PUBLISHED IN TCI WEEKLY NEWS
May 23rd 2015
Dental pain can be caused by a number of different factors including decay, gum disease, abscesses or trauma. As an immediate measure I would recommend an over-the-counter painkiller and then a visit to the dentist as soon as you can to determine the exact cause of the pain after which the correct treatment can be carried out and the pain relieved.
Toothache is one of the most common causes of dental pain. It can be from a live tooth or one that is dead or dying; in each scenario the cause may be different.
If the toothache is a sudden, acute pain caused by hot or cold temperatures then is likely that the tooth is still vital (live). It is probably the case that there is an area of new decay which has reached through to the dentine inside the tooth and is causing the temperature sensitivity and the pain. This can also occur if decay has occurred under an existing restoration- a crown, bridge or a filling. Even if a tooth is already filled or crowned there is still the chance of further decay- and therefore the potential for toothache- if the teeth are not cared for and a good oral hygiene regime followed. In all of these cases it is likely that a filling or some other type of restoration is required.
If the toothache is an sharp, immediate pain when pressure is put on the tooth then the cause could be a cracked or fractured tooth. The nerve is still alive and as the pressure is applied, the cracked portion of the tooth can move/ open and stimulate the nerve causing the pain. If the crack does not extend all the way down to the root, this can usually be fixed with a filling; if it does extend through the root, the only solution is extraction. In the scenario where a piece of the tooth is completely fractured away then the exposed dentine will be sensitive or painful. In some cases the tooth is broken significantly enough that the nerve is exposed which may possibly be seen as a pink/ red area in the dentine. This is likely to be very painful. This would be treated either by a filling or a crown depending upon the extent of the missing tooth. It may also necessary to remove the nerve and the tooth to be root filled.
If a tooth is dying then the toothache will be exacerbated by a hot stimulus and relieved by cold. In time the tooth will become pressure sensitive and this is a sign that the tooth has died and as abscess is starting. Teeth with these symptoms often need root canal treatment.
Toothache can also be a symptom when the surrounding gums are inflamed. In this case it is not individual teeth that need treatment but attention needs to be given to the overall health of the gums through thorough flossing and cleaning, both at home and professionally at the dentist.