Pain management toothache. Comprehensive Guide to Toothache Pain Management: Causes, Remedies, and When to Seek Professional Help

04.08.197930.11.2021 by alexxlab

What are the common causes of toothaches. How can you manage tooth pain at home. When should you see a dentist for a toothache. What are the potential complications of untreated tooth decay.

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Understanding Toothaches: Causes and Symptoms

A toothache is characterized by pain in or around a tooth, ranging from mild discomfort to severe, throbbing pain. The intensity and nature of the pain can provide clues about its underlying cause.

Common Causes of Toothaches

Tooth decay
Dental cavities
Gum disease
Tooth fracture
Abscessed tooth
Damaged fillings
Teeth grinding (bruxism)
Infected gums

The origin of toothache pain often lies in the pulp of the tooth, which contains sensitive nerves and blood vessels. When this area becomes irritated or infected, it can result in significant discomfort.

Recognizing Toothache Symptoms

Toothache symptoms can vary depending on the underlying cause and severity of the problem. Common signs include:

Sharp or throbbing pain
Sensitivity to hot or cold temperatures
Pain when biting or chewing
Swelling around the affected tooth
Fever or headache
Bad taste in the mouth
Difficulty opening the mouth wide

Is there a way to distinguish between different types of tooth pain? While not definitive, the nature of the pain can offer clues. A sharp pain when biting down might indicate a cracked tooth or cavity, while a persistent, dull ache could suggest an infection or abscess.

Home Remedies for Toothache Relief

While home remedies can provide temporary relief, they are not substitutes for professional dental care. However, these methods can help manage pain until you can see a dentist:

Saltwater Rinse

A saltwater rinse can help reduce inflammation and kill bacteria. Mix 1/2 teaspoon of salt in a cup of warm water and swish it around your mouth for 30 seconds before spitting it out. How does this work? The salt helps to draw out excess fluid from the gums, reducing swelling and providing temporary relief.

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. Acetaminophen is another option for pain relief, though it doesn’t address inflammation. Always follow the recommended dosage and consult a healthcare professional if you have any concerns.

Cold Compress

Applying a cold compress to the outside of your cheek near the affected area can help numb the pain and reduce swelling. Wrap ice in a towel and apply it for 15-20 minutes at a time.

Clove Oil

Clove oil has natural analgesic and antibacterial properties. Apply a small amount to a cotton ball and gently dab it onto the affected area. How effective is clove oil for toothaches? While scientific evidence is limited, many people find it provides temporary relief.

When to See a Dentist for Tooth Pain

While home remedies can provide temporary relief, certain situations require immediate professional attention. Seek dental care if:

The pain is severe or lasts more than 1-2 days
You have a fever, earache, or pain when opening your mouth wide
You experience swelling in your face or cheek
You have broken or knocked-out a tooth
You’re having trouble breathing or swallowing

Can delaying dental treatment worsen a toothache? Absolutely. Postponing professional care can lead to more severe infections, increased pain, and potentially more extensive and costly treatments in the future.

Professional Toothache Treatments

The appropriate treatment for a toothache depends on its underlying cause. Here are some common professional treatments:

Fillings

For cavities, the dentist will remove the decayed portion of the tooth and fill it with a suitable material like composite resin or amalgam.

Root Canal

If the pulp of the tooth is infected, a root canal may be necessary. This procedure involves removing the infected pulp, cleaning the root canal, and sealing it.

Extraction

In cases where the tooth is severely damaged or decayed, extraction may be the best option. The dentist will remove the entire tooth and may discuss replacement options like implants or bridges.

Antibiotics

If there’s an infection present, the dentist may prescribe antibiotics to clear it before proceeding with other treatments.

How long does it take to recover from these dental procedures? Recovery times vary, but most patients experience significant improvement within a few days to a week after treatment.

Preventing Toothaches and Maintaining Oral Health

Prevention is always better than cure when it comes to dental health. Here are some strategies to prevent toothaches and maintain good oral hygiene:

Brush your teeth twice daily with fluoride toothpaste
Floss at least once a day
Use an antiseptic mouthwash
Limit sugary and acidic foods
Avoid smoking and excessive alcohol consumption
Visit your dentist regularly for check-ups and cleanings
Replace your toothbrush every 3-4 months
Consider dental sealants for added protection against decay

How often should you visit the dentist for preventive care? Most dental professionals recommend check-ups and cleanings every six months, though some individuals may need more frequent visits based on their oral health status.

Toothaches in Children: Special Considerations

Toothaches in children require special attention, as young children may not be able to accurately describe their pain or its location. Parents should be vigilant for signs of dental discomfort in their children.

Signs of Toothache in Children

Irritability or crying without apparent reason
Difficulty eating or loss of appetite
Holding the cheek or jaw
Disturbed sleep
Fever

How should parents handle their child’s toothache? First, try to determine the location and severity of the pain. Offer child-appropriate pain relievers and use a cold compress if there’s swelling. If symptoms persist or worsen, consult a pediatric dentist promptly.

Preventing Toothaches in Children

Establishing good oral hygiene habits early can help prevent toothaches and other dental problems in children:

Start brushing as soon as the first tooth appears
Use age-appropriate toothpaste and toothbrushes
Supervise brushing until the child can do it effectively on their own
Limit sugary snacks and drinks
Consider dental sealants for added protection
Schedule regular dental check-ups

At what age should a child first visit the dentist? The American Academy of Pediatric Dentistry recommends that children see a dentist by their first birthday or within six months after their first tooth erupts.

Toothache Complications and Long-Term Effects

Untreated toothaches can lead to serious complications and long-term effects on oral and overall health. Understanding these potential consequences underscores the importance of prompt dental care.

Potential Complications of Untreated Toothaches

Dental abscess: A pocket of pus that can form in different parts of a tooth as a result of bacterial infection
Sepsis: A life-threatening condition that occurs when the body’s response to infection causes widespread inflammation
Osteomyelitis: An infection that spreads to the bone supporting the tooth
Cellulitis: A bacterial skin infection that can spread to other parts of the face and neck
Tooth loss: Severe decay or infection may necessitate tooth extraction

Can a toothache affect overall health? Indeed, chronic dental infections can have systemic effects, potentially contributing to conditions such as cardiovascular disease, diabetes complications, and pregnancy risks.

Long-Term Effects of Chronic Tooth Pain

Persistent toothaches can have significant impacts on quality of life and overall well-being:

Chronic pain and discomfort
Difficulty eating and nutritional deficiencies
Sleep disturbances
Reduced productivity at work or school
Psychological effects such as anxiety and depression
Social isolation due to self-consciousness about dental issues

How can these long-term effects be mitigated? The key is early intervention. Seeking prompt dental care at the first sign of tooth pain can prevent minor issues from escalating into major health concerns.

Emerging Trends in Toothache Management and Dental Care

The field of dentistry is constantly evolving, with new technologies and approaches emerging to improve toothache management and overall dental care. Here are some exciting developments:

Advanced Diagnostic Tools

3D imaging: Provides detailed views of dental structures for more accurate diagnoses
Intraoral cameras: Allow dentists to show patients real-time images of their oral cavity
AI-assisted diagnostics: Help identify potential issues earlier and with greater accuracy

Innovative Treatment Approaches

Laser dentistry: Offers less invasive treatments for various dental procedures
Regenerative therapies: Aim to regrow damaged tooth tissues
Smart toothbrushes: Provide real-time feedback on brushing technique and habits
Teledentistry: Enables remote consultations and follow-ups

How might these advancements change the future of dental care? These innovations have the potential to make dental treatments more efficient, less invasive, and more accessible, potentially reducing the incidence and severity of toothaches.

Personalized Dental Care

The trend towards personalized medicine is also influencing dentistry. Genetic testing and biomarker analysis may soon allow dentists to tailor prevention and treatment strategies to individual patients based on their unique risk factors and oral microbiome.

What role does patient education play in these emerging trends? As dental care becomes more technologically advanced, patient education becomes increasingly crucial. Dentists and patients must work together to understand new treatment options and make informed decisions about oral health care.

In conclusion, while toothaches remain a common dental problem, advancements in prevention, diagnosis, and treatment offer hope for more effective management and improved oral health outcomes. By staying informed about these developments and maintaining good oral hygiene practices, individuals can take proactive steps towards healthier smiles and pain-free teeth.

What to Do and When to See a Doctor

A toothache refers to pain in or around your tooth. This discomfort can range from a minor issue, like gum irritation, to an indication of a larger problem, like tooth decay.

Causes of Tooth Pain

Toothaches are a result of:

Serious tooth pain doesn’t resolve on its own and requires a visit to your dentist.

Toothache Symptoms

Symptoms of tooth pain vary depending on the size and location of the dental problem. A cavity might not be painful at first. But as your tooth continues to decay, it may cause significant problems, including:

Tooth sensitivity
Pain when biting or chewing
A mild ache that worsens when you drink or eat something hot, cold, or sweet
Pits or holes in your tooth
Discoloration and staining on the surface of your tooth

How to Manage a Toothache

Home Remedies

Start with these treatments, which you can find in your kitchen, medicine cabinet, or nearby pharmacy:

Saltwater Rinse: Mix 1/2 teaspoon salt into 8 ounces of water, swish around your mouth for 30 seconds to one minute, and then spit it out. Saltwater removes debris in between your teeth and soothes inflammation.
Hydrogen Peroxide Rinse: Blend equal parts hydrogen peroxide and water and swish. Don’t swallow it! A 3% solution of hydrogen peroxide helps reduce bacteria, inflammation, and pain.
Over-The-Counter (OTC) Painkillers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Aleve), or acetaminophen (Tylenol) reduce pain and inflammation. If you are treating a child, use a formula designed for their age and weight. Avoid giving children under 16 aspirin. Tylenol is a good substitute.
OTC Numbing Treatments: Dental gels and liquids containing benzocaine help numb the gums and teeth, reducing pain. Gently dab on the tooth and surrounding gum tissue.
Cold Compress: Hold a cold washcloth or ice pack on your cheek to reduce swelling in your mouth or jaw.

Toothache Alternative Remedies

These natural remedies won’t stop decay or heal an abscess but may provide temporary relief:

Garlic: Make a paste and apply it to the affected tooth. Garlic can relieve pain and kill bacteria.
Clove Oil: Add a drop or two to a cotton pad and dab it on your tooth. Clove oil is a natural antiseptic that reduces pain and inflammation.
Vanilla Extract: Sprinkle a few drops on a cotton ball and place it on the affected area. The alcohol in vanilla numbs the pain.
Peppermint Tea: Hold a warm teabag against your tooth to soothe inflammation.

Toothache in Children

Toothache symptoms are similar in adults and children. However, children can’t always pinpoint the source of pain. If your child has a fever and a sore tooth, ask these questions:

Where is the pain in your mouth?
What tooth is sore?
Is the pain constant?
Does eating hot soup or ice cream make it hurt more?

A child’s toothache may not be obvious or as present as other dental problems. See the dentist for an accurate diagnosis.

When to See Your Dentist

Toothache remedies can alleviate pain for a brief time, but they won’t solve underlying issues. If your tooth pain persists or continues to get worse, it’s time to see a dentist.

Expect a thorough physical exam of your jaw, mouth, teeth, throat, nose, neck, and ears. The dental team may take an X-ray to determine the cause of your tooth pain.

Toothache Treatment

Treatment depends on what is causing your pain:

Cavity: If there is decay, your dentist will remove it, fill the cavity, or remove the tooth.
Bacterial Infection: Your dentist may remove the pulp at the center of the tooth if it’s infected. He or she will then protect the area with a sealing material. This procedure is called a root canal.
Food debris, fever, or jaw problems: Small pieces of food may be stuck in your gums and lead to infection. You’ll need a deep cleaning and possibly gum therapy. If your jaw is swollen or you have a fever, you may need an antibiotic.

A toothache isn’t something to ignore, especially if you’re in constant pain. Visiting the dentist is the best way to stop the ache and prevent an infection from getting worse.

Emergency Care

Untreated cavities and tooth decay can have serious complications for adults and children, even if they don’t have their permanent teeth. Possible complications include:

An abscess or a pocket of pus around a tooth that can spread and lead to a more serious infection
Throbbing pain
Damaged or broken teeth
Chewing problems
Tooth loss

Causes, Symptoms, Treatment & Prevention

Overview

What is a toothache?

A toothache is a pain in or around a tooth. Minor toothaches can come from a temporary gum irritation that you can treat at home. More serious toothaches are caused by dental and mouth problems that won’t get better on their own and will need to be treated by a dentist.

Why is my toothache so painful?

The pulp inside your tooth is soft material filled with nerves, tissues and blood vessels. These pulp nerves are among the most sensitive in your body. When these nerves are irritated or infected by bacteria (abscess), they can cause severe pain.

Symptoms and Causes

What are possible causes of toothache?

Toothaches can be caused by:

Tooth decay.
Abscessed tooth (a bacterial infection inside the center of the tooth).
Tooth fracture (broken tooth).
A damaged filling.
Repetitive motions, such as chewing gum or grinding or clenching teeth. These motions can wear down your teeth.
Infected gums.
Eruption (teeth coming out of the gums) or removal of a tooth (for example, wisdom teeth).

What are symptoms of toothache?

Tooth pain that may be sharp, throbbing, or constant. In some people, pain results only when pressure is applied to the tooth (biting down on something).
Swelling around the tooth.
Fever or headache.
Foul-tasting drainage from the infected tooth.
A bad odor from the mouth.

If you experience trouble breathing and swallowing along with your pain, call a dental professional right away.

Management and Treatment

Can my toothache go away on its own?

Some toothaches that come from pain around (but not inside) your tooth can get better without a trip to the dentist. Pain from a temporary irritation (redness) in the gum can be resolved within a few days. During this time try not to chew around the affected area. Eat soft foods, like eggs and yogurt, and avoid sweets and very hot or very cold foods if teeth are sensitive.

How do I treat a toothache at home?

For temporary relief of a toothache, you can do the following:

Rinse with warm saltwater. Saltwater can loosen debris between your teeth, act as a disinfectant and reduce inflammation. Stir a ½ teaspoon of salt into a glass of warm water and rinse your mouth thoroughly.
Rinse with hydrogen peroxide. A hydrogen peroxide (3% solution) helps to reduce inflammation and pain. Dilute the hydrogen peroxide with equal parts water and rinse thoroughly. Don’t swallow it.
Cold compress. For swelling and pain hold a cold compress of ice wrapped in a towel to the painful area for 20-minute periods. Repeat every few hours.
Pain medications. Over-the-counter pain medications can reduce pain and inflammation. NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin®, Advil®) and naproxen (Aleve®) can be used, or take acetaminophen (Tylenol®) if you can’t take NSAIDs. Don’t give a child under the age of 16 aspirin; use Tylenol instead.

Natural or herbal treatments

Clove oil. A natural antiseptic that numbs pain and reduces inflammation. Dab a small amount of clove oil on a cotton ball and apply to the painful area. Or add a drop of clove oil to a small glass of water and rinse your mouth thoroughly.
Vanilla extract. The alcohol in vanilla extract numbs pain temporarily and its antioxidants help the area heal. Use your fingertips or cotton ball to apply the extract to the tooth and gum a few times a day.
Peppermint tea. Peppermint’s soothing properties can be applied to the painful area with a cooled down peppermint tea bag. Hold this warm tea bag against the tooth and gum.
Garlic. Make a paste of a crushed garlic clove and apply to the affected area. Garlic can kill bacteria (it contains the antimicrobial allicin) and relieve pain.

What happens when I go to the dentist’s office for my toothache?

Temporary, home-made pain relief won’t be enough if your toothache is progressing. Call your dental professional when it becomes clear that the problem in your mouth is getting worse despite your best efforts.

At the office your dental team will review your medical history. You’ll be asked questions like:

Where is the pain located?
When did it start?
How severe is it?
What makes the pain worse and what gives you relief?

The dental team will also do a physical exam. They’ll check your mouth, teeth, gums, jaws, tongue, throat, sinuses, ears, nose and neck. You’ll probably get X-rays of your mouth taken to help show the cause of your toothache.

How will the dentist treat my toothache?

Treatment by a dental professional depends on what is causing your toothache.

If a cavity is causing the toothache, your dentist will fill the cavity or take the tooth out, if necessary.
A root canal (a procedure to remove and replace infected pulp with sealing material) may be needed if the cause of the toothache is an infection of the tooth’s nerve. Bacteria that have worked their way into the inner space of the root of the tooth cause infection.
An antibiotic may be prescribed if there is fever or swelling of the jaw. A small piece of food (like a popcorn hull) can get stuck under the gums causing an infection. In this instance, a deep cleaning may be performed or recommended followed by further periodontal (gum) therapy if necessary.

Prevention

How can I prevent a toothache?

Since most toothaches are the result of tooth decay, good oral hygiene practices can prevent toothaches:

Brush regularly with a fluoride toothpaste.
Floss at least once a day.
See your dentist twice a year for professional cleaning.

Also, eat foods low in sugar and ask your dentist about sealants and fluoride applications.

Living With

When should I see a dentist for a toothache?

See your dentist as soon as possible if:

You have a toothache that lasts longer than one or two days.
Your toothache is severe.
You have a fever, earache or pain when you open your mouth wide.
You experience swelling in the mouth or face.

The proper diagnosis and treatment of dental infections are important to prevent it from spreading to other parts of the face and skull and possibly even to the bloodstream.

Toothaches can be extremely uncomfortable but the pain isn’t permanent as long as it’s treated. Your dental professional can relieve your pain and prevent any infections in your mouth from spreading in your body.

Can a toothache make me sick, or even be fatal?

A toothache itself isn’t fatal. But an untreated infection in your tooth (or any other part of your body) can spread. You can become sick, and this illness could turn into something serious or even life-threatening. So if you toothache isn’t getting better it’s a good idea to contact your dentist.

Causes, Symptoms, Treatment & Prevention

Overview

What is a toothache?

Why is my toothache so painful?

Symptoms and Causes

What are possible causes of toothache?

Toothaches can be caused by:

Tooth decay.
Abscessed tooth (a bacterial infection inside the center of the tooth).
Tooth fracture (broken tooth).
A damaged filling.
Repetitive motions, such as chewing gum or grinding or clenching teeth. These motions can wear down your teeth.
Infected gums.
Eruption (teeth coming out of the gums) or removal of a tooth (for example, wisdom teeth).

What are symptoms of toothache?

Tooth pain that may be sharp, throbbing, or constant. In some people, pain results only when pressure is applied to the tooth (biting down on something).
Swelling around the tooth.
Fever or headache.
Foul-tasting drainage from the infected tooth.
A bad odor from the mouth.

If you experience trouble breathing and swallowing along with your pain, call a dental professional right away.

Management and Treatment

Can my toothache go away on its own?

How do I treat a toothache at home?

For temporary relief of a toothache, you can do the following:

Rinse with warm saltwater. Saltwater can loosen debris between your teeth, act as a disinfectant and reduce inflammation. Stir a ½ teaspoon of salt into a glass of warm water and rinse your mouth thoroughly.
Rinse with hydrogen peroxide. A hydrogen peroxide (3% solution) helps to reduce inflammation and pain. Dilute the hydrogen peroxide with equal parts water and rinse thoroughly. Don’t swallow it.
Cold compress. For swelling and pain hold a cold compress of ice wrapped in a towel to the painful area for 20-minute periods. Repeat every few hours.
Pain medications. Over-the-counter pain medications can reduce pain and inflammation. NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin®, Advil®) and naproxen (Aleve®) can be used, or take acetaminophen (Tylenol®) if you can’t take NSAIDs. Don’t give a child under the age of 16 aspirin; use Tylenol instead.

Natural or herbal treatments

Clove oil. A natural antiseptic that numbs pain and reduces inflammation. Dab a small amount of clove oil on a cotton ball and apply to the painful area. Or add a drop of clove oil to a small glass of water and rinse your mouth thoroughly.
Vanilla extract. The alcohol in vanilla extract numbs pain temporarily and its antioxidants help the area heal. Use your fingertips or cotton ball to apply the extract to the tooth and gum a few times a day.
Peppermint tea. Peppermint’s soothing properties can be applied to the painful area with a cooled down peppermint tea bag. Hold this warm tea bag against the tooth and gum.
Garlic. Make a paste of a crushed garlic clove and apply to the affected area. Garlic can kill bacteria (it contains the antimicrobial allicin) and relieve pain.

What happens when I go to the dentist’s office for my toothache?

At the office your dental team will review your medical history. You’ll be asked questions like:

Where is the pain located?
When did it start?
How severe is it?
What makes the pain worse and what gives you relief?

How will the dentist treat my toothache?

Treatment by a dental professional depends on what is causing your toothache.

If a cavity is causing the toothache, your dentist will fill the cavity or take the tooth out, if necessary.
A root canal (a procedure to remove and replace infected pulp with sealing material) may be needed if the cause of the toothache is an infection of the tooth’s nerve. Bacteria that have worked their way into the inner space of the root of the tooth cause infection.
An antibiotic may be prescribed if there is fever or swelling of the jaw. A small piece of food (like a popcorn hull) can get stuck under the gums causing an infection. In this instance, a deep cleaning may be performed or recommended followed by further periodontal (gum) therapy if necessary.

Prevention

How can I prevent a toothache?

Since most toothaches are the result of tooth decay, good oral hygiene practices can prevent toothaches:

Brush regularly with a fluoride toothpaste.
Floss at least once a day.
See your dentist twice a year for professional cleaning.

Also, eat foods low in sugar and ask your dentist about sealants and fluoride applications.

Living With

When should I see a dentist for a toothache?

See your dentist as soon as possible if:

You have a toothache that lasts longer than one or two days.
Your toothache is severe.
You have a fever, earache or pain when you open your mouth wide.
You experience swelling in the mouth or face.

The proper diagnosis and treatment of dental infections are important to prevent it from spreading to other parts of the face and skull and possibly even to the bloodstream.

Can a toothache make me sick, or even be fatal?

Managing tooth pain in general practice

Singapore Med J. 2019 May; 60(5): 224–228.

, MBChB,¹, BDS,², MDS, MBBS,², BDS, MSc,² and , MCFP, MHPE¹

Sky Wei Chee Koh

¹Department of Family Medicine, National University Health System, Singapore

Chun Fai Li

²University Dental Cluster, National University Health System, Singapore

John Ser Pheng Loh

²University Dental Cluster, National University Health System, Singapore

Mun Loke Wong

²University Dental Cluster, National University Health System, Singapore

Victor Weng Keong Loh

¹Department of Family Medicine, National University Health System, Singapore

²University Dental Cluster, National University Health System, Singapore

Correspondence: Dr Sky Wei Chee Koh, Resident, Family Medicine Residency Programme, Department of Family Medicine, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 9, Singapore 119228. gs.ude.shun@hok_cw_yksThis article has been cited by other articles in PMC.

Abstract

Tooth pain is a common presentation in primary care, with 32.4% of Singaporeans experiencing pain from dental caries in their lifetime. Some systemic conditions can have oral presentations, and oral conditions may be associated with chronic disease. A good history and examination is key in delineating odontogenic from non-odontogenic causes of tooth pain. Primary care physicians should accurately diagnose and assess common dental conditions and make appropriate referrals to the dentist. Common non-odontogenic causes of orofacial pain can be mostly managed in primary care, but important diagnoses such as acute coronary syndrome, peritonsillar abscess and temporal arteritis must not be missed. Ibuprofen has been shown to be effacious, safe and cost-effective in managing odontogenic pain. Antibiotics are indicated when there is systemic or local spread of dental infection. Without evidence of spread, antibiotics have not been shown to reduce pain or prevent subsequent dental infections.

Keywords: dental care, facial pain, general practice, primary health care, toothache

Mr Tan, a 48-year-old banker with no significant past medical history, visited your clinic with the complaint of severe right-sided tooth pain that radiated to the right temporal region of the head. The pain was excruciating and had affected his concentration at work. The over-the-counter paracetamol he had taken did not seem to relieve the pain and Mr Tan felt that it could not just be a simple toothache. He asked you to prescribe some antibiotics to treat what he believed was a dental infection.

WHAT IS TOOTH PAIN?

Tooth pain, which is often known as toothache, refers to the symptom of pain arising from the tooth (or teeth).

HOW COMMON IS THIS IN MY PRACTICE?

Dental caries () is a common dental condition. Globally, up to 35% of people have untreated dental caries,(1) and an estimated 32.4% of the Singapore population will experience pain from symptomatic dental caries in their lifetime.(2) Locally, oral disease is ranked 16th in terms of years lost to disability and has been an important cause of functional and social impairment.(2) Other common causes of tooth pain include periodontal disease and dental trauma. Patients often seek the opinion of their family doctors for their tooth pain.

Photograph shows dental caries in a patient, with visible tooth decay (arrows).

HOW IS THIS RELEVANT TO MY PRACTICE?

Primary care physicians are well placed to help patients presenting with tooth pain at their clinics for a number of reasons: they provide opportunistic general and dental health promotion advice, manage a number of causes of orofacial pain, and diagnose systemic conditions that have oral presentations. Primary care physicians need to keep in mind how chronic conditions and lifestyle factors may relate to oral conditions. For instance, patients with poorly controlled diabetes mellitus have a threefold increased risk of developing periodontitis ().(3) Smoking and alcohol consumption increase the risk of oropharyngeal cancers, and patients with osteoporosis on long-term bisphosphonates or RANKL (receptor activator of nuclear factor kappa-B ligand) inhibitors such as denosumab are at increased risk of medication-related osteonecrosis of the jaw.(4)

Photograph shows a patient with periodontitis characterised by gingival recession (arrow).

In turn, oral conditions may be associated with chronic conditions. For example, poor oral hygiene increases the risk of infective endocarditis-related bacteraemia after tooth brushing by three- to fourfold.(5) In addition, conditions such as oral candidiasis may point to the underlying immunosuppression seen in HIV infection.(6) This bidirectional relationship underscores the pivotal role that primary care physicians play in the prompt diagnosis, investigation and management of patients with oral conditions.

WHAT CAN I DO IN MY PRACTICE?

Clinical history and examination

Many oral conditions may mimic tooth pain and it is important to delineate the different causes with history-taking and examination. We suggest the following:

Identify the source of pain by taking a comprehensive pain history.
Check for fever and signs of spread (e.g. local swelling or cervical lymphadenopathy).
Examine the oral cavity (i.e. tonsils, palate, tongue and ulcers).
Examine the dentition and gums, specifically looking out for dental caries (), gingival oedema and abscesses, loose or broken fillings, ill-fitting dentures, and tooth mobility.
Screen for other possible causes of non-odontogenic pain (e.g. temporomandibular joint, eyes, sinuses, ears, and the parotid and submandibular glands).

Diagnosis and management

The key decision point in managing patients with tooth pain is determining whether the pain is odontogenic or non-odontogenic in origin.

Odontogenic pain

Odontogenic pain, or pain arising from the tooth, may be recognised by the following characteristics: it is often localised to the tooth, has an excruciating and acute onset, and is exquisitely sensitive to hot or cold stimulus. It may be aggravated by biting or chewing, is typically associated with dental caries or dental trauma (look for chipped surfaces or lacerated gingival tissues) and may sometimes be due to periodontal disease. In general, patients with odontogenic pain should be referred to a dentist. A summary of the common causes of odontogenic pain seen in primary care are listed in .

Table I

Causes of odontogenic pain.

Non-odontogenic pain

Non-odontogenic pain refers to tooth pain that does not arise from the tooth. As there are many non-odontogenic causes of tooth pain, an exhaustive list is beyond the scope of this article and more comprehensive resources are recommended.(10,11) Nonetheless, the primary care physician needs to consider the following red flags in patients who seem to present with tooth pain: (a) acute coronary syndrome – presenting with radiation of pain to the jaw; (b) peritonsillar abscess – presenting with odynophagia, trismus and hoarseness; and (c) temporal arteritis – presenting with temporal headache, visual defects, jaw claudication, or neck and shoulder stiffness.

Common non-odontogenic causes of orofacial pain seen in primary care are highlighted in . Most of these may be easily diagnosed and managed in primary care.

Table II

Causes of non-odontogenic orofacial pain.

Prescribing analgesia for odontogenic pain

Paracetamol and short-acting non-steroidal anti-inflammatory drugs (NSAIDs) form the mainstay of pain management. Ibuprofen has been shown to have good efficacy and safety, and is cost-effective.(20) Opioid alternatives such as tramadol, which carries the risk of dependency and other side effects, may be carefully considered if required. Antimicrobial mouthwash can be useful for osteonecrosis of the jaw and pericoronitis (i.e. impacted wisdom tooth).

The role of antibiotics in odontogenic pain

A Cochrane review recommends that antibiotics are indicated when there is clinical evidence of systemic (e.g. fever or malaise) or local spread of dental infection (e.g. cellulitis, lymphadenopathy or diffused swelling).(21) In such instances, antibiotics with coverage of oral bacteria such as a penicillin with beta-lactamase inhibitor or metronidazole may be prescribed.(22) Antibiotics have a limited role in the treatment of dental infection without spread: the evidence has not shown that antibiotics reduce pain(23) or prevent subsequent dental infections(24) when there is no evidence of spread. Instead, inappropriate use of antibiotics risks resulting in antimicrobial resistance and has adverse effects with minimal benefit to patients. Despite this, the reported rate of antibiotic prescription in primary care patients with odontogenic pain in the United Kingdom has been disproportionately high at 57%.(25)

In summary, a safe approach to clinical decision-making in patients presenting with tooth pain entails careful differentiation between odontogenic versus non-odontogenic pain, keeping in mind the possibility of underlying red flags. Management decision-making includes the use of simple analgesics, antibiotics only when clinically indicated, and prompt dental or specialist referral when required.

TAKE HOME MESSAGES

The first step in managing tooth pain is to differentiate between odontogenic and non-odontogenic pain with a detailed history and clinical examination of the oral cavity.
Keep in mind red flags that may cause non-odontogenic pain, such as acute coronary syndrome, peritonsillar abscess and temporal arteritis.
Management of odontogenic pain includes relief of symptoms and, when required, timely referral to the dentist for assessment, tests and treatment.
Analgesia such as paracetamol and NSAIDs (e.g. ibuprofen 400 mg three times daily) is preferred.
Antibiotics are only indicated if clinical evidence of local or systemic spread of dental infections is present.

On further assessment, you determined that Mr Tan’s pain was odontogenic. There was tenderness on percussion of the upper right first molar, a sharp shooting pain on cold stimulus, and lingering of the pain for almost one minute after the cold was removed, suggesting possible endodontic disease. Without evidence of systemic or local spread of infection, you explained that Mr Tan did not need antibiotics. Instead, you suggested that it would be beneficial to see a dentist for assessment and possible root canal treatment. You added ibuprofen to his prescription and arranged a referral to the dentist for the following day.

REFERENCES

1. Marcenes W, Kassebaum NJ, Bernabé E, et al. Global burden of oral conditions in 1990-2010:a systematic analysis. J Dent Res. 2013;92:592–7. [PMC free article] [PubMed] [Google Scholar]3. Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. J Am Dent Assoc. 2003;134:34S–40S. [PubMed] [Google Scholar]4. Chan BH, Yee R, Puvanendran R, Ang SB. Medication-related osteonecrosis of the jaw in osteoporotic patients:prevention and management. Singapore Med J. 2018;59:70–5. [PMC free article] [PubMed] [Google Scholar]5. Lockhart PB, Brennan MT, Thornhill M, et al. Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Ame Dent Assoc. 2009;140:1238–44. [PMC free article] [PubMed] [Google Scholar]6. Alpert PT. Oral health:the oral-systemic health connection. Home Health Care Manag. 2017;1:56–9. [Google Scholar]7. Blakey GH, White RP, Jr, Offenbacher S, et al. Clinical/biological outcomes of treatment for pericoronitis. J Oral Maxillofac Surg. 1996;54:1150–60. [PubMed] [Google Scholar]9. Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw–2014 update. J Oral Maxillofac Surg. 2014;72:1938–56. [PubMed] [Google Scholar]10. Scrivani SJ, Spierings EL. Classification and differential diagnosis of oral and maxillofacial pain. Oral Maxillofac Surg Clin North Am. 2016;28:233–46. [PubMed] [Google Scholar]11. Chi AC, Neville BW, Krayer JW, Gonsalves WC. Oral manifestations of systemic disease. Am Fam Physician. 2010;82:1381–8. [PubMed] [Google Scholar]12. McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA. 2004;291:1587–95. [PubMed] [Google Scholar]13. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update):adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1–S39. [PubMed] [Google Scholar]14. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version) Cephalalgia. 2013;33:629–808. [PubMed] [Google Scholar]15. Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults:the american headache society evidence assessment of migraine pharmacotherapies. Headache. 2015;55:3–20. [PubMed] [Google Scholar]17. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications:recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28:6–27. [PMC free article] [PubMed] [Google Scholar]18. Mujakperuo HR, Watson M, Morrison R, Macfarlane TV. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev. 2010:CD004715. [PubMed] [Google Scholar]19. Gronseth G, Cruccu G, Alksne J, et al. Practice parameter:the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review):report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71:1183–90. [PubMed] [Google Scholar]21. Cope AL, Chestnutt IG, Wood F, Francis NA. Dental consultations in UK general practice and antibiotic prescribing rates:a retrospective cohort study. Br J Gen Pract. 2016;66:e329–36. [PMC free article] [PubMed] [Google Scholar]22. Cope A, Francis N, Wood F, Mann MK, Chestnutt IG. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database Syst Rev. 2014:CD010136. [PubMed] [Google Scholar]23. Oral and Dental Expert Group. eTG Version 2. Melbourne: Therapeutic Guidelines Limited; 2012. Therapeutic guidelines:oral and dental. [Google Scholar]24. Runyon MS, Brennan MT, Batts JJ, et al. Efficacy of penicillin for dental pain without overt infection. Acad Emerg Med. 2004;11:1268–71. [PubMed] [Google Scholar]25. Agnihotry A, Fedorowicz Z, van Zuuren EJ, Farman AG, Al-Langawi JH. Antibiotic use for irreversible pulpitis. Cochrane Database Syst Rev. 2016;2:CD004969. [PubMed] [Google Scholar]

Oral Analgesics for Acute Dental Pain

Nonopioid analgesics include nonsteroidal anti-inflammatory drugs (NSAIDs), as well as acetaminophen. Examples of NSAIDs include ibuprofen, naproxen, celecoxib, and aspirin. They each work via slightly different mechanisms, but in general inhibit cyclooxygenase (COX), an enzyme involved in the conversion of arachidonic acid to prostaglandins, which are mediators of inflammation, fever, and pain.^{4, 5} The mechanism by which acetaminophen provides pain relief is less clear, but there is some evidence suggesting it involves the inhibition of prostaglandin synthesis in the central nervous system.^{4, 6}

NSAIDs act peripherally, meaning they help with pain by reducing inflammation at the site where it is occurring. Alternatively, acetaminophen acts centrally by blocking the transmission of pain signaling within the central nervous system. Due to these differing mechanisms of action, taking NSAIDs and acetaminophen in combination has been shown to be highly effective in reducing mild to moderate pain, as the pain is being blocked at both ends of the nociceptive pathway.⁷

Acetaminophen and some NSAIDs (aspirin, ibuprofen, and naproxen sodium) are available to patients over-the-counter (OTC) in standard doses (e.g., 200 mg ibuprofen; 325 or 500 mg acetaminophen), but higher doses of these medications can be prescribed to patients. In 2020, the U.S. Food and Drug Administration approved an OTC fixed-dose combination product containing ibuprofen plus acetaminophen; each 2-caplet dose contains 250 mg ibuprofen and 500 mg acetaminophen.⁸ There are also several other NSAIDs only available with a prescription, such as celecoxib, ketoprofen, and diclofenac.⁷

Although effective in relieving acute pain, use of NSAIDs, especially long-term use, can be accompanied by adverse effects. Because prostaglandins have a role in gastrointestinal (GI) mucosal protection and also play an essential role in renal perfusion, by blocking prostaglandin synthesis, NSAIDs can cause GI and renal adverse effects. The most common adverse effect with NSAID use is GI toxicity, which can result in symptoms such as nausea, heartburn, abdominal pain, and bleeding. Additionally, NSAIDs may increase the risk of serious cardiovascular events and nephrotoxicity.^{4, 9} All prescription NSAIDs must display a black box warning that cardiovascular thrombotic events as well as gastrointestinal risks are possible when using the medication.⁴

Acetaminophen use has been associated with liver toxicity as well as other less serious adverse effects such as headache, agitation, and GI symptoms.⁴ Prescription acetaminophen must display a black box warning about hepatotoxicity, as taking over 4,000 mg per day has been associated with acute liver failure.⁴ Patients may be at risk of exceeding this 4,000 mg limit with OTC drugs, as there are many OTC combination drugs that contain acetaminophen as an active ingredient (i.e., cold and flu medications), and patients may unknowingly take more than one acetaminophen-containing drug at once.¹⁰ When NSAIDs are taken in combination with acetaminophen, there is little indication that adverse effects are any greater than those experienced with each drug individually.⁷

Management of acute dental pain: a practical approach for primary health care providers

If pus is present, it needs to be drained, the cause eliminated, and host defences augmented with antibiotics. The microbial spectrum is mainly gram positive including anaerobes. Appropriate antibiotics would include a penicillin or a `first generation’ cephalosporin, combined with metronidazole in more severe cases.

Paracetamol or a non-steroidal anti-inflammatory drug is the recommended analgesic in the initial treatment of dental pain.

Food impaction and pericoronitis

Soft tissue problems that may cause dull, throbbing, persistent pain include local inflammation (acute gingivitis associated with food impaction) or pericoronitis.

Chronic periodontitis with gradual bone loss, rarely causes pain and patients may be unaware of the disorder until tooth mobility is evident. There is quite often bleeding from the gums and sometimes an unpleasant taste. This is usually a generalised condition, however, deep pocketing with extreme bone loss can occur around isolated teeth. Food impaction in these areas can cause localised gingival pain. Poor contact between adjacent teeth and the presence of an occluding cusp forcing food into this gap can also cause a build-up of food debris and result in gingival inflammation.

Acute pericoronitis involves bacterial infection around an unerupted or partially erupted tooth and usually affects the lower third molar (wisdom tooth). The condition is often aggravated by the upper molar impacting on the swollen flap of soft tissue covering the unerupted tooth. There may be trismus.

Treatment

Food debris should be removed and drainage established, if pus is present. Irrigation with chlorhexidine and rinsing the mouth with hot salty water is recommended. Early referral to a dentist is indicated. Cellulitis can develop, requiring urgent referral to a surgeon.

Acute necrotising ulcerative gingivitis

Acute necrotising ulcerative gingivitis is a rapidly progressive infection of the gingival tissues that causes ulceration of the interdental gingival papillae. It can lead to extensive destruction. Usually young to middle-aged people with reduced resistance to infection are affected. Males are more likely to be affected than females, with stress, smoking and poor oral hygiene being predisposing factors. Halitosis, spontaneous gingival bleeding, and a `punched-out’ appearance of the interdental papillae are all important signs.

The patients quite often complain of severe gingival tenderness with pain on eating and tooth brushing. The pain is dull, deep-seated and constant. The gums can bleed spontaneously and there is also an unpleasant taste in the mouth.

Treatment

As there is an acute infection with mainly anaerobic bacteria, treatment follows surgical principles and includes superficial debridement, use of chlorhexidine mouthwashes and a course of metronidazole tablets. Treating the contributing factors should prevent a recurrence.

Dry socket

A dull throbbing pain develops two to four days after a mandibular tooth extraction. It rarely occurs in the maxilla. Smoking is a major predisposing factor as it reduces the blood supply. The tissue around the socket is very tender and white necrotic bone is exposed in the socket. Halitosis is very common.

Treatment

The area should be irrigated thoroughly with warm saline solution. If loose bone is present, local anaesthesia may be necessary to allow thorough cleaning of the socket. Patients should be shown how to irrigate the area and told to do this regularly. Analgesics are indicated, but pain may persist for several days. Although opinion is divided as to whether or not dry socket is an infective condition, we do not recommend the use of antibiotics in its management (see box).

Temporomandibular disorders

Temporomandibular disorders may lead to pain that is confused with toothache. Patients usually complain of unilateral vague pain occurring in the joint area and in the surrounding muscles of mastication. If the patient bruxes (clenches or grinds) at night, then pain in the temporal area on waking is common. Patients who clench during the day may find they get symptoms at the end of the day. The symptoms are often cyclical, resolving then recurring again. On questioning, patients will frequently be able to reveal stressful incidents that may have triggered this process. Palpation of the muscles of mastication will elicit tenderness, usually unilaterally. There may also be tenderness around the temporomandibular joints, limitation in mouth opening and obvious wear of the teeth. This wear may contribute to dentine sensitivity, as the enamel is worn away by the tooth grinding. Wear facets will be seen on restorations as well as natural teeth. Quite often, neck and shoulder muscles are tender to palpation. There may be joint pain with clicking and grating.

Treatment

Reassurance about the self-limiting nature of the problem and its reversibility may be all that is needed. Anti-inflammatory drugs and muscle relaxants can also help. Construction of a night-guard and muscle exercises may be indicated subsequently. These exercises may include gentle passive stretching, or resistance and clenching exercises.²

Sinusitis

This is caused by infection of the maxillary sinus, usually following an upper respiratory tract infection. However, there can be a history of recent tooth extraction leading to an oro-antral fistula. Patients usually complain of unilateral dull pain in all posterior upper teeth. All these teeth may be tender to percussion, but they will respond to a pulp sensitivity test. There are usually no other dental signs.

The pain tends to be increased on lying down or bending over. There is often a feeling of `fullness’ on the affected side. The pain is usually unilateral, dull, throbbing and continuous. Quite often the patient feels unwell generally and feverish.

Treatment

Pain originating from the sinus arises mainly from pressure. Decongestants can help sinus drainage. Antibiotics probably have only a minor role in mild cases. Referral to an otorhinolaryngologist for endoscopic sinus surgery may be indicated in chronic cases.³

Alpharetta GA Tooth Pain Relief, Toothache

Are you suffering from toothache and are looking for tooth pain relief and treatment in the Alpharetta area? A severe toothache can ruin your day, and it is unlikely to feel better until you see a dentist for treatment. Tooth pain that lasts for more than a few hours is usually caused by a dental issue that is irritating the nerves inside the tooth. When you need tooth pain relief, count on the dental professionals at Creative Dentistry & Medspa to provide quick and effective dental care at our clinic in Alpharetta, GA.

Tooth pain can be caused by decay, infection, cracks and other damage to the tooth. It is never a good idea to ignore tooth pain or placate it with pain relievers, as it is a sign there is something wrong with the tooth. In most cases, tooth pain can be relieved in one visit. We can remove decay or repair damaged teeth to provide pain relief and restore your tooth. Even severe dental issues like tooth infections can be fixed with a root canal. This procedure may require more than one visit, but you will likely have relief from the pain after your first treatment.

Jaw Pain Relief

Toothaches are not the only oral pain we treat at Creative Dentistry & Medspa. We can also find the root cause of jaw pain that can make chewing difficult or keep you awake at night. Jaw pain is often caused by stress on the jaw joint, and it can be an indicator or symptoms of TMD (temporomandibular joint disorder). Our experienced dentists can perform a thorough dental exam to determine what is causing your jaw pain and offer a treatment solution for jaw pain relief.

You do not need to live with oral pain. If you or a family member have a toothache or jaw pain, contact us at Creative Dentistry & Medspa to schedule your appointment. We offer emergency dentistry and same day appointments for new and existing patients who need to see a dentist right away.

How to make pain relief for severe toothache at home

Date of publication: 02.10.2018

A toothache always comes unexpectedly and, of course, at the wrong time. From mild discomfort to severe pain that prevents you from sleeping, eating, working and communicating with people. You need to visit the dentist’s office as soon as possible. But this is not always possible.

Therefore, funds are used for self-relieving severe toothache. This will help you get through the night or a couple of days before your doctor visit.

Why does toothache occur

Pain is a signal from the body that something has gone wrong. In the case of toothache, there are several reasons for its occurrence:

Caries. At first, the formation of caries only increases the sensitivity of the teeth. This is a reaction to cold and hot, later to sour and sweet. As the disease develops and the carious cavity deepens, the process approaches the pulp and causes much more serious discomfort.
Pulpitis. This is an inflammation of the pulp as a result of the penetration of infection through a hole in the tooth. Pain with pulpitis occurs suddenly, does not depend on food intake and other external stimuli. It can be removed permanently only by removing damaged tissue and installing a seal. The tooth will have to be depulpated, that is, to remove the nerve.
Gingivitis, periodontitis. This is an inflammation of the soft tissues around the teeth, which can cause pain when chewing and pressing on the tooth. The danger of such diseases is that they can provoke loosening of the gums and mobility of the teeth.
Periodontitis. This is an inflammation of the hard tissues surrounding the tooth. Threatens with the appearance of cysts and the loss of a diseased tooth.

What to do if a tooth hurts

In any case, you need to visit the dentist as soon as possible. If there is no way to do this immediately, you can try to relieve the pain at home. Basic rules of conduct for severe toothache:

Brush your teeth, make sure that there are no food debris in the cavity of the diseased tooth.
Rinse mouth with warm baking soda solution.
Do not chew solid food, free the affected side from the chewing load.
Avoid hot and cold drinks and food.
Better not to lie down or do it with a high pillow. When sitting or half-sitting, the pain may not be as severe.
Do not use a heating pad or other heating methods. First, it will increase blood flow and increase pain.Secondly, without an accurate diagnosis, one cannot be sure that there is no abscess in the gum, ready to burst from warming up. A hot compress will inevitably accelerate the growth of bacteria, which will only harm.
The sore spot can be cooled. A small piece of ice wrapped in several layers of cloth will help dull the pain for a while.
It is worth taking a pain reliever. A strong analgesic will be required.
If the pain is provoked by an inflamed gum, herbal decoctions and infusions for rinsing can be used.Sage, chamomile, plantain, lemon balm, oregano are great for this.
A solution of honey as a rinse has good disinfecting properties.

Doctor’s actions if a tooth hurts

If a patient comes to an appointment with acute pain, the first thing to do is to give him an injection of anesthesia. After that, diagnostics can be carried out, which usually consists in a visual examination and an X-ray. In the picture, in most cases, the cause of the problem will be clearly visible.The most common cause of toothache is pulpitis. In this case, a number of manipulations are required:

Pain relief.
Removal of damaged tooth tissues, depulpation.
Treatment of canals, their filling.
If there are signs of infection, medication may be placed in the ducts. Gargles may also be prescribed to eliminate infection and relieve inflammation. In this case, a temporary filling is placed.
Installation of a permanent seal.

If the pain is caused by a problem with soft tissues, anti-inflammatory drug therapy, various procedures, and rinsing are required.

Expert opinion

Lyubov Ivanovna Kopylova

dentist-therapist

Experience: more than 10 years

Any type of pain relief is a temporary measure for those cases when it is not possible to immediately go to the dentist.If there is such an opportunity, there is no need to waste time and mask the signs of the disease, no pain reliever or method is curative. Only the qualified help of a specialist will allow you to restore your dental health. Moreover, the use of folk remedies is not suitable for everyone. We remind you that admission of patients with acute pain in dental clinics is carried out without an appointment and out of turn.

Prevention of dental pain

The main condition in order to avoid toothache is careful oral care.This requires:

Visit your dentist at least twice a year.
Brush your teeth twice a day with a toothpaste brush. Do not use aggressive pastes, so as not to damage the enamel. The brush must be replaced with a new one every three months.
Use dental floss and special rinsing solutions. This will help remove plaque from areas that are not accessible by a toothbrush. Rinsing has a beneficial effect on the gums, strengthening them and preventing the growth of bacteria.
Give up bad habits.
Do not bite nails, pens, matches or other objects.
Eat right to ensure you have enough vitamins and minerals to keep your mouth healthy.
Do not ignore the signals of the body and consult a doctor when the first alarming symptoms appear.

At home, you can only get rid of pain, that is, from a symptom. The reason can only be eliminated by a specialist.Therefore, as soon as possible when pain appears, it is important to make an appointment with the dentist. This will help to carry out the treatment as quickly, simply and inexpensively as possible.

How to treat a toothache – Dentistry “Kingdom of Smiles”

Toothache can be very different both in nature and in intensity. It can be light, growing, radiating to the back of the head and temples, pulsating and constant. It is important to understand that the tooth itself has no sensitivity, pain appears in the pulp, where many nerve endings are located.Self-relieving pain is possible only when there is no way to go to the dental clinic for professional help. In this case, it is allowed to take painkillers and use folk methods.

Since toothache is debilitating and very exhausting, it is not recommended to endure it.

Causes of pain

Unfortunately, it is very difficult to determine the cause of toothache on your own. There are many factors that affect the health of the oral cavity.Each pathology requires an individual approach, only after examination the dentist will be able to conclude about the appropriateness of one or another method of treatment.

The most common reasons include nerve damage, periodontitis, deep caries, severe chips and cracks, a bare tooth neck, inflammation, teething, flux, improper dental treatment in the past, as a result of which not all caries affected areas of hard tooth tissues, and much more.

Also, acute pain can occur for non-dental reasons. It is customary to include diseases such as trigeminal neuralgia, as well as migraines, inflammatory processes (otitis media, sinusitis), heart and vascular problems. During pregnancy, women may also begin to hurt teeth that have never bothered her before. This is due to a serious lack of certain trace elements in the body, such as calcium.

Pain medications

Strong painful sensations have never brought joy to anyone, so they cannot be tolerated.There are cases when acute pain becomes the cause of damage to the human cardiovascular system, as well as the brain and nerve endings. If there is no way to go to the dentist’s office, if a person is far out of town or outside the window in the middle of the night, self-administration of analgesics is allowed.

The following drugs that are approved for sale without a prescription and are excellent pain relievers today include: Citromone (in addition to pain relief, it also helps to bring down the temperature, fights inflammation, acts as quickly as possible, but is not suitable for long-term use without consulting a specialist), Analgin (one of the most available and safe means).

You can also take one-time stronger pain relievers, for example, Ketanov, Ketorolac or Ketorol. You can choose any of the means, because the active substance they have is the same. No less famous drugs for the elimination of toothache: Nise (not suitable for pregnant and lactating women), Tempalgin, Paracetomol and others.

Pain relief at home

If you are afraid of taking strong painkillers and at the same time do not have access to the clinic, you can try to eliminate the pain using one of the well-known folk methods.The most popular option is to rinse your mouth with saline. To do this, dissolve 1 tablespoon of salt in 1 glass of warm water. Rinsing should be done every 2-3 hours.

Another method is the application of compresses soaked in medicinal tinctures, for example, eucalyptus, propolis or valerian. These substances also have a cooling and analgesic effect, so the pain should be relieved. Some people prefer applications of heated propolis, which is placed in the aching tooth.

No less popular is the method of pain relief with vodka. Rinsing the mouth should be done regularly to kill the bacteria present on the enamel, tongue and gums. However, such treatment is definitely not suitable for pregnant women, lactating women, as well as children and people with strong alcohol dependence.

90,000 Why does the tooth ache after filling: the tooth aches after filling

With caries, rather deep cavities are often formed that require tissue preparation and filling.However, the patient’s suffering may not end there, the pain may persist even after treatment. At the same time, the question is quite reasonable: why does the tooth hurt after filling, what to do in this case? The carious cavity was eliminated, the pathological process was eliminated. There are a lot of reasons for pain after dental treatment: you need to understand when you just need to wait, and when you need to go to the dentist again.

Causes of pain

Treatment of medium and deep caries is a rather complex procedure that requires precision of action, comparable to surgery.In the course of treatment, the enamel, dentin and other tissues of the tooth are affected: this can be expressed in the form of pain syndrome, which intensifies after the cessation of the action of the anesthetic. The absence of pain is characteristic of superficial caries, which does not require tissue preparation and anesthesia.

Pain after tooth filling is normal if it persists for no more than 10 days. The nature of the pain after treatment by the dentist is usually aching, it appears or intensifies when chewing or pressing on the tooth.If the tooth hurts quite intensely after filling, these sensations cause significant discomfort, symptomatic pain medication may be recommended. In the event that after filling the toothache bothers for a long time and intensifies, it is necessary to visit the dentist again to identify the cause of this condition. In addition to the physiological causes of pain, the following are distinguished:

Main causes	Why exactly does pain occur?
Poorly performed tissue preparation	The affected tissues are not completely removed, the pathological process develops further, penetrating further and further into the deeper layers.
Violation of the filling technique	Due to the formation of voids, the filling material has little contact with its own tissues, as a result of which pain occurs, secondary caries may develop, etc.
Allergic reaction to filling material	It is almost impossible to predict this situation, since the cause is the individual characteristics of the organism.
Non-compliance with medical recommendations after treatment	Eating immediately after filling (the rule applies only to some materials).
Poor root canal obturation	With pulpitis, the dentist must fill the canals with a special sealing compound.If the canals are poorly filled, cavities can form inside the tooth, where infection can easily enter. The inflammatory process in this situation can threaten with the loss of a tooth.

Medical errors often cause pain after caries treatment. Most often, poor-quality filling of the root canals of the tooth is observed. A tooth ache after filling can also be due to the fact that the dentist forgot to put an insulating pad between the dentin and the filling when treating deep caries.One of the serious and unpleasant complications is the accidental perforation of dental hard tissues of the tooth with dental instruments: in the future, they can become inflamed, which contributes to a number of other pathological processes. This is accompanied by intense pain, a high risk of secondary complications. Perforation requires urgent and high-quality treatment, otherwise a person may lose a tooth.

Filling material can get into the sinus area, which is sometimes observed in the treatment of deep caries of the upper teeth.In this case, after a while, sinusitis develops, flowing into a chronic form. The cause of this complication often remains undetected for a long time, so sinus inflammation can accompany the patient throughout his life.

90,000 Pain relievers during pregnancy – Dental clinic “Novostom”

One of the most common questions that NOVOSTOM specialists have to answer is the possibility of using painkillers by pregnant women.Alas, it is impossible to answer unequivocally.

Pregnancy provokes hormonal changes in a woman’s body. And problems with teeth against this background are not uncommon. In this case, the body works according to the principle “all the best for the child”, which is why women often lack nutrients, including calcium, which is necessary for teeth. In addition, if the oral cavity has not been sanitized, the process of reproduction of harmful bacteria is activated during pregnancy.

Dentists of the NOVOSTOM clinic recommend seeking professional orthodontic treatment immediately after the first symptoms appear.The discomfort that a woman experiences due to toothache has a negative effect on the fetus. Therefore, it is better to immediately consult a specialist. But if this is not possible, you may need to take painkillers.

When pain relief may be needed

Diseases of the dentition, in which the use of painkillers is possible, are as follows:

What products can be used during pregnancy?

It is strictly forbidden to use synthetic pain relievers without a doctor’s prescription during pregnancy.Therefore, try to see a dentist as soon as possible. At SCNT “NOVOSTOM” you will receive qualified advice and will be able to undergo an examination that will show what can be used, taking into account your individual characteristics.

For pregnant women, preparations with a low content of the active ingredient are prescribed. However, even if you have an effective medication prescribed by your doctor, go to the clinic for treatment as soon as possible. Even if the pills were able to reduce discomfort or completely remove them, it is necessary to fight the cause of the Pain.In some cases, specialists may prescribe baby gels that are used for teething in babies. However, their use is permissible only with a doctor’s prescription.

As for the available tools that will help relieve pain and not harm the fetus, you can use a cold compress. It is unacceptable to use hot compresses. If you develop swelling, contact your dentist immediately!

Also for dental diseases, topical antiseptics can be used.It must be remembered that self-medication during pregnancy is not permissible; it can be dangerous for both the mother and the fetus. Therefore, when the first symptoms appear, including pain, you should consult a dentist.

90,000 how to anesthetize the area, remove, relieve inflammation for an adult

How to quickly cope without pills

Now that we have analyzed the most effective methods, it remains to talk about the methods that people have used for centuries in order to forget about unpleasant sensations at least for a day.

Everything that we will consider below is not a solution to the problem, but only folk recipes to temporarily muffle discomfort. We will highlight the most effective ones used in everyday life.

Onions or garlic as a home remedy for toothache

If you ask the older generation, they will recommend these particular products. Their benefits are strong antibacterial, anti-inflammatory and antiseptic effects.

Cut the fresh part of the onion in half.From there it is recommended to get the middle and put it on the sore spot. You can additionally rub the juice with the gums if they become inflamed. The greatest effect has a mixture of rubbed slices of both plants. The resulting gruel should be placed on the inflamed unit and covered with a cotton swab on top. Before starting the procedure, you must thoroughly rinse your mouth so that no food particles remain in the cracks.

But the method cannot be more effective than an appointment with a doctor. We strongly recommend that when the first symptoms appear, do not self-medicate, but sign up for a clinic.

How to Reduce and Stop Tooth Pain at Home – Lard

Another method that our ancestors used to get rid of discomfort. It is necessary to remove the skin from a small greasy slice, peel off the salt from it and apply it to the sore gum. In about 20 minutes, the discomfort should subside.

You can combine the method with the previous example – grind onion or garlic into porridge, add a pounded greasy layer to them and apply to the inflamed area.It is believed to help draw out pus and relieve swelling. The main thing is not to take a smoked or peppery product, so as not to worsen your own condition. Dentists advise not to abuse such funds because of the possibility of complications due to the formation of a fatty film that clogs bacteria in the inflammatory focus.

How to blunt with alcohol

Another option, how you can anesthetize a tooth at home and relieve pain, for an adult patient, both before and after admission.It is enough just to take the strong drink that you have at home from the bar or refrigerator. Rum, whiskey, cognac – any will do. It is necessary to rinse it in your mouth. Swallowing is optional. The alcohol contained in the composition will affect the nerve endings and make the gums numb.

It is worth noting that alcohol treatment is categorically contraindicated for pregnant and lactating women, people with kidney, liver or heart problems, as well as everyone until the age of majority. Also, patients with open wounds in the mouth should not use this method.

In any case, this is just an opportunity to slightly reduce aching or sharp soreness before a doctor’s appointment.

Clove and fir oil

It is believed that one of these types of ethers can cope with unpleasant sensations. They are good antiseptics and anesthetics and help fight inflammation. Just 2-3 drops on cheesecloth are enough and apply for 10 minutes. It is not advisable to use this for pregnant women and people with individual intolerance. It is also not worth abusing, one lotion in the evening before a visit to the dentist is the best solution.

How will peppermint help

Plant leaves can reduce soreness, kill germs and minimize odor. To prepare a pain reliever, you need:

take ½ tablespoon of the herb;
to be thrown into a ceramic container;
add 250 ml of hot water there;
cover with gauze and wait an hour;
strain.

How and what can be anesthetized at home, if a tooth hurts badly – apply the resulting gruel to the gum.If there are fresh leaves, then they are allowed to be chewed. But it is worth remembering about the possibility of an allergic reaction and sticking of plant particles in chips and cracks.

Potatoes

Folk methods also suggest getting rid of the discomfort with raw potatoes. You need to remove the peel from it and grate the pulp on a fine grater. You can add a little salt to enhance the effect. Apply the resulting gruel to a cotton swab and apply to the aching gum. It should be anesthetized in about half an hour.

The product soothes well and relieves puffiness. But still, it is just a vegetable, not a medicine that only relieves symptoms, and does not affect the cause.

What to do at home, how to rent?

Of all the types of pain, the most suffering for a person is toothache. Everyone must have come across it both in childhood and as an adult.

Paradoxically, most people are frivolous about the need for regular visits to the dentist.After all, people know well where to turn in case of acute toothache and understand that the disease will not go away on its own. That a tooth, having begun to decay, will not return to its normal state without the help of a doctor – and at the same time they do not rush to the clinic. Why?

Several reasons for fear of going to the dentist:

1. Negative past experience. Even if it is old or associated only with a feeling of fear at the first visit;
2.Unknown – it seems to a person that his problem may be too neglected and will require serious measures;
3. Bad teeth. Moreover, if the doctor once criticized the patient’s attitude to caring for them;
4. Some women do not want to be treated by a male dentist. they think that they will look unaesthetic and ridiculous, sitting in front of him in a helpless state with their mouths open, etc.

Meanwhile, due to far-fetched fears, the condition of the teeth is constantly deteriorating, and there is no point in postponing a visit to the doctor, because.because in any case it will have to be applied, but with a timely visit to the office, the intervention will be minimal. Having decided to take a responsible attitude to the state of the oral cavity and starting to regularly go to the dentist, one day, with surprise and pride, a person discovers that the fear has disappeared, that sitting in a dental chair and experiencing pain are completely different things. That here – everything is under the control of a specialist, and there is nothing to fear.

Causes of acute toothache

If you once had a toothache, consulting a doctor would be the most correct decision.Because there is definitely a reason for this pain. More about why a tooth hurts:

1. Deep caries, accompanied by the penetration of infection into the tooth tissue. Acute toothache occurs when exposed to an irritant – for example, sweet or cold food;
2. Crack in the tooth, incorrectly placed filling;
3. Periodontitis. The disease is accompanied by inflammation of the bone tissue around the apex of the tooth root. In this case, the gum swells and becomes inflamed, and the tooth itself looses and hurts badly at any touch;
4.Abscess. It is characterized by the appearance of an abscess and a throbbing painful swelling.
5. Pulpitis – when the lesion affects the dental nerve. Pulpitis develops from caries when streptococci and their toxins enter the pulp. This pain often radiates to the ear or temple. Most often, it manifests itself at night and in the evening, and during the day it can be provoked by careless touching a sick tooth. The pain is acute, it is exhausting and does not allow you to go about your usual activities. It may seem that not one, but several teeth are hurting;

Night toothache

As already mentioned, an acute or severe aching toothache often bothers exactly at night, and subsides with the onset of the day.In the evening she comes back again and does not give a full rest. It turns out that during the day a person calms down and does not consider it necessary to go to the doctor, and at night he regrets his frivolity, but where to go in case of acute toothache, when all dental offices are closed? Causes of severe toothache at night:

In the daytime, people are busy, they are at work or school, the brain is constantly busy processing a large amount of information, and the signals that come from a bad tooth are superficially and incompletely perceived.At night, when affairs and worries fade into the background, attention is focused on the sensations of the body.
Staying in a horizontal position, as a result of which the blood supply to the jaw increases. Pulpitis is an inflammation of a nerve in the canal. There are also blood vessels, which, with increased blood flow, expand and press harder on the nerve.

How to relieve a toothache at home

It is unnatural to endure unpleasant, exhausting pain, it is necessary to take measures as soon as possible to return to a normal state.There is not always where to turn in case of acute toothache immediately, so you need to try to relieve pain on your own.

Rinse

The easiest way is to rinse your mouth from the side of the aching tooth with water or soda solution. Food debris often gets into the carious cavity, which causes pain. If you find any anesthetic drops in your home medicine cabinet, you can moisten a small piece of cotton wool with them and place it in your tooth. Such a measure will help numb the pain.But if you use it often, it will soon cease to work.

Folk remedies

There are several popular ways to relieve toothache that, according to reviews, can help:

1. Place a piece of onion or garlic next to a sore tooth;
2. Place a small piece of unsalted bacon between the tooth and the cheek;
3. Lubricate the gums of a diseased tooth with the juice of indoor plants of aloe or kolanchoe;
4.Apply a compress of ground clove spice to the gum near the tooth;
5. Gargling with tinctures of valerian, birch buds, calendula, motherwort;
6. Application of tampons dipped in vodka;
7. Exotic Chinese method – massage with the thumb of one hand of the area between the thumb and forefinger of the other hand.

Pain medications

Someone tries to use fewer medicines, and some, on the contrary, do not believe in the effectiveness of traditional medicine.Let’s list the main drugs that can help relieve toothache. These are analgin, ibufen, citromone, tempalgin, pentalgin, ketanov, paracetomol. All of them are known, are available in almost every pharmacy and are inexpensive. Therefore, it is better to have a supply of painkillers, even if they are not useful, than to save a small amount on their purchase and be left without help in case of acute toothache.

These remedies only help to ease the pain for a while at home, but do not eliminate its cause.It is impossible to completely remove pain without treatment.

Acute toothache and pregnancy

When looking for a remedy to soothe a toothache, the expectant mother should think first of all about the safest remedies for the baby. Rinsing with water at room temperature, compresses with vegetable oil, star balm, cloves, aloe and kolanchoe leaves are suitable.

The specialist can advise modern analgesics that do not harm the unborn child.These are drugs whose active ingredients do not penetrate the fetal plasma. Acceptance of no-shpy is allowed. Paracetomol will also not harm, but it does not always help with severe pain.

Means that are given to babies when teething the first teeth are suitable.

If the pain is too severe, you can drink ketans, but it is better to limit yourself to one pill.

Many women believe that getting treatment from a dentist during pregnancy will harm their unborn baby.In fact, any dentist will tell you that even if a rotten tooth doesn’t hurt, it inevitably spreads the infection throughout the body. Nothing prevents her from penetrating to the fetus, provoking the development of serious health problems. Of course, ideally, teeth should be cured at the stage of planning pregnancy, but if it has already begun, you cannot delay treatment. Today in the dental office there are tools and materials that are harmless for both mom and baby.

What not to do

Unknowingly, a person can worsen his condition.Many people think that if a toothache hurts, you need to lie down and lie down. Although this pain is exhausting, the horizontal position will increase blood circulation in the head area, and the discomfort will intensify. You can relax while sitting or half-sitting.

It is extremely important to know that even such a simple technique as rinsing with warm, and even more so hot water, can be harmful if you do not have caries, but purulent inflammation. The reason is also an increase in blood flow. Heating can provoke an enlargement of the abscess, and it will be more difficult to fix the problem even in the doctor’s office.If the cause of the pain is suppuration, you can only rinse the tooth with cool water. Hot and warm compresses should not be used either.

Where to go with acute pain free of charge

Everyone can have their teeth treated at the local polyclinic, and it will not cost a dime. Even on weekends, healthcare facilities receive patients with acute pain. The doctor will determine the cause of the pain and provide the necessary assistance. After pain relief, you may need another visit to the doctor – this will be determined on the spot.Do not forget that there is always where to turn for acute pain for free. There is no need to waste time, thereby worsening your situation.

21st century. Stop being afraid!

We have already said that the fears of pregnant women about dental treatment are groundless. Moreover, their fear can be dangerous for the child. What else is a relic and does not correspond to reality? Let’s list the main fears.

1.Fear of injections. Some people think that the pain-relieving injection will be too painful or will not work as it should. Previously, only novocaine and lidocaine were used, which did not work for long and were not always effective. Modern anesthetic drugs are highly effective and have a long-lasting effect. They are safe and suitable for pregnant women and people with cardiovascular disease.
2. Fear of removing the nerve. The tooth hurts, and the reason is in the pulp – many are afraid of the very thought that the doctor will touch the source of the pain.Today, a nerve can be removed in one visit to the doctor (without opening the canals, placing arsenic and placing a temporary filling) – without pain and any discomfort.
3. Fear of the drill. Since Soviet times, the eerie sound of a drill has remained in the memory of many. But now there are ultrasonic and chemical methods of preparation. They are no less effective and allow you to completely heal your teeth without noise and pain.

In a word, all fears are far-fetched and even dangerous, given that time plays against you with a toothache.The further the visit to the doctor is postponed, the more difficult the treatment can be. At the same time, there are no insoluble problems for modern dentistry – specialists will certainly help everyone who applies. And so that an acute toothache does not catch by surprise, undergo preventive examinations – it is enough to do this once a year.