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The history of your tooth is not completely clear, so I must make some assumptions. It sounds like the amalgam was removed from your tooth and an alternative restorative material placed -- this was probably a tooth colored material called composite.
Composite fillings can be very successful when placed with care, and they are certainly very cosmetic, which is why most people like them. However, when a tooth has multiple fillings over a period of years, may have had some recurrent decay around old fillings and is under function like grinding, ice eating, clenching or just because of normal chewing, the pulp (nerve) inside the tooth cannot heal properly after awhile. In other words, the tooth becomes physiologically old, while it may not be very chronologically old.
This may be what has happened to your tooth, and if the pain is spontaneous, that is, the tooth hurts by itself when not specifically stimulated by chewing, hot or cold, it probably needs a root canal. This would be successful most of the time unless the tooth had a vertical fracture or a periodontal defect that needed care. I hope this clears some of your questions up.
Dr. Chuck Wakefield
Associate Professor
Director Advanced Education in General Dentistry
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