Posts for tag: toothache
It's 3:00 PM, your child has just come back from the school playground — and she's complaining of a toothache that's making her miserable. She can't seem to say if there was a particular injury or a blow, but the more she talks about it, the worse it gets. You're the parent... what are you going to do now?
If you've ever been through this type of situation, you know that a calm demeanor and a little TLC can go a long way. But how do you know whether you're facing a dental emergency, or a routine booboo? Here are a few general rules that may help.
First, relax: Without a fever and facial swelling, a child's toothache isn't usually an emergency. But any tooth pain that keeps a child up at night or lasts into the next day should be evaluated by a dentist. Even if it's nothing but a small cavity (the most common cause of toothache) you don't want to let it go untreated. That could allow it to turn from a small discomfort into a major problem — like a painful abscess.
There are some things you can do at home to try and get a handle on what's causing the pain. Encourage the child to show you exactly where the pain is located, and to tell you when and how it started. Then, examine the area closely. Look for obvious brown spots, or even tiny cavities (holes) on biting surfaces or between teeth, which might indicate decay. Also check the gums surrounding the tooth, to see if there are sores or swelling.
You may find evidence of a traumatic injury, like a cut or bruise — or, if only swelling is apparent, it may mean an abscess has formed. If nothing looks amiss, try gently flossing on either side of the hurting tooth. This may dislodge a particle of food that's causing pain and pressure.
If the pain persists, you can try giving an appropriate dose of ibuprofen or acetaminophen, or applying an ice pack on the outside of the jaw — one minute on and one minute off. But even if you can make the immediate pain go away, don't neglect the situation that caused it. Unless you're absolutely sure you know why the toothache occurred, you should bring the child in for an examination. It will put your mind at rest — and maybe prevent a bigger problem down the road.
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.”
When a 51-year-old Swedish man developed a throbbing toothache with facial swelling, he knew he needed to get to the dentist right away. There was only one problem: The unnamed individual was inside the Östragård minimum-security prison, serving a short sentence. But he didn’t let that stop him from getting dental treatment — he simply broke out of jail and headed straight for the nearest dental office.
“In the end, I just couldn’t stand it,” he explained to the Swedish newspaper Dagens Nyheter.
After the offending tooth was extracted, the offender himself went to the local police precinct and turned himself in. Taking his circumstances into account, the court added just 24 hours to his original sentence, and he was released soon thereafter. “Now I only have to pay the dentist bill,” he noted.
While we certainly don’t encourage jailbreaks, we might feel that this fellow made the right choice. It’s important to know when you need to get dental treatment right away, and when you can wait. Here are some very basic guidelines:
- If you’re suffering a traumatic dental injury that is causing you severe pain, or you can’t control bleeding after applying pressure for a few minutes, go to the nearest emergency room right away (as you would for any serious injury).
- If your tooth is knocked out or loosened, it should be treated in the dental office or emergency room within 6 hours. Place it back in its socket (in the correct orientation), if possible; if not, tuck it between the cheek and gum, or put it in a glass of cold milk. Hold the loose tooth gently in place. It’s often possible to successfully re-implant a tooth that has received quick first aid.
- If a tooth is chipped or cracked less severely, try and save any missing pieces, and make an appointment to come in as soon as you can. Don’t forget to bring the pieces with you!
- If you have acute or persistent tooth pain, come in to our office right away. There are many things that can cause tooth pain, including tooth decay (a bacterial infection), a loose filling, or tooth sensitivity. Minor sensitivity or occasional aches when chewing can be temporarily eased by rinsing with warm salt water and taking an over-the-counter pain reliever; more severe pain may indicate that you need root canal treatment to preserve a tooth in which the pulp has become seriously infected.
Pain is the body’s way of telling you that something’s wrong. When you experience mouth pain, it’s best for you to see us as soon as possible. Quick treatment just might save your tooth — and perhaps save you from a far steeper bill for tooth replacement. If you would like more information about dental emergencies, call our office for a consultation. You can learn more in the Dear Doctor magazine article “Tooth Pain? Don’t Wait!”
People who fly or scuba dive know firsthand how changes in atmospheric pressure can affect the body: as minor as a popping in the ears, or as life-threatening as decompression sickness. Pressure changes can also cause pain and discomfort in your teeth and sinuses — in fact, severe pain could be a sign of a bigger problem.
Barotrauma (baro – “pressure;” trauma – “injury”), also known as a “squeeze,” occurs when the unequal air pressures outside and inside the body attempt to equalize. Many of the body's organs and structures are filled with air within rigid walls; the force created by equalization presses against these walls and associated nerves, which in turn causes the pain.
The sinus cavities and the middle ear spaces are especially sensitive. Each of these has small openings that help with pressure equalization. However, they can become swollen or blocked with mucous (as when you have a head cold), which slows equalization and contributes to the pain.
It's also possible to experience tooth pain during pressure change. This is because the back teeth in the upper jaw share the same nerve pathways as the upper jaw sinuses — pain originating from the sinuses can be felt in the teeth, and vice-versa. In fact, it's because of this shared pathway that pressure changes can amplify pain from a tooth with a deeper problem, such as a crack, fracture or a defect in dental work.
Besides problems with your teeth, the severe pain could also be related to temporo-mandibular joint dysfunction (TMD), which is pain or discomfort in the small joint that connects your lower jaw to your skull. There are a number of causes for this, but a common one for scuba divers is an ill-fitted regulator mouthpiece that they are biting down on too hard while diving. A custom-fitted mouthpiece could help alleviate the problem.
If you've been experiencing tooth pain during pressure change events, you should see us for an examination before you fly or dive again. There might be more to your pain — and correcting these underlying problems could save you extreme discomfort in the future.
If you would like more information on the effects of atmospheric pressure changes on teeth, 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 “Pressure Changes Can Cause Tooth & Sinus Pain.”
It can be daunting for parents to know just what to do when their child complains of an ache or pain. What if your child tells you their tooth hurts — is that cause for alarm? That's actually not so easy to determine, but there are some things you should do when your child has a toothache.
First, try to determine from your child exactly where the pain is coming from and how long it's been hurting. Look for an apparent cause for the pain: the most common is tooth decay, considered a type of infection caused by bacteria, and normally indicated by brown spots or tiny holes (cavities) on the biting surfaces or between teeth. Look for swelling or tenderness in the gum tissues, a sign of a possible abscess. Debris caught between teeth may also cause pain.
The pain might stem from an injury. Though the lips and outer tissues may appear fine, a blow to the face or other traumatic incident may have damaged the teeth. Without treatment, pulp tissue within a traumatized tooth may die and lead to an infection and potential tooth loss.
If you see any of these signs or symptoms, or the pain keeps your child up at night or continues into the next day, you should contact our office as soon as possible so that we can do a full evaluation of the tooth. In the meantime, there are some things you can do to help lessen the pain. First, clean the teeth to remove any debris. Administer ibuprofen or acetaminophen (in the proper dosage for a child) for pain relief. An ice pack against the jaw may also help, but alternate on and off in five-minute intervals to prevent burning the skin with the ice.
If these steps stop the pain within an hour, you can wait until the next day to make an appointment. If not, this may be indicative of an abscess forming and you should not delay contacting our office. The quicker we can properly diagnose and begin treatment, the less chance your child will suffer from any long-term damage to their teeth.
If you would like more information on caring for a child's 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 Child's Toothache.”