Dental pain

Symptoms Of Dental Pain

• Dull-aching toothache that may radiate to the gums or jaws.
• Pain that worsens while biting or chewing food.
• Pain exacerbated by excessively hot or cold foods or sweets.
• Pain accompanied by bleeding or discharge from the gums.
• Swelling of the gums or face, which may be accompanied by a fever.
• Occasionally, a bad mouth odor and bad taste in the mouth may be present, along with toothache.

Causes Of Dental Pain

There can be multiple causes of dental pain such as:

• Fracture of the tooth
• Dental caries or tooth decay that cause cavities and infection in the tooth
• Periodontal or gum infections
• A dental abscess, i.e., a collection of pus or fluid near the tooth, which occurs in tooth infections
• Erosion of tooth enamel and gum recession
• Lack of space for eruption of wisdom teeth
• Accumulation of food particles and debris between the teeth
• Repetitive clenching or grinding of teeth
• Loose or fractured old filling or a cracked tooth cap
• Ill-fitted dentures or braces

Risk Factors For Dental Pain

Dental pain is most commonly seen in children and adolescents, with a prevalence rate ranging around 9.4%. It is more common in the lower socio-economic population who have limited access to quality healthcare. Dental pain is also common in the elderly population and is the primary reason for dental procedures in the elderly population.

Additionally, the risk of dental problems is more often associated with the following:

• Poor oral hygiene

• Excessive consumption of sweets, starchy or acidic food and drinks

• Smoking

• Diabetes

• Weak immune system due to certain medications (such as chemotherapy for cancer) or certain diseases (such as HIV)

• Xerostomia or dry mouth due to inadequate salivation which can happen after injury to head or neck, after radiation therapy or as side effect of certain drugs

• Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into the mouth, leading to dissolution of enamel and thereby causing tooth damage.

• Eating disorders like Anorexia and Bulimia can lead to wearing of teeth and cavities. They also affect production of saliva.

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Diagnosis Of Dental Pain

When you visit your dentist for dental pain, they will perform a thorough oral examination and get a detailed history of symptoms. 

Some of the common tests used to diagnose dental pain include:

• A tooth percussion test is done by gently tapping the tooth with the end of mouth mirror to check the response.
• To perform a tooth mobility test, the dentist carefully tries to move your tooth to check whether it is loose. 
• A tooth sensitivity test involves checking the response of the tooth to hot or cold stimuli. 

Additional investigations may be needed to evaluate the condition further which include imaging studies and lab tests.

Imaging studies: Dental X-Ray and X-Ray TM Joints help visualize the teeth and jaws to know what abnormalities may potentially be causing the pain. A detailed visualization is possible with CBCT (Cone Beam Computed Tomography). This method is used when individual x-rays of teeth alone are unable to identify the cause of dental pain.

Laboratory tests: Sometimes, lab tests such as complete blood count (CBC), erythrocyte sedimentation rate (ESR) and diabetes screening may help diagnosis in treatment planning.

Prevention Of Dental Pain

Since most of the toothaches occur due to poor oral hygiene, good dental hygiene practices can mostly prevent dental pain. You can keep your teeth and gums healthy by-

• Brushing gently with fluoride-containing toothpaste at least twice a day

• Flossing regularly to clean the spaces between the teeth

• Rinsing and gargling after meals to prevent lodging of food particles and debris between the teeth

• Avoiding excessive sugar, starch or acidic food and beverages in your diet

• Reducing consumption of sticky foods like caramel or chocolate that get stuck in grooves and pits of teeth for a long duration

• When consuming sweet foods, it is better to consume them with the meal rather than as a snack.

• Avoiding frequent snacking. When you eat or drink beverages other than water,bacteria in the mouth create acids that can dissolve tooth enamel. Frequent snacking throughout the day can keep your teeth under constant attack.

• Avoiding extremely hot or cold foods if you have sensitivity issues

• Avoiding chewing on very hard foods like ice or sugarcane that can cause tooth fractures. Using teeth for opening food packets or cracking open nutshells can also increase the chances of a tooth fracture.

• Regular appointments with the dentist for professional cleaning of teeth and examinations.

• Application of dental sealants or protective coatings on teeth and fluoride treatment if advised by the dentist.

Specialist To Visit 

Toothaches can be very uncomfortable but the pain isn’t permanent as long as it’s treated. Your dentist can relieve your pain and prevent any infections from spreading. It is not advised to delay your visit to the dentist as cavities can get worse over time.

It is necessary to seek dental or medical care if you have:

• Toothache that lasts more than 2 days

• Toothache that is severe and persistent in nature

• Pain that does not go away after taking painkillers

• Fractured or broken tooth

• Extreme tooth sensitivity 

• Swelling around the tooth, in the jaw or face

• Bad odor or foul taste in the mouth

• Toothache accompanied by fever and chills

• Earache or pain when you open your mouth wide

• Trouble swallowing or excessive pain or bleeding from gums

• A facial rash associated with a toothache

• Recent head or face injury in addition to dental injury

Doctors/specialists who can help you to diagnose and treat dental problems or any other associated medical issues are:

• Dentist

• General physician

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Treatment Of Dental Pain

The treatment for dental pain is broadly divided into providing pain relief and treating the underlying cause.

1. Medicines for dental pain relief

• NSAID painkillers are prescribed to provide relief from mild to moderate dental pain.

• Opioid painkillers or combination medicines are prescribed to treat severe dental pain.

• Anti sensitivity toothpastes can provide some relief from sensitivity of teeth.

2. Treatment of underlying cause

• Antibiotics are prescribed by dentists to treat dental infections

• Mouthwashes are also recommended to combat infections

3. Dental procedures 

These procedures can be advised if needed and may include:

1. Scaling and planing- In case of plaque accumulation and gum infection,the dentist may carry out professional cleaning or scaling of teeth or numb the gums to remove plaque buildup below the gum line.

2. Cavity filling - For a shallow cavity in the tooth, the dentist will remove the decay and seal the tooth with a filling.

3. Root canal treatment (RCT) - In case of a deep cavity that infects the pulp of the tooth, the dentist will perform a root canal treatment. In this procedure, all the vital contents of the tooth (nerves and blood vessels) are removed and the root canal system is sealed with an inert filling material. RCT is usually followed by a dental cap or crown.

4. Tooth extraction - If the tooth is badly damaged and cannot be saved, it may be advised to get it extracted.

Home-care For Dental Pain

If you have mild dental pain, home remedies may provide considerable relief. Home remedies are also useful in alleviating symptoms of severe disease. You can do the following at home to help ease dental pain:

• For many people, rinsing the mouth with lukewarm saline water is an effective first-line treatment. Saline water is a natural disinfectant, which helps in reducing inflammation and ease any pain or swelling.You can mix 1/2 teaspoon of salt in a glass of lukewarm water and use it as a mouthwash.

• Applying an ice pack or cold compress externally can help reduce inflammation and swelling and thereby give some relief in pain.

• Avoid eating foods that are hard to chew. Do not chew on the painful side.

• You can apply clove oil or peppermint oil to the affected area. It is known to help with pain relief from toothaches.

• Do not consume excessively hot or cold foods or sweets as these may worsen the sensitivity and increase your pain.

• Gently brush your teeth at least twice a day. Rinse and gargle after every meal to avoid food particles from getting stuck in between the teeth.

Complications Of Dental Pain

A toothache on its own does not cause any severe complications and in most cases, tooth infections can be easily treated.

Sometimes, tooth infection can cause an abscess in which pus is collected inside the tooth or gums. In very rare cases, delay in treatment can cause this infection to spread to other areas of the body resulting in any of the following complications:

• Sinusitis: can occur rarely from untreated upper teeth infection

• Osteomyelitis: Infection of the bone surrounding the tooth

• Ludwig angina: Submandibular space infection

• Cavernous sinus thrombosis: Infection of the blood vessels within the sinuses

• Cellulitis: An infection of the skin and fat directly beneath the skin

• Parapharyngeal abscess: An abscess at the back of the mouth

• Septicemia: Medical condition in which the immune system overreacts to an infection in the blood

These conditions can be life threatening and require immediate attention and intervention.

The following signs and symptoms may indicate any possible spread of infection to other parts of the body:

• High fever

• Chills

• Swelling of the face or the jaw

• Foul-smelling discharge from the tooth

• Nausea

• Vomiting

• Severe headache

• Itching or burning sensation on the skin

• Drooping eyelids

• Double vision

• Confusion 

Alternative Therapies For Dental Pain

1. Ayurveda: Dental or oral health is called ‘Danta Swasthya’ in Ayurveda. There are various Ayurvedic practices which can be opted for good oral health, such as:

• Chewing sticks of medicinal trees, like Neem, Meswak, etc., are used as an alternative to conventional brushing techniques. While chewing these sticks, the medicinal extracts get released into the mouth, which helps promote and maintain healthy teeth and gums.

• Oil pulling is an ancient practice that involves swishing oils inside the mouth. Sunflower oil, sesame oil, or coconut oil is used for oil pulling. This has been used as a traditional remedy to prevent teeth and gum diseases.

• Medicinal condiments and herbs like clove, garlic, vanilla extract, peppermint, wheatgrass, thyme are found to be useful in relieving dental pain and are famously used as home remedies to treat toothaches.

2. Homeopathy: Homeopathy is an alternative form of medicine that follows the principle of ‘like kills like’. Homeopathy doctors prescribe diluted tinctures that elicit symptoms similar to those the patient is already experiencing. 

• Tinctures of Belladonna and Arnica Montana are found to be useful in relieving toothaches. 

• Calcarea carbonica, Chamomilla, Antimonium crudum, etc., are also helpful in relieving dental pain. 

• Arsenicum album is effective in treating gum diseases, such as bleeding gums.

You can prevent tooth pain by following basic oral hygiene such as brushing and flossing your teeth twice a day and regularly visiting your dentist’s clinic. However, if you are suffering from a toothache, then you can try these simple home remedies to get some relief in pain naturally.Click Here!

Living With Dental Pain

Dental Pain or Toothache is one of the commonest pain experienced by patients worldwide. It’s normal to occasionally battle with tooth pain because of sensitive teeth, gums infections or dental cavities. Though good and consistent oral hygiene measures help in preventing a lot of dental problems, sometimes, as much as one tries to brush twice a day, floss every day, and eat a healthy diet, one can still suffer from dental issues. For eg. Some may be genetically predisposed to have more brittle,sensitive teeth or more acidic saliva. Unfortunately, some can suffer from any form of accident resulting in fracture of teeth and thereby resulting in dental pain.

Dental pain can come with a lot of annoyance and irritation. Continuous pain can lead to avoidance of food and thereby causing nutritional deficiencies or weight loss. Due to heightened dental sensitivity patients may not be able to enjoy their favorite sweets or ice-cream. Another cause of concern in patients with dental infections is bad breath or foul odor coming from the mouth. This can lead to extreme social embarrassment or isolation.

Prevention of a disease is always better than its cure. Good oral hygiene practices and routine visits to the dentist are essential to keep the teeth and gums healthy life-long. In cases where dental problems happen in spite of taking precautions, one should not be disheartened as most dental problems are easily treatable and have a good outlook. Home remedies and a prompt visit to the dentist without much delay can go a long way in getting relief from toothache.