Tips for Diagnosing and Treating Tooth Pain

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Toothaches can be extraordinarily painful. Sometimes the pain is all you can think about. There are many causes of tooth pain, the most obvious of which is a problem with the tooth or jaw. The dental causes of tooth pain fall into three categories:

Damage: Trauma, including chips and breakage, can cause damage to teeth. This breakage can cause tooth pain.

Decay: Tooth decay has several degrees of severity. Cavities are holes that penetrate the enamel and the underlying dentin and cause pain. Abscesses are more severe. When an abscess occurs, the dental nerves and pulp become infected.

Disease: Redness and swelling of the gums indicate gum disease or gingivitis. Gum disease can cause gum and tooth pain. Other diseases, including oral cancer, may also contribute to tooth pain.

If you have tooth pain that persists for longer than one or two days, make a dentist appointment immediately. Unless it is an emergency, says dentist Warren Melamed, it is likely that you will have to wait a few days for your appointment.

If you have a toothache and cannot see a dentist right away, here are some things you can do to relieve pain while you wait:

• Avoid foods and beverages that are very cold or very hot. The decay or damage may have exposed the dentin layer of the tooth. Extreme temperatures may cause additional pain.
• Use over-the-counter pain relief medicine that is designed to reduce inflammation. Never put pain relief medication directly on the tooth or gum tissue as this application could damage these areas.
• Gently floss between the painful teeth. Removing the food particles and plaque may help to reduce the pain from the toothache.
• Use clove oil, or eugenol, for pain relief. Clove oil has both antiseptic and anesthetic properties. Soak a small piece of cotton in the oil anduse a pair of tweezers to hold the cotton on the tooth for 10 seconds. Make sure that you do not swallow any of the oil.
• Rinse with warm salt water.Salt water works as an antiseptic, removing bacteria from the infected or vulnerable area. Rinsing may provide additional pain relief.

There are some causes of tooth pain that are not directly related to your dental health. If none of the three general categories of pain are causing the problem, consider the following conditions:

• Sinus Infection: Sinuses that are infected can become swollen, putting pressure on certain teeth.
• Cluster Headache: Cluster headaches cause pressure that may contribute to tooth pain. Their exact cause remains unknown.
• Heart Attack: Pain from a heart attack may radiate into the lower jaw.
• Diabetes: Uncontrolled blood sugar can increase your risk of tooth decay. Frequent cavities may be an indication of a more serious problem.
• Viral Infections: Viral infections such as shingles can cause tooth pain.
• Nerve Diseases: Trigeminal neuralgia is an example of a nerve disease that is associated with sharp pain on one side of the face. 

Toothaches are preventable in most cases, especially when the pain is caused by decay. Follow good oral hygiene practices, making sure to brush and floss twice a day. Sealants and fluoride applications can also defend your teeth from bacteria. Consult with your dentist for more information on how to protect your teeth.

How often should I brush and floss?

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

What can I do about stained or discolored teeth?

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The color of our teeth also comes from the inside of the tooth, which may become darker over time. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains. Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened. This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!

How can I tell if I have gingivitis or periodontitis (gum disease)?

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.
• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
• Persistent bad breath – Caused by bacteria in the mouth.
• New spacing between teeth – Caused by bone loss.
• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
• Pus around the teeth and gums – Sign that there is an infection present.
• Receding gums – Loss of gum around a tooth.
• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Flouride

In the 1940’s, water fluoridation officially started in the United States. While it is believed that water fluoridation does reduce tooth decay, there are many areas of the United States that don’t have fluoride added to their water.

In the same decade that water fluoridation commenced, people in non-fluoridated areas wondered how their children could reap the the benefits of fluoride if their water supply was not yet fluoridated.

Trials were performed in which dietary fluoride supplements were administered to children in order to determine if they could receive fluoride’s anti-cavity effects in pill form.

After this trial period, the American Dental Association (ADA) came up with the very first fluoride dosage schedule in 1958. In the years that followed, the American Academy of Pediatrics as well as the ADA had two separate fluoride dosage schedules. Unfortunately, many children started getting dental fluorosis, and as a result, the amount of recommended fluoride was gradually reduced. Finally, in 1994 the ADA and AAP finally agreed on the following schedule, which was reaffirmed in 2010.

Source: OralAnswers.com

Why is it important to use dental floss?

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.

How to floss properly:

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health. This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!