Dentist Blog

Posts for tag: tooth pain

By Mark Makela D.D.S., PC
August 15, 2014
Category: Oral Health
Tags: toothache   tooth pain  
ToothPainLeadstoJailBreak

When a 51-year-old Swedish man developed a throbbing toothache with facial swelling, he knew he needed to get to the dentist right away. There was only one problem: The unnamed individual was inside the Östragård minimum-security prison, serving a short sentence. But he didn’t let that stop him from getting dental treatment — he simply broke out of jail and headed straight for the nearest dental office.

“In the end, I just couldn’t stand it,” he explained to the Swedish newspaper Dagens Nyheter.

After the offending tooth was extracted, the offender himself went to the local police precinct and turned himself in. Taking his circumstances into account, the court added just 24 hours to his original sentence, and he was released soon thereafter. “Now I only have to pay the dentist bill,” he noted.

While we certainly don’t encourage jailbreaks, we might feel that this fellow made the right choice. It’s important to know when you need to get dental treatment right away, and when you can wait. Here are some very basic guidelines:

  • If you’re suffering a traumatic dental injury that is causing you severe pain, or you can’t control bleeding after applying pressure for a few minutes, go to the nearest emergency room right away (as you would for any serious injury).
  • If your tooth is knocked out or loosened, it should be treated in the dental office or emergency room within 6 hours. Place it back in its socket (in the correct orientation), if possible; if not, tuck it between the cheek and gum, or put it in a glass of cold milk. Hold the loose tooth gently in place. It’s often possible to successfully re-implant a tooth that has received quick first aid.
  • If a tooth is chipped or cracked less severely, try and save any missing pieces, and make an appointment to come in as soon as you can. Don’t forget to bring the pieces with you!
  • If you have acute or persistent tooth pain, come in to our office right away. There are many things that can cause tooth pain, including tooth decay (a bacterial infection), a loose filling, or tooth sensitivity. Minor sensitivity or occasional aches when chewing can be temporarily eased by rinsing with warm salt water and taking an over-the-counter pain reliever; more severe pain may indicate that you need root canal treatment to preserve a tooth in which the pulp has become seriously infected.

Pain is the body’s way of telling you that something’s wrong. When you experience mouth pain, it’s best for you to see us as soon as possible. Quick treatment just might save your tooth — and perhaps save you from a far steeper bill for tooth replacement. If you would like more information about dental emergencies, call our office for a consultation. You can learn more in the Dear Doctor magazine article “Tooth Pain? Don’t Wait!

By Mark Makela D.D.S., PC
December 31, 2013
Category: Oral Health
Tags: tooth pain  
ConfusingToothPain

Is it a root canal problem, a gum infection, or both?

Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.

When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.

The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.

To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).

Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.

If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”

By Mark Makela D.D.S., PC
October 22, 2013
Category: Oral Health
Tags: toothache   tooth pain  
Thattoothachemaystillbeaproblemevenifthepainisgone

You experience a painful toothache that lasts for a few days, but eventually the pain subsides. Since there's no longer any pain, there's no longer anything wrong with the tooth, right?

Maybe not — the toothache may be the result of a decay-induced infection that has developed deep in the pulp of the tooth. The infection inflames both the pulp tissue and the nerves bundled in it (a condition known as pulpitis). Because it occurs in an enclosed space, the pain is even more severe.

Now it's possible for the inflammation to subside and the nerves to heal, which would explain the pain subsiding. But there is another, more likely scenario: the infected pulp tissue can no longer fight the infection and dies. The affected nerves die also, which is why you no longer feel any pain — the dead nerves are no longer transmitting a signal to the brain. The infection, however, is very much alive and continues to advance deeper into the surrounding tissues where it may eventually develop into a painful abscess.

So, how can we determine which of these two scenarios you are actually experiencing? A visit to our office for testing is the surest way to find out. The most common test involves temperature sensation, usually with the application of ice to the affected tooth. If there's no sensation, then that's evidence the nerves in the tooth have died.

If that's the case, it's important then to take steps to stop the infection's advance before it does even more damage. The most likely treatment is a root canal, a procedure that accesses the pulp from the top of the tooth, removes the dead tissue, and then cleans and prepares the root canals for filling. This procedure can usually be performed in our office, but more involved cases may require an endodontist, a specialist in root canals.

In any case, if you experience a severe toothache, please have it examined. And remember — the absence of pain after a toothache doesn't necessarily mean the problem is gone.

If you would like more information on the diagnosis and treatment of an acute toothache, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Severe Toothache.”

By Mark Makela D.D.S., PC
August 03, 2012
Category: Oral Health
Tags: toothache   tooth pain  
TestingyourKnowledgeonToothPain

When it comes to tooth pain, it is important to identify two things: what is causing your pain and what can be done about it. In some instances you can handle it yourself at home; however, for others, you should contact us so that we can diagnose and treat the problem. See how much you really know about tooth pain by taking our true/false test.

  1. It is perfectly normal to experience tooth sensitivity to hot and cold foods for a few days after dental treatment.
    True or False
  2. If you experience sharp pain when biting down on foods, you should hold off on contacting us to see if the pain gets better on it own.
    True or False
  3. Tooth pain is caused by a reaction of nerves inside the tooth's enamel with the severity of the pain dependant upon the type and degree of the stimulus.
    True or False
  4. Generally speaking, pain is a protective response that ranges from minor to severe as a way of informing the body that something is wrong.
    True or False
  5. If a tooth's root surface is sensitive, you should use a firm toothbrush to ensure that you are keeping the area clean by thoroughly removing dental bacterial plaque.
    True or False
  6. Lingering pain after eating hot or cold foods and liquids probably means that the pulp within your tooth is probably damaged or inflamed as a result of deep tooth decay or injury from a physical trauma.
    True or False
  7. Regarding tooth sensitivity, you should only contact us if the pain persists for several months because this is not likely to be anything serious.
    True or False
  8. If a tooth's pulp becomes damaged or dies, you will need a root canal.
    True or False
  9. With tooth pain, knowing how long to wait before you contact us can save physical, financial and emotional stress.
    True or False
  10. People often confuse tooth and sinus pain because they both can feel the same — a dull ache with pressure in the upper teeth and sinus area on one or both sides of the face.
    True or False

Answers: 1) True. 2) False. You should contact us asap for an examination before the pain worsens. 3) False. The nerves are located in the tooth's pulp chamber. 4) True. 5) False. Use a soft bristled toothbrush not a firm one. 6) True. 7) False. While tooth sensitivity generally does not signal a serious issue, if it persist for days or worsens, contact us. 8) True. 9) False. Early interception is best. 10) True.

To learn more, continue reading the Dear Doctor magazine article “Tooth Pain? Don't Wait!” Or contact us today to schedule an appointment to discuss your questions.