Toothache?  What to do

Many of us have had sleepless nights because of a dreaded toothache.  The lucky ones may of had an inkling of warning, but most are totally caught off guard by this dental emergency.  As a practicing dentist in Naples, Florida, there are some tricks that you can use to improve your comfort.

Most often, when a patient experiences a toothache  it is associated with an abscessed tooth.  When a tooth abscesses, the nerve inside the tooth dies and becomes infected.  The resulting infection radiates pain throughout the jaw.  Very often, there may be little warning that such an infection is occurring.  Signs of a dental abscess include tenderness to chewing, throbbing pain, and the tooth may even loosen up.  Unfortunately,  intervention by your dentist  is necessary when a tooth becomes abscessed.  If the tooth is restorable, a root canal may be recommended, and if it's considered non-restorable, extraction of the tooth may be recommended.  Over-the-counter pain relievers  usually have minimal effect on a true dental abscess.  The best choice of action  would be to contact your dental office for an immediate evaluation.  An antibiotic may be prescribed which will usually relieve the discomfort  within a day.  Stronger pain medication may also be prescribed  as needed.

The second-most common cause of a dental toothache would be a gingival abscess, or a "gum"  infection  around the tooth.  These types of infections exist on the outside of the tooth, and are usually caused by poor hygiene, history of periodontal disease, or quite possibly a foreign body, such as food  which gets caught under the gum line.  These types of infections have nothing to do with the nerve inside the tooth, and can be treated differently.   Many patients would try vigorous saltwater rinsing, mouthwash rinses,  and tooth brushing to help combat  this type of infection.  Normally, the gum is swollen around the tooth making it quite tender.  If it is in fact a foreign body causing the infection, much like a splinter in a finger, eventually the infection will pass once the foreign body is loosened. This typically would take a few days.  It is recommended that one seek  professional  advice from  a dentist  to verify  the cause of the infection.   Normally in the dental office,  the area would be cleansed, and any foreign debris or plaque removed.   The tissue would normally return to normal  within the week.

 Lastly the most common toothache we see has dentists involves the fracture of the tooth.  If the fracture is significant,  it exposes the sensitive layer of the tooth  below the enamel,  and in extreme cases exposes the nerve.  When this occurs, dental intervention is absolutely necessary.  If the nerve has been  involved,  a root canal or extraction  be recommended.  If the fracture does not extend into the nerve,  the tooth may require restorations such as a filling,  or crown,  depending on the size  of the  broken area.

As a practicing dentist,  I do recommend  that whenever people experience a dental toothache,  that he or she seek consult from a dentist  so that the proper diagnosis and treatment  can be offered.    Such a plan puts the patient's  health  and comfort  in top priority.

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