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John G.
Plummer & Associates
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OnLine
Advice Below
What is toothache?
The most common cause of toothache, or pain in the region of
the jaws and face, is pulpitis - inflammation of the pulp of
the tooth. The short, sharp pains usually occur in response
to hot, cold or sweet stimuli. If left untreated, the pulp
dies and becomes infected, leading to the formation of a
dental abscess. The pain from a dental abscess tends to be
in response to pressure on the tooth, and is throbbing and
continuous. Toothache may be difficult to locate as the
nerves supplying the teeth sometimes give the wrong message
to the brain. This means that, although you feel pain in a
particular tooth, the problem may actually be in a different
tooth - even one located in the opposite jaw.
How can toothache be avoided?
The best way to prevent toothache is to keep your teeth and
gums healthy. Try to avoid cavities by reducing your intake
of sugary foods and drinks. Brush your teeth twice daily
using a toothpaste containing fluoride. To get the most
benefit from the fluoride, do not rinse after brushing.
Clean between your teeth using dental floss, dental tape,
woodsticks or an inter-dental brush. Visit your dentist
regularly. This way, problems can be diagnosed early.
What should I do if I have toothache?
The following advice may be helpful until you are able to
see your dentist in the morning:
avoid hot, cold or sweet stimuli. This will help prevent
pain from pulpitis.
if the pain is prolonged and severe, painkillers, oil of
cloves, may provide some relief.
Remember even if the pain goes away, without treatment it
will eventually become worse.
if the pain is caused by exposed root surfaces, toothpaste
for sensitive teeth, either used normally or rubbed onto the
exposed root, may be helpful.
a hot saltwater mouthwash (a teaspoon of salt to a cup of
water) used to thoroughly rinse the painful area may help if
the problem is caused by a tooth erupting.a saltwater
mouthwash can also prevent infection if you have mouth
ulcers.
visit your dentist as soon as possible. .
Seek advice from your dentist before the problem becomes
severe. Pulpitis is often reversible and, once your dentist
has identified and treated the problem, the toothache will
disappear. A dental abscess will require extraction of the
tooth or a more complicated filling (root canal treatment )
if the tooth is to be saved.What is a dental abscess? A
dental abscess occurs when the nerve of a tooth has become
infected. This is usually due to dental decay, but may also
be caused by injury to the tooth. Pus is formed, which can
only escape through the root of the tooth. This causes
pressure under the tooth, which makes it painful if touched.
The pain is intense and throbbing may affect the side of the
face.
What should I do if I get a dental
abscess?
You should seek advice from a dentist as soon as possible to
get the abscess drained. It may be possible to drain the pus
through the tooth itself so the tooth can be saved (root
canal treatment). If not, the tooth will need to be
extracted to prevent the abscess recurring. Sometimes, a
dental abscess may burst. This allows the pus to drain and
can ease the pain. The process can be encouraged by using a
hot salt-water mouthwash (a teaspoon of salt to a cup of
water). Do not apply any heat directly to the face - a
hot-water bottle, for example - as this will make the
swelling worse. However, something cold on the face may ease
the swelling, while painkillers occasionally help reduce the
pain. In severe cases, antibiotics may be necessary.
Remember that even if the abscess drains by itself, you
should seek advice from your dentist for further assessment.
What is sinusitis?
Sinusitis is the infection of the para-nasal sinuses which
are the air-filled spaces in the bones of the skull that
open into the nose. One pair lies in the cheeks and another
in the forehead.
What complications might arise from sinusitis?
Please Infection in the sinuses in the forehead or those
between the nose and the eye may spread to other adjacent
areas.
Spread of infection to the orbit (the bone surrounding the
eye) causes swelling of the eyelids, and the eyeball may be
pushed forwards by swelling. If this situation is left
untreated, vision may be affected. Due to the close
proximity of the sinuses and the upper teeth roots, when an
infection occurs in the sinuses it can sometimes mimic
toothache.
What treatment is available?
Please Acute sinusitis will often settle on its own.
Decongestant medication may help but should only be used for
five to seven days in the case of nasal sprays or drops.
Severe cases may be treated with an antibiotic, such as
amoxicillin, doxycycline or erythromycin. Chronic sinusitis
usually requires surgical drainage of the sinuses involved.
Dental Trauma
Dental trauma occurs when the tooth receives a blow. Teeth
can be broken, loosened or knocked out completely (this
requires immediate treatment as it gives the best possible
chance of saving the tooth).
Milk teeth are not re-implanted as they can fuse to the bone
and cause further problems later with the permanent/adult
tooth.
What should you do about dental injuries?
Following an accident involving the face/mouth:
-check the teeth by looking, or using a finger.
-locate any missing teeth or fragments of teeth.
-only touch the crown of the tooth - the part usually
visible in the mouth.
-do not wash or rinse the fragment or tooth with anything,
even water.
-store the fragment or tooth in milk, if possible. If the
person is conscious, not shocked and old enough to
cooperate, -the fragment can be stored in their mouth under
the tongue.
-seek advice from a dentist immediately.
A tooth that has been knocked out, or even a broken tooth,
has a better chance of being successfully re-implanted if
this is done as soon as possible (ideally within half an
hour).
What can your dentist do?
Please It may be possible to re-implant the adult tooth if
help is sought quickly, the bone is not too badly damaged
and the patient is in a fit state for treatment.
Milk teeth are not re-implanted as there is a risk of
harming the permanent tooth underneath.
Soft tissue damage may require stitches.
The tooth fragment or a white filling material may be used
to rebuild the tooth.
A splint is often required to hold a loosened or
re-implanted tooth in place.
A tetanus booster and/or antibiotics may be required.
The tooth will need to be regularly checked and X-rayed.
Wisdom teeth painful
It's well known that impacted wisdom teeth (not enough space
to erupt or lost direction), if infected, can be quite
painful, and perhaps even cause gum disease or decay in
adjacent teeth. Many dentists will recommend removal of
impacted wisdom teeth to prevent problems occurring in
future. However pain from wisdom teeth can also occur when
the wisdom is not impacted.
If your gums are sore and swollen, use a mouthwash of medium
hot water with a teaspoon of salt. Swish the salt water
around the tooth, trying to get into the areas that your
toothbrush cannot reach. An antibacterial mouthwash such as
Corsydol can also reduce the inflammation. pain-relieving
tablets such as Paracetomol or Asprin can be useful in the
short term, but see your dentist if the pain continues.
Restorations Out or
Broken
Keep it safe and take it to your dentist. If not painful you
can leave till next day when the surgery opens.
If on holiday you can purchase a repair kit from a pharmacy
that will enable you to recement your crown or bridge until
you can see your dentist again. You may also use chewing gum
to mould over area or denture fixative to fix crown or
bridge in as an emergency measure. Remember teeth can shift
so don't delay in seeking treatment from your dentist.
Avoid eating on that side. If painful avoid anything too hot
or too cold. Take painkiller if necessary.
Fractured Tooth
Keep it safe and take it to your dentist. If not painful you
can leave till next day when the surgery opens.
If on holiday you can purchase a repair kit from a pharmacy
that will enable you to cover the tooth until you can see
your dentist again. You may also use chewing gum to mould
over area.
Avoid eating on that side. If painful avoid anything too hot
or too cold. Take painkiller if necessary. Best to see your
dentist as soon as possible.
Bleeding following extraction
Bite firmly down on the gauze placed in your mouth by the
dentist.
This is to help stop the bleeding. Keep this in your mouth
for at least 10-15 minutes or until you get home. Do not
spit during this period.
Do not rinse your mouth today, or touch the socket.
Avoid hot drinks and food today .
Avoid alcohol for the rest of the day.
Do not smoke for the rest of the day.
Avoid exercise today. It may be helpful to sleep with an
extra pillow tonight.
Brush your other teeth as recommended taking special care
near sockets.
As the anaesthetic wears off, you may experience some
discomfort. If necessary, take a mild analgesic. (e.g.
Paracetamol, if it agrees with you.).
The day after the extraction, you should bathe your mouth
gently twice daily with a mouthwash - this will speed
healing.
A teaspoon of salt in a tumbler of lukewarm water provides
an ideal mouth rinse.
Avoid hard foods which may traumatise socket. Brush your
other teeth as recommended taking special care near sockets.
If bleeding starts again
Bite tightly on a clean rolled up handkerchief for 15
minutes while sitting upright. It may be necessary to repeat
this. If you fail to stop the bleeding, get in touch with
the practice.
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