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My tooth hurts. What should I do?
DOCTOR ZABEK: Where is the pain? What causes the pain? Is it sharp or a dull ache? Does it come and go? The method of pain control you need takes into account these concerns.
If the pain is from a small cavity, just cover it with some cotton or one of the temporary cements from the grocery store or pharmacy. That should help some aches from sweet, cold and hot. Call us or your dentist and get the tooth restored.
If you have a large hole in the tooth, it may be difficult to use the cotton, so covering it with some kind of dental filling, or stopping it up may be harder to do. I had a patient once who got relief from sugarless bubblegum -- it worked on a Sunday night, and we saw her first thing on Monday morning.
Sometimes, however, if the tooth itself is infected inside (in the pulp), you'll want to leave it open to drain the gases and such. Usually these are not sharp aches felt after sweets, but can be sensitive to pressure, heat, coldness or a combination. This results in an ache oftentimes quite persistent and extremelly annoying, enough to step you in your tracks. You will likely need pain medication, in severe cases accompanied by antibiotics. If the pulp is infected, it needs treatment. We can assess whether or not you need root canal therapy.
If the tooth is hypersensitive, try not to bite on it. Think of your teeth as fingers: you never think about your teeth or fingers until they are hurt. Then every time you hit your finger, it takes longer for it to heal -- your teeth are like fingers in that respect. Teeth experience the "black 'n' blue" finger thing when they are hypersensitive. The dentist will adjust the bite when you him/her for that kind of pain.
Some little aches can be handled by desensitizing toothpastes and flouride. Some brand names include Sensodyne (the first one, nowadays better tasting), Protect and Denquel are some major brands available. Crest and Colgate have their versions of these products, too.
Recently, I read an article summarizing "dentin hypersenstivity" -- sore teeth. People who take in a lot of acidic foods (sodas, lemons, tomatoes, etc.) definitely have "softer" teeth and are demineralizing their enamel. Let's face it. If your diet is M&Ms and Pepsi during the day after orange juice in the morning, you're likely to be demineralizing. The solution: drink flouredated water, or use a flouride mouth wash, or ask for ask for stronger flouride content toothpaste from your dentist. We can also give you prescription rinses and flouride treatments in extreme cases.
It takes a little time to reverse the demineralizing effect, but remineralizing the enamel is better than a mouthful of fillings and crowns to restore your normal functions and fun.
It's possible that a gum problem may be the source of your pain. Read my article on bleeding gums for more information on this topic.
Some other causes of pain in the your jaw that may not be your tooth: heart attacks, cancer, nerve disorders and phantom pain (toothaches where there is no tooth).
Painful conditions from wisdom teeth are common. Food can get caught in the area and start some trouble. Impacted wisdom teeth (buried under the gum or partially buried) have numerous painful outcomes if not managed properly. Again, anti-inflammatories like Tylenol, Ibuprofen, Vioxx and and oxygenation agent to help bubble up the debris may be helpful until you can see the dentist.
I don't like to see anyone hurting. In today's world, there are many dentists who are qualified to keep you out of painful situations. We are happy to see you for preventive care. It's necessary. Pain isn't.
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