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Posts for tag: toothache

By John Kelmenson, D.D.S.
May 22, 2019
Category: Oral Health
Tags: toothache  
WhatsCausingYourThrobbingToothache

There are few more painful experiences than a toothache. You can't ignore it: it's as if your mouth is screaming for relief.

But while the throbbing pain can tell you something's wrong, it may not be clear exactly what's wrong. There's more than one possibility — it could be with the tooth itself, the gums around the tooth or a combination of both.

In the first case, a toothache could be a sign of severe tooth decay within the tooth's innermost layer, the pulp. The pain you feel comes from the nerves within the pulp under attack from the infection.

For this level of decay there's one primary way to save the tooth and stop the pain: a root canal treatment. In this procedure we remove all the infected and dead tissue from the pulp and fill the empty chamber and root canals with a special filling. We then seal and crown the tooth to prevent further infection.

Another source of toothache happens when your gums have become painfully inflamed due to infection. This is usually caused by periodontal (gum) disease, triggered by a thin film of bacteria and food particles on tooth surfaces known as plaque. In this case, we must remove all plaque and calculus (hardened plaque deposits) from tooth and gum surfaces, including on the roots. Your gums can then heal and return to health.

But your situation could be more complex. Untreated tooth decay can advance to the roots and subsequently infect the gums. Likewise advanced gum disease can pass the infection from the gums to the root and into the pulp.  For such cases you may need a specialist, either an endodontist specializing in root canal issues or a periodontist specializing in the gums.  They can better diagnose the origin and extent of the problem and offer advanced techniques and treatments to deal with it.

It's possible in these more complex situations your tooth has become diseased beyond repair and must be replaced. It's important, then, that you see us if you experience any significant tooth pain, even if it seems to go away. The sooner we diagnose and begin treating the cause of your pain, the better your chances of regaining your dental health.

If you would like more information on treating dental disease, 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 “Confusing Tooth Pain.”

By John Kelmenson, D.D.S.
February 16, 2019
Category: Oral Health
Tags: toothache  
4ThingsyouShoulddoifYourChildComplainsofaToothache

If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.

Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.

Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.

Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.

Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.

Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.

If you would like more information on dental care for your child, 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 Child’s Toothache.”

By John Kelmenson, D.D.S.
November 11, 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 John Kelmenson, D.D.S.
December 20, 2013
Category: Oral Health
Tags: tooth decay   toothache  
FiveFactsAboutToothachesinChildren

When it comes to childhood injuries — cuts and scrapes, growing pains, even wounded pride — it's often a parent's job to try and make things better. But sometimes it's hard to know whether the hurt indicates a serious problem, or if it's a situation that will resolve itself as soon as the sun comes up. If pain is being caused by a toothache, here are some general rules that can help you figure out what's the best thing to do.

1. Unless it's accompanied by fever and swelling, a child's toothache isn't generally an emergency.

The first thing to do is calm down (both you and the child) — and talk! Find out exactly where the pain comes from, and when and why it might have started. (Your child may have forgotten to tell you about that fall in the gym...) Sometimes, a little sleuthing will give you a clue about what's causing the pain.

2. Tooth decay, a bacteria-induced infection, is the most common cause of toothaches.

Check the teeth for brown spots or tiny holes (cavities) which might indicate decay — especially on the biting surfaces and in the areas between teeth. Next, look at the gums around the hurt tooth. If they show cuts or bruises, that's a sign of trauma. If you see only swelling, it may indicate the formation of an abscess.

3. If nothing looks obviously wrong, try gently flossing both sides of the tooth.

This may dislodge a bit of trapped food or candy, and relieve the pressure and soreness. But if that doesn't help, remember that some conditions — like nerve damage inside the tooth, for example — may have no apparent symptoms except pain.

4. Treat pain with an appropriate dose of acetaminophen or ibuprofen.

Base the dose on your child's age and weight, according to the medication's instructions. You can also apply an ice pack (one minute on, one minute off) to the outside of the jaw. But NEVER rub aspirin (or any painkiller) directly on a child's gums: It can cause burns and severe discomfort.

5. Pain that keeps a child awake at night, or persists into the next day, needs professional evaluation as soon as possible.

Otherwise, unless the pain resolves quickly and you're sure you know exactly what caused the toothache, it's best to bring your child in for an examination as soon as it's practical. You'll feel better having a dental professional, backed with years of experience and training, taking care of your child's health — and you just might prevent a future problem.

If you have questions about toothaches in children, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “A Child's Toothache.”

By John Kelmenson, D.D.S.
November 26, 2013
Category: Oral Health
Tags: toothache  
IdentifyingtheSourceofMouthPainLeadstoMoreEfficientTreatment

You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.

This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.

We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.

Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.

The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.

Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.

If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”