch Dr. Saylor and Dr. Afonso discuss this topic on our YouTube channel. 

Are you experiencing pain after a routine dental treatment? Call our office to schedule a consultation with our experienced team of dentists at 813-689-4226 or schedule an appointment online.