Toothache Overview (cont.)
Donna S. Bautista, DDS
Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a toothache?
- What causes a toothache?
- What are toothache symptoms and signs?
- How is a toothache diagnosed?
- What is the treatment for a toothache?
- Are home remedies effective for a toothache?
- How is a toothache treated during pregnancy?
- What is the prognosis for a toothache?
- Is it possible to prevent a toothache?
- Find a local Doctor in your town
What are toothache symptoms and signs?
Signs and symptoms that can might indicate a tooth problem are
- pain with biting or chewing,
- teeth hypersensitivity to changes in temperature,
- cheek or gums swelling near tooth,
- discharge or bleeding of gums,
- constant throbbing within a tooth.
A toothache can present as a dull or sharp pain that may arise spontaneously on its own or by stimulation.
Additional symptoms may include
How is a toothache diagnosed?
The dentist performs a series of diagnostic tests along with dental X-rays to determine the origin of a toothache. These tests try to mimic what may be causing the pain, such as cold stimuli, biting or chewing pressure, and finger pressure on the gums. The response to a cold stimuli test can help in determining whether a tooth is vital (nerve is intact within tooth) or suffering from pulpitis (inflammation of the pulp). Duration and acuity of pain from cold stimuli is helpful information in diagnosis.
Sometimes, the cause of a toothache may come from somewhere different than where pain is actually felt. This is called "referred pain." For these situations, diagnostic dental tests are particularly important in accurately detecting the problem.
What is the treatment for a toothache?
Treatment for a toothache depends on the cause of the pain and how much damage is present. In general, the best way to stop a toothache is to remove any present infection or decay and repair the damage to protect exposed, sensitive areas. For a shallow cavity on a tooth, the decay is removed and a filling is placed to seal the tooth. If the cavity is very deep and gets into the pulp, "root canal treatment" is performed because the pulp has been exposed and infected with bacteria. This procedure essentially removes all the vital contents of the tooth (nerves and blood vessels) and seals the inner aspects of the tooth (root canal system) with an inert filling material. Root canal treatment along with antibiotic therapy is usually needed for an abscessed tooth that has very localized infection. If the infection has become widespread, antibiotic therapy and additional steps may be needed to properly drain the infection. Sometimes extraction of the tooth may be the only option for treatment if the tooth or surrounding gum and bone are too damaged.
For a periodontal abscess, a simple drainage procedure is performed under local anesthesia. Additionally, the affected gum pocket is thoroughly cleaned to remove any tartar buildup and debris. Once the area has been cleaned up, the pocket is irrigated with an antimicrobial rinse. Sometimes, antibiotics are locally-administered into the pocket to further aid in healing. Depending on the extent of the abscess, oral antibiotics may also be prescribed. A follow-up visit is recommended to make sure the infection has completely resolved and develop a plan to properly maintain the area.
For tooth fractures or cracked tooth syndrome situations, dental crown placement is the usual treatment. A crown will replace missing tooth structure and/or it will help protect the weakened tooth from further breakdown and sensitivity.
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