Dental pain

• What is dental pain?
• Statistics of dental pain
• Risk factors for dental pain
• Progression of dental pain
• Symptoms of dental pain
• Clinical examination of dental pain
• How is dental pain diagnosed?
• Prognosis of dental pain
• Treatment
• References

What is dental pain?

Dental pain or toothache is simply defined as an uncomfortable sensation related to the teeth or surrounding structures.

Statistics of dental pain

Virtually everyone in some way has experienced dental pain or toothache in some form and therefore from personal experience knows of its existence. The most common cause of dental pain is dental caries.

Risk factors for dental pain

Common dental causes of toothache include dental cavities, dental abscess, gum disease, sensitive tooth root (dentine hypersensitivity), cracked tooth, impacted teeth and eruption of teeth.

Dental pain also can be from non dental origin such as angina or heart attack, sinusitis, psychological disorders and tumours.

Progression of dental pain

Dental pain can be either acute dental pain (happening suddenly), or chronic dental pain (happening over a long duration of time). The treatment of the dental pain depends on the nature, onset and the factors causing the pain.

Symptoms of dental pain

General dental pain symptoms include:

• Pain on drinking hot or cold beverages;
• Pain on eating sweet snacks;
• Generally sensitive teeth;
• Pain on biting or during chewing food;
• Severe pain that wakes you up while you are sleeping;
• Severe continuous pain that comes suddenly, without doing anything.

All of the above or any feeling of discomfort might be an indication for you to visit your dentist.

Clinical examination of dental pain

When you visit your dentist, they will ask you a few questions about the nature of your pain, including:

• When did you start to feel pain?
• Does the pain linger for seconds, minutes or hours?
• Is the pain increased with hot, cold or sweet foods?
• Does the pain wake you up at night?
• Can you determine the tooth that causes the pain?

These questions, together with the dental examination, help in recognising the cause of the dental pain.

How is dental pain diagnosed?

In order to identify what has caused the dental pain, the dentist may use one or more of the following tests.

Test for sensitive teeth

The dentist uses a special device to test if the tooth is still vital (alive), or not. This test may be repeated several times in different appointments.

Cold test

The dentist applies a special cold dental material to the tooth in question. This will aid in diagnosis and decision making whether the tooth needs a root canal treatment or a filling.

Heat test

The dentist applies a special hot dental material to the tooth in question. This will aid in diagnosis and decision making whether the tooth needs a root canal treatment or a filling.

Looking for cavities in your mouth

Using certain examination instruments, the dentist will be able to perform a full check-up to look for dental caries.

Tapping on the teeth

The dentist will use the handle of the dental mirror to tap on the tooth in question and adjacent teeth. This sometimes aids in locating the tooth causing the dental pain.

Check if the teeth are mobile

Using two handles of two dental instruments, or using one handle and one finger, the dentist can check the mobility of the tooth (how much it moves).

Check the structures around the teeth

Passing one or two fingers on the gums and cheeks, the dentist can check for other abnormalities in the mouth that may cause the dental pain.

Biting on cotton or gauze

The dentist places a cotton roll on the tooth in question and asks the patient to close the mouth. This will aid in diagnosis of cracked teeth.

Taking x-rays

X-rays are an important diagnostic test in dentistry, the dentist can inspect hidden areas of the teeth, the bone around the teeth, dental caries, and any other abnormalities.

Prognosis of dental pain

Treatment is dependent on the type and nature of pain. Treatment of the pain may require root canal treatment, removal of the tooth, or simply fluoride application.

Treatment of dental pain

When the dentist has identified what is causes the dental pain, they will be able to treat your teeth efficiently. You might end up with the following types of treatment.

Fluoride application

Fluoride can be supplied in three forms: fluoride varnish, fluoride gel and fluoride mouthwash. The dentist may use a small brush to apply the fluoride varnish or a tray for the fluoride gel. On the other hand the dentist may instruct you to use a fluoride mouthwash at home.

Fillings for your cavities

Generally dentists use white fillings (composite) for anterior teeth (teeth in the front of the mouth) and silver fillings (amalgam) for posterior teeth (teeth in the back).

Scaling and polishing of your teeth

Cleaning your gums and teeth professionally.

Root canal treatment

The dentist will remove the dental pulp (the nerve and blood supply of the tooth), clean and shape the root canal over a series of appointments and then place a sterile filling inside the root canal.

Removal of the tooth

This is simply extraction of the tooth and is always the last treatment option when all other treatments fail.

Antibiotics

Antibiotics may be prescribed as an adjunct to the main dental treatment, especially in cases of bacterial infection (dental abscess). Antibiotics by themselves are not an effective treatment for dental pain.

Pain killers

Pain killers can temporarily relieve dental pain. They are not a definitive treatment because the underlying cause of dental pain still needs to be treated.

 

Kindly written by Dr Akhil Chandra BDSc(Hons UWA); Dentist, Whitfords Dental Centre, and Editorial Advisory Board Member of the Virtual Dental Centre.

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