One of the most dreaded and feared types of pain is dental pain. Memories of a bad toothache or dental experience or even the imagination of such pain cripples many people with fear. The goal of this article is to give a broad, simplified overview of the most common types of pain and methods to alleviate them.
Toothaches can vary in intensity and cause. As dentists, we often can narrow down the cause and treatment of a tooth simply by how the symptoms of a toothache present. Teeth that spontaneously ache all the time or hurt more with hot drinks or food are most likely infected and require root canal treatment or an extraction. Depending on the situation, an antibiotic may help on the short term until definitive treatment can be completed. A toothache has intense pain to cold that lingers a long time or the patient states they can feel their heartbeat in the tooth, typically indicates an inflamed nerve. This is called irreversible pulpitis and requires the same options of root canal treatment or extraction. But in this situation an antibiotic is not effective. Many patients report that they feel pain start but hope it will go away. If you have either of the above situations, it is best to see a dentist soon as pain will typically get worse either on the short term or will return in the future and be severe.
Sensitive teeth are quite common and for sake of this article will be defined as being triggered by hot, cold, or sweets that is of short duration and only when the irritant is happening. If you have sensitivity to cold and sweets the diagnosis is typically either receding gums exposing the root surface, abrasion on the side of your tooth, or a cavity. If the sensitivity is deemed to be from receded gums or abrasion, using a sensitivity toothpaste and avoiding whitening products can help control it. If that isn’t effective, then fillings or grafting of the gums is necessary. Sweet sensitivity is commonly can with cavities, but usually only when a cavity gets moderately large. The recommended treatment is often a filling but occasionally sealing worn tooth structure or desensitizers are recommended.
Biting pain is often, but not exclusively, a result of a crack in the tooth. This is common in people who have had previous cavities that needed to be filled. Cavities weaken the tooth and fillings are not able to bring the strength back to a virgin tooth strength. Constant chewing and grinding applies forces that over time allow a tooth to form cracks. Cracks form small and gradually grow larger and deeper until you eventually have pain on biting or break a chunk off a tooth. When a crack is noted, the most common recommended treatment is a crown or other restoration that covers the chewing surface to prevent the crack from propagating further. There is no home treatment for cracks other than avoiding chewing on a tooth.
Gum pain is most often from food getting stuck between teeth. So, if the pain isn’t intense this is one type of pain that time may heal on its own. There are times when you will be unable to remove the irritant and may need to have dental intervention. If gum pain is more generalized then there are other possible causes such as illness, medication side effects, or nutritional deficiencies.
Jaw pain is another common complaint we as dentists see. Pain from the jaw joint can be quite difficult to diagnose and treat. If you ever experience it, the first recommended steps are to avoid overusing your jaw by avoiding chewing gum, chewy foods, limiting opening wide, talking less, and a softer diet. In some cases, a mouth guard is recommended if you may be clenching or grinding at night. In other cases, a chiropractor may get involved if the jaw is out of alignment due to a large yawn or trauma.
The most feared dental pain is pain while receiving dental treatment. With our modern topical and regular anesthetics, pain can be eliminated in almost all situations. There are a minority of people who have increased anxiety, hypersensitivity, or decreased effectiveness from anesthetic in whom alternative options are needed. Depending on health status there are safe and effective sedation options available, though none without some risks. No matter how high or low your anxiety and pain threshold is, the most effective way to avoid dental pain is to catch problems early and be diligent with your teeth at home with oral care and and diet. A final statement to remember: The smaller the dental problem - the less pain, cost, and complications. Or another traditional way to put it: An ounce of prevention is worth a pound of cure.