I had a filling which involved drilling the tooth, but the drilling did not touch the nerve. According to the x-ray taken at the same time, the nerve is in fact some distance from where the filling was taking place (lower right molar).

Now the local anesthetic has worn off, my tooth is aching. The gums do not hurt (so it is not caused by the dentist applying pressure to the area) and as far as I am aware there are no other nerves within the enamel of the tooth.

So, why does my tooth ache? Is it something to do with the nerve 'waking up' after being anesthetized?

Just to be clear it is not a severe ache or of any concern, only in the background, and I am curious as to the cause. The dentist did say it would ache, so it's obviously a normal thing, but I didn't think to ask why!

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    $\begingroup$ There can still be a pressure exerted on the nerve, the filling exerts a pressure on the tooth which then propagates through the entire tooth. $\endgroup$ – Count Iblis Oct 27 '15 at 19:06
  • $\begingroup$ I didn't think of that - he did really seem to 'pack in' the filling and that could cause pressure inside the tooth. $\endgroup$ – Lyall Oct 27 '15 at 19:26

See, since it was a simple drilling followed by restoration or filling, that means the infection was superficial, not involving the pulp where the nerves and blood vessels are situated. Ok, so now to remove the superficial infection the dentist might have used an airotor. It's an instrument which rotates at high speed, has a hole for water spray to cool the fictional heat generated while it removes the caries or the infection from the tooth.High speed handpieces Now as you may be knowing the crown portion of tooth has three layers- enamel, dentin and pulp. Only the pulp portion is innervated.

Now when the instrument is drilled into the tooth the infected enamel and superficial infected dentin must have been removed. The dentin has numerous tubules known as dentinal tubules. These contain a fluid called dentinal fluid. Whenever there is any stimulus which has not yet reached the pulp, but may have reached the dentin, eg of stimulus in the form of pressure, temperature change, sweet food, sour food etc, cause the fluid to move or get displaced. The displacement of dentinal fluid stimulates nerve endings in the pulp and hence generates a pain/ sensitivity response to your brain.Hydrodynamic theory

Now the drilling causes heat generation, even though little, due to the coolant, plus pressure and hence causes the fluid to displace and hence pain. This pain usually ends after the treatment. However the restoration placed, you should have specified which restoration- silver coloured (amalgam) or the tooth coloured. These again have chemicals. These chemicals can penetrate through the tubules to the pulp to elicit a painful response even after the treatment. To prevent this, a liquid known as varnish is applied which acts as an insulator. Also if the infection is deeper, a base or other material depending on the type of restoration is also applied to prevent other stimuli. Varnish and bases So either there may be a failure in these insulating materials or your pulp may require some time to heal from the procedure. It may have got healed by third or fourth day, if it was due to procedural trauma. In either case you should contact your dentist.

Hope I have solved your question :)

References have been given in the parentheses


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