Unknown Severe dental pain
Unknown Severe Dental Pain
1 Do you have any pain at the moment?
A Yes, I have pain all the time and it is irradiating to my ear and/or across the jaw
B The pain is occasional only if I drink or eat something
C It comes and goes without any reason
2 For how long you had the pain?
A A day
B A week
C A month
3 Can you describe the pain?
A It is a throbbing pain
B It is a stabing pain
C It is a sharp pain
D It is a dull pain
E It is a just a sensitivity
4 What irritatives makes it worse?
A Cold drinks or food?
B Hot drinks or food?
C Both
D Chewing – I can not eat
5 Is it painful when chewing, closing teeth together?
A Yes, very
B No, not realy
Unknown toothache – dental pain
Pulpitis 1ac 2bc 3bc 4abc 5b
Ok, it looks like the pulp (nerve) is irritated and inflamed and that is why you have so much pain. Most likely there is a cavity (a hole) in the tooth or a decay underneath the filling which caused the inflammation.
Regardless of the cause of pulpitis the inflammation can be associated with a bacterial infection. As in the case of a caries that penetrates the pulp cavity the tooth is no longer sealed to infectious pathogens, where as when the blood supply is cut off to the pulp, bacteria have an opportunity to over take the pulp.
When the pulp becomes inflamed pressure begins to build up in the pulp cavity exerting pressure on the nerve of the tooth and the surrounding tissues. Pressure from inflammation can cause mild to extreme pain, depending upon the severity of the inflammation. Often, pulpitis can create so much pressure on the tooth nerve the individual will have trouble locating the source of the pain, confusing it with neighboring teeth. Inflammation in the tooth provides a difficult environment for reducing the inflammation in the pulp cavity. Unlike other parts of the body where pressure can dissipate through the surrounding soft tissues and where lymph can reach, the pulp cavity is very different. The dentine surrounding the pulp is hard and does not give under the pressure of the inflammation so the pressure has very little chance of dissipating before pulpal necrosis occurs. The pulp cavity inherently provides the body with an immune system response challenge, which makes it very unlikely that the bacterial infection can be eliminated. The pain will usually stop once the pulp has died, however the infection can spread to the ancillary anatomy.
What to do
You can use opioid analgesics co-codamol 8/500 containing codeine phosphate 8 mg and on paracetamol 500 mg 0.5–1 g every 4–6 hours to a max. of 4 g daily.
The most common pain reliever for dental pain is Ibuprofen and it’s relatives (NSAIDs) if you can take them). Over-the-counter It is sold in 200 mg tablets and directions on the box are to take two every 4-6 hours. This is a very low dose and four, or even six tablets will be much more effective in the beginning, but try not to exceed 800mg limit .
What not to do
In this case only the dentist can relief the pain completely by extirpating (removing) the nerve. RCT. So do not wait and seek medical attention as soon as possible.
Periapical abscess 2bc 3ad 4d 5a
Ok, it looks like we are dealing with an infection and most likely it is a periapical abscess. Usually it refers to the tooth in which necrotic pulp (nerve) is a cause of infection spreading in to the bone.
The pain is gnawing and continuous, throbbing. The involved tooth is painful when percussed (tapped), and often the teeth cannot close without added discomfort. Hot foods may increase the pain.
If treatment is delayed, the infection may spread through adjacent tissues, causing varying degrees of facial oedema (swelling), and fever. The infection may spread to osseous (bony) tissues or into the soft tissues of the floor of the mouth.
Local swelling and gingival fistulas may develop opposite the apex of the tooth, especially with deciduous (temporary) teeth. Drainage into the mouth causes a bitter taste. Abscesses from lower molars may drain at the angle of the jaw.
A chronic periapical abscess usually presents few clinical signs, since it is essentially a circumscribed area of mild infection that spreads slowly.
What to do
Prompt antibiotic therapy and surgical intervention in more extreme cases are usually successful in limiting the abscess or osteomyelitis, although often not before extensive and permanent damage has been done.
The most common antibiotics is Amoxycillin 250mg 3*daily for 7 days
If you are allergic to penicillins or you had Amoxycillin recently and it did not work you need different antibiotics which are targeting anaerobic bacteria Metronidazole 200mg 3*daily for 3 days is the other option.
Please don‘t forget that you can not use any alcohol while taking antibiotics, cause it could lead to severe nausea and vomiting or worse. And make sure you finish the hole treatment course, even if got a lot better.Otherwise some of bacteria is left and it may become more resistant to the antibiotics you used.
To relieve the pain and discomfort associated with an abscessed tooth, warm salt-water rinses and over-the-counter pain-reducing medication like Ibuprofen 400mg 3-4*day can be used. Bed rest, a soft diet, and fluids may be necessary.
What not to do
Do not wait and hope it will get better. Dental abscess is a very serious condition and in some cases it can cause death. So do not ignore it contact your dentist as soon as possible. Failure to treat an abscess can lead to serious infection as the pus spreads. Fever and malaise intensify when the infection penetrates the bone marrow of the jaw, producing osteomyelitis.
Do not rely only on aspirin, paracetamol or ibuprofen alone, they will not treat the infection, they work as a painkillers nothing else. You need antibiotics.
Make sure you are not allergic to any of the above medications, and double check with a pharmacist for a side effects.
Back to Dental emergency test
If you can not get any answers to your questions and problems, it is always the best thing to contact your dentist for further examination and assistance.
