I wrote dozens of articles about the dental experience and I realized now that I forgot the first reason people go to the dentist! — TOOTHACHE!
So let’s try to explain what can happen to you in your mouth if it goes wrong! I think that’s why you’re documenting yourself on the web and reading this article.
Basically, the types of toothache for which you go to the dentist in an emergency are 5:
- Pain from caries near a live nerve
- Pain from an abscess or acute apical periodontitis
- Gum pain
- The pains from cracks in the teeth
- Muscle pains
Ok, two are not Toothache, but I have to write TOOTHACHE often, otherwise you will not find this article when you look on Google for Toothache and so I went ahead because I wrote toothache 4 times in 3 lines.
Before talking about toothache (and we are 5 times in 4 lines), however, let’s debunk a myth.
CAVITIES DON’T HURT
… unless they are very large or that they create a hole in which food can enter, especially the sweet one, which generates a throbbing pain until the food is washed away by the little hole or the hole.
Furthermore, caries can often affect already devitalized teeth and therefore be asymptomatic! If you’ve read THE SUPERDENT LEGEND on this blog, you know what I’m talking about.
Let us now turn to the pains that alarm the patient because they are more intense.
Nerve pain is generally a pain that is difficult to refer to a particular tooth unless you feel a crater with your tongue and then you understand quite well what is the element responsible for toothache.
Usually, these are pangs that start from the temple or ear and spread to the lips. The signs are a growing pain in reaction to cold foods or drinks, with a tail of pain that tends to get longer and longer.
Generally, as long as the pain remains only for a few seconds and passes, we talk about pulp hyperemia, which means a state of inflammation from which we can still turn back if we remove the tooth decay in time, with some hope of keeping the tooth alive.
However, if the toothache begins to increase or to appear at night, or the tail of pain tends to approach the tenth of a second then the devitalization becomes almost sure also because when the dentist works, despite the anesthesia you do not feel anything, often risks giving the final blow to a nerve that is already super-inflamed and that is still heated or even drilled when caries reaches the nerve.
Of course, the pain in the cold can also manifest itself due to some uncovered roots, but if in doubt I suggest you show yourself if the cold water creates you pangs that you never had before! Also because it seems that the pain of pulpitis (acute inflammation of the nerve) is the most intense that can be tried together with that of childbirth and renal colic … for now, I have only tried renal colic and I do not wish it!
A little curiosity, if suddenly the cold, from a factor that triggers a toothache, begins to give relief and it is the heat that generates a very strong pain, most probably it is a terminal phase of pulpitis in which the nerve is going to “Die alone” and move on to stop hurting.
If this should happen to you, and I do not wish it, it does not mean that you are cured because the tooth could now go on to hurt over beating and generate a kind of abscess or inflammation of the ligament around the root.
The pain of abscess or inflammation of the ligament around the root is typically detectable because it recognizes the annoying tooth, which hurts when tapped and which often seems suddenly even higher than the others.
Although there may be a number of special situations, too technical to explain in a blog aimed at patients, these pains are often related to the presence of bacteria that come out of the root or that enter from the gum directly on the contour or bottom of a tooth root, generating a bacterial charge that can lead to the formation of abscesses with relative swelling.
Often in these cases, antibiotic treatment may be necessary, but I advise you not to do your own thing, perhaps asking the pharmacist on duty because it is always better not to abuse antibiotics to avoid making them ineffective when they are really needed!
Also, in this case, it is better to go to the dentist at the first signs of localized pain by beating on a tooth, to try to prevent the formation of a painful abscess with relative swelling.
I’m certainly simplifying because there may be special situations that simulate this pain, otherwise it would be too easy!
I’ll just tell you one that often confuses even dentists who don’t know which way to go. Acute or chronic exacerbated sinusitis pain can simulate an upper arch toothache, especially on the first and second molars. This is due to the anatomical proximity of the roots of these teeth with the cavities that heat the air we breathe (the maxillary sinuses) and therefore the patient feels badly beating on the teeth but the problem does not derive from these.
They can help you distinguish the problem from the heaviness of the cheekbone, the pain to press on the cheekbone a couple of centimeters under the eye or the throbbing pain to bend and make efforts, even just climbing the stairs. And eye, that sinus pain can also be very strong!
Distinguishing sinusitis from a toothache is easy for the dentist if the teeth are perfectly healthy on a radiographic and clinical examination and alive if stimulated with cold, but it becomes more difficult in people who have devitalized teeth or with large fillings in the painful arch …
I talked to you about this situation to give you more information, but if you have a bad throat and localized to the teeth of the upper arch, go to the dentist, don’t think about sinusitis a priori unless you have just been strongly cooled and you already know about having that problem!
Gum pains are usually not very strong and derive from inflammations that often resolve on their own.
Typical that of the wisdom tooth that is popping up or that has only popped halfway and has no chance of getting out completely. Often in these cases, the gum becomes inflamed with localized pains that extend to the lymph nodes under the corner of the jaw.
Sometimes you even get to no longer be able to open your mouth due to the inflammation that is created! In these cases, the solution is clearly to remove the tooth and it is usually not correct to take antibiotics because it is only inflammation and not a bacterial infection!
There are also abscesses related to periodontal problems (ie the tissues surrounding the tooth) that manifest with severe pain and swelling of the gums or acute gingivitis which can be very painful and even difficult to resolve quickly because they require the administration of a combination of antibiotics and carry out in-depth hygiene sessions quickly to eliminate subgingival calculus and the possible presence of necrotic gums (death), as in the case of GUNA, acute ulceronecrotic gingivitis, which has a difficult name and is not frequent but can be very painful.
If you have discomfort or pain in the gum that does not resolve in a few days with a greater commitment to hygiene (floss, brushes, and mouthwashes) also, in this case, consult your dentist!
One form of a particular toothache is one that occurs with a jolt on a tooth to press and release! This is usually the sign of a crack in a tooth, often already clogged but sometimes even perfectly healthy, in patients who may be strong grinders (see the article on bruxism by clicking here if you want to learn more).
In these cases, there may also be a pain in the heat or cold and the problem can be solved with a filling eliminating the crack … In some cases, unfortunately, however, we end up having to devitalize the tooth because the crack arrives directly on the nerve.
In these cases, it is important that the dentist takes precautions to protect the tooth from the risk of fracturing, but he will take care of that!
We mentioned grinding. Here, this can lead to another form of pain even very strong to the muscles of the face, which is often confused with an inflamed nerve toothache, because the pain involves the ear, the temple, etc.
In reality, sometimes the accumulation of lactic acid in the masticatory muscles due to their excessive use can give a sort of very painful cramp.
In these cases, it is possible to administer muscle relaxants, apply patches for muscle pain, and prepare a bite to be worn at night or even during the acute phase.
So sometimes even a toothache that is not about teeth can be the responsibility of the dentist who is one of the first professionals to consult for many of the facial pains.
I realize that in the end everything is always resolved in a single simple solution …
Just go to the dentist when you have pain!!
The message is that toothache can be prevented, even if a good dose of bad luck is always there. For which the invitation is to report you periodically and regularly from the dentist for a sitting of hygiene and a check. You will never be able to avoid all the urgencies, but a good number of them, yes!
Information brought you by Massimo – Write me with your Panoramic X-Rays view for a free specialist diagnosis by sending an email to firstname.lastname@example.org
The Content above even if the above information is written or supervised by a professional in dentistry. A physical examination is a procedure by which the dentists investigate the oral cavity of patients for signs of disease. — Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. — Always seek the advice of your physician or other qualified health providers with any questions you may have regarding your medical condition