Toothache
Problem
There are various degrees of toothache. Obviously if the pain and suffering is mild or only occasional, you may not contact us immediately. If the pain keeps you up all night and is constant then you are likely to call us. so let’s try to quantify the pain.
Mild
Only occasionally and when it occurs you may rate it 1-2 out of 10. Sometimes you are unsure which tooth is causing the problem.
Moderate
Rated 4-5/10. May be infrequent but the pain is a little more intense. It may occur to hot cold or eating on the tooth. However it comes and goes and the pain may be relieved with analgesics
Severe
Rated 8-10/10. The pain is very severe and disrupts your daily routine. It may have kept you up all night. The pain is unrelenting, it comes in waves and there is not much you can take to stop the pain.
Causes
Mild discomfort
- Tooth decay
- Weak areas of the tooth lacking calcium
- Sensitive exposed roots from receded gums
- Crack in tooth
Moderate pain
- Deeper tooth brush abrasion
- More severe tooth decay or a deeper crack in the tooth, particularly if the tooth has a large silver coloured filling
- Food-packing between teeth due to gaps, broken fillings/chipped teeth
Acidic foods
Severe pain
- Dying nerve in the tooth
- Gross amounts of decay close to the nerve
- Large cavity
- Old large metal filling that is leaking, or close to the nerve
- Chronic gum disease
Diagnosis
- Dental examination to look for obvious cavities/exposed nerves/inspection of gums
- X-rays to detect hidden cavities between teeth
- Tooth tapping test to see if the infection has spread into the jaw bone
- CO2 ice test to determine if the nerve has died
Solution
Early onset of any discomfort should be identified. Even if you experience mild symptoms, then please tell the Dentist. Why? because the problem may be solved by simple measures such as doing a small filling, or applying a paste over the exposed nerves.
However, if further symptoms are associated whenever you subject the teeth to temperature, then fillings may or may not fix the problem as it may be too late.
Here is a summary:
Mild discomfort
Removing decay with a simple filling or applying a de-sensitizing material over exposed nerves.
Moderate pain
Removing decay/crack by placing a filling, onlay, or crown
Severe pain
- Root canal therapy if you choose to keep the tooth
- Extracting the tooth if you don’t want root canal
If Ignored
The two words most patients hate to hear.
Extraction or Root canal therapy. These are the only options in cases of severe tooth infection.
These are more complicated treatments that could be avoided by early detection and treatment of the problem. Just think removing a tooth and having a replacement tooth in the future is a more expensive option to treating the early onset symptoms.
If a crack remains untreated, and the tooth splits in half, the tooth cannot be saved, so extraction is the only treatment option.
