Posts for tag: toothache
Pain has a purpose: it tells us when something's wrong with our bodies. Sometimes it's obvious, like a cut or bruise. Sometimes, though, it takes a bit of sleuthing to find out what's wrong.
That can be the case with a toothache. One possible cause is perhaps the most obvious: something's wrong with the tooth. More specifically, decay has invaded the tooth's inner pulp, which is filled with an intricate network of nerves that react to infection by emitting pain. The pain can feel dull or sharp, constant or intermittent.
But decay isn't the only cause for tooth pain: periodontal (gum) disease can trigger similar reactions. Bacteria living in dental plaque, a thin film of food particles on tooth surfaces, infect the gums. This weakens the tissues and can cause them to shrink back (recede) from the teeth and expose the roots. As a result, the teeth can become painfully sensitive to hot or cold foods or when biting down.
Finding the true pain source determines how we treat it. If decay has invaded the pulp you'll need a root canal treatment to clean out the infection and fill the resulting void with a special filling; this not only saves the tooth, it ends the pain. If the gums are infected, we'll need to aggressively remove all plaque and calculus (hardened plaque deposits) to restore the gums to health.
To further complicate matters, an infection from tooth decay could eventually affect the gums and supporting bone, just as a gum infection could enter the tooth by way of the roots. Once the infection crosses from tooth to gums (or gums to tooth), the tooth's long-term outlook grows dim.
So, if you're noticing any kind of tooth pain, or you have swollen, reddened or bleeding gums, you should call us for an appointment as soon as possible. The sooner we can diagnose the problem and begin appropriate treatment the better your chances of a good outcome — and an end to the pain.
If you would like more information on diagnosing and treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain: Combined Root Canal and Gum Problems.”
Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.
Here are some common reasons that teeth ache:
- Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
- Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
- Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
- Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
- Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
- Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
- Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.
As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!
If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”
You experience a painful toothache that lasts for a few days, but eventually the pain subsides. Since there's no longer any pain, there's no longer anything wrong with the tooth, right?
Maybe not — the toothache may be the result of a decay-induced infection that has developed deep in the pulp of the tooth. The infection inflames both the pulp tissue and the nerves bundled in it (a condition known as pulpitis). Because it occurs in an enclosed space, the pain is even more severe.
Now it's possible for the inflammation to subside and the nerves to heal, which would explain the pain subsiding. But there is another, more likely scenario: the infected pulp tissue can no longer fight the infection and dies. The affected nerves die also, which is why you no longer feel any pain — the dead nerves are no longer transmitting a signal to the brain. The infection, however, is very much alive and continues to advance deeper into the surrounding tissues where it may eventually develop into a painful abscess.
So, how can we determine which of these two scenarios you are actually experiencing? A visit to our office for testing is the surest way to find out. The most common test involves temperature sensation, usually with the application of ice to the affected tooth. If there's no sensation, then that's evidence the nerves in the tooth have died.
If that's the case, it's important then to take steps to stop the infection's advance before it does even more damage. The most likely treatment is a root canal, a procedure that accesses the pulp from the top of the tooth, removes the dead tissue, and then cleans and prepares the root canals for filling. This procedure can usually be performed in our office, but more involved cases may require an endodontist, a specialist in root canals.
In any case, if you experience a severe toothache, please have it examined. And remember — the absence of pain after a toothache doesn't necessarily mean the problem is gone.
If you would like more information on the diagnosis and treatment of an acute toothache, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Severe Toothache.”
When it comes to childhood injuries — cuts and scrapes, growing pains, even wounded pride — it's often a parent's job to try and make things better. But sometimes it's hard to know whether the hurt indicates a serious problem, or if it's a situation that will resolve itself as soon as the sun comes up. If pain is being caused by a toothache, here are some general rules that can help you figure out what's the best thing to do.
1. Unless it's accompanied by fever and swelling, a child's toothache isn't generally an emergency.
The first thing to do is calm down (both you and the child) — and talk! Find out exactly where the pain comes from, and when and why it might have started. (Your child may have forgotten to tell you about that fall in the gym...) Sometimes, a little sleuthing will give you a clue about what's causing the pain.
2. Tooth decay, a bacteria-induced infection, is the most common cause of toothaches.
Check the teeth for brown spots or tiny holes (cavities) which might indicate decay — especially on the biting surfaces and in the areas between teeth. Next, look at the gums around the hurt tooth. If they show cuts or bruises, that's a sign of trauma. If you see only swelling, it may indicate the formation of an abscess.
3. If nothing looks obviously wrong, try gently flossing both sides of the tooth.
This may dislodge a bit of trapped food or candy, and relieve the pressure and soreness. But if that doesn't help, remember that some conditions — like nerve damage inside the tooth, for example — may have no apparent symptoms except pain.
4. Treat pain with an appropriate dose of acetaminophen or ibuprofen.
Base the dose on your child's age and weight, according to the medication's instructions. You can also apply an ice pack (one minute on, one minute off) to the outside of the jaw. But NEVER rub aspirin (or any painkiller) directly on a child's gums: It can cause burns and severe discomfort.
5. Pain that keeps a child awake at night, or persists into the next day, needs professional evaluation as soon as possible.
Otherwise, unless the pain resolves quickly and you're sure you know exactly what caused the toothache, it's best to bring your child in for an examination as soon as it's practical. You'll feel better having a dental professional, backed with years of experience and training, taking care of your child's health — and you just might prevent a future problem.