I have been using Invisalign to straighten my teeth. I have been regularly monitored throughout the treatment by my cosmetic dentist. The gap in my front teeth is looking really closed up now. I am happy! But, I got this weird pain in my premolar last week. I am on my fourth round of trays. When the dentist checked out the tooth, it was one with a really old filling. He decided to remove the filling and do something to help with the nerve pain and perform a temporary treatment. But he wants to wait before he fills it in case there is something more serious happening with the tooth. It has been several days now and the tooth is still hurting really bad. Is this normal pain because I have Invisalign?

– Sara in Colorado

Sara,

As you probably are aware, when you use Invisalign the teeth can feel more sensitive than normal. Sometimes they can even hurt to chew on. This is because the teeth are moving and there is increased pressure placed on them to correct their position. This could be contributing to the pain you are experiencing. When the gum tissue and membrane stretches for the tooth to move, it can be painful.

But, from the sounds of it, your issue is on a tooth with an old filling. The dentist took a precautionary measure and probably used temporary filling material. It is difficult to tell you precisely what is going on, but your cosmetic dentist took a conservative approach to see if you pain would subside. You could be dealing with a crack in the old filling or the tooth itself. Food or particles may have entered the crack and can cause more decay. If the decay has entered into the pulp of the tooth, there could be an infection present. This would require more extensive treatment. If the pain worsens, throbs, or keeps you up at night, contact your dentist right away. A root canal may be required to save the tooth. Did he do an x-ray? If not, and the pain worsens, that will be the next step to further diagnose what is really going on. Sit tight as long as the pain isn’t too intense. But keep in touch with your dentist if it doesn’t go away.

Best case scenario, the filling will be replaced with a white composite filling and you will still be able to continue with your Invisalign treatment. Hard to tell from what you have disclosed.