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Writer's pictureDavid Chen, DDS

Do Fillings Hurt Without An Injection?

Updated: Aug 22

The last time you had a cavity filling done, the injection hurt more than the rest of the procedure! What if you did the filling without an injection?




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Can you get a cavity filled without numbing?

As a matter of fact, you can get a dental filling without having to be numb. We actually have about three patients out of the 4,000 active patients in our long island city office that do not require a dental numbing shot or the numbing gel for their fillings.


We are actually quite surprised by that, even though the numbers are quite low because it is approximately 0.0008% of our patients that do not require any anesthesia at all. They may be an anomaly to be honest.


Just to be clear, they requested no numbing and they've never needed any local anesthesia for all of their previous teeth fillings either. The cavities that we've done on them were not small either so we're really not quite sure how it is possible but we have to believe what we see...



With that being said, we should ignore those 3 outliers because they skew the data and are not representative of what the average person will experience.


There are THREE scenarios where it IS possible to do the procedure without numbing:

  1. If you popped off a filling while eating and it was very shallow.

  2. A small cavity that is still in the enamel.

  3. You already had a root canal on it.


Missing filling

The first scenario where the filling is missing. Do you see all of the yellow? That is the dentin and a dental filling should've been covering it but the patient popped if out while eating. In this case, there is no decay and we don't really need to do much drilling so we can just lightly polish it and then fill it right away. No injection necessary.


missing filling

Cavity in enamel only

The second scenario where it is a very small cavity that is still in the enamel. It looks a lot worse than it seems. We often find that smaller ones like these haven't really penetrated the tooth beyond the enamel and into the dentin.


enamel decay only

We should be able to drill it out and fill it without much sensitivity. The patient may feel a slight tingle in their tooth if the decay happens to get close to the dentin though!


Root canal treated tooth

The third scenario is when the tooth has already had a root canal. In other words, it has no nerves so it can't feel anything. You can drill this tooth as much as you want without a dental numbing shot and the patient won't even blink.


root canal treated premolar
root canal treated premolar

This is also why we do not give an injection to our patients who have finished their root canal and have returned for their crown. Although sometimes we do numb them but for other reasons!


Why do dentists numb you for fillings?

Besides those 3 scenarios from above, most dentists will give you anesthesia for a tooth filling approximately 99% of the time. The filling without numbing or filling without novocaine cases make up only about 1% of all of them.


With the statistics like that, you will most likely feel sensitivity and maybe even some pain if you were not numb. I mean, do you really want to find out if you need the cavity filling anesthesia after the fact? It is definitely safer to just get the anesthesia for fillings. But, if you still insist on trying without it, we can always oblige you!


But yes, most cavity fillings are not small, they're typically medium size or larger. The vast majority of them have already penetrated into the dentin so you are guaranteed to feel some kind of sensation while your dentist is removing the decay by drilling.


The dentin is filled with nerve endings unlike the enamel. The enamel is not alive so drilling on it typically doesn't elicit any sensations.



The types of tooth filling anesthesia

The three most commonly used local anesthetic for a filling procedure are Lidocaine, Septocaine, and Carbocaine. They may come with epinephrine, which controls bleeding and helps the anesthesia last longer. Modern day dentists don't use Novocaine anymore since it isn't as effective as the newer types listed above.



Do you need anesthesia for fillings if you get put to sleep?

Yes, you can be put to sleep for cavity fillings but you will still need numbing for the cavity filling. The reason is because the anesthesia for putting you to sleep only puts your mind to sleep but it doesn't put your tooth to sleep. Your tooth will still need to have its own separate tooth filling anesthesia to put it to sleep.



Conclusion

The answer is no, you don't have to be numb for a filling because there are 3 scenarios that let you get away without it. You could also be an outlier and just have very high pain tolerance. But, for the vast majority of people yes fillings do hurt without an injection and it is unlikely for you to able to do a filling without anesthetic!


If you have any questions, feel free to come in for a consultation. We're located in the Court Square area of LIC, in other words, we offer dental fillings in long island city.


David Chen 200 x 200.jpg

About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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