So you have a toothache – now what?

06 Oct 2023

So you have a toothache – now what?

Have you ever had tooth or gum pain, panicked, only to find that the pain disappears after a few days? Or Maybe your teeth hurt only in specific situations, like when you are tucking away into your favourite ice cream. Or perhaps you just bit down on a popcorn seed, lo and behold your tooth cracks. At what stage do you need to worry? At what point do you need to seek urgent care? If these are questions that you would like answered, keep reading below.

First and foremost, I cannot stress enough how important it is to ensure biannual checkups in order for your dentist to catch things EARLY. Catching problems early can often help to avoid more complicated and costly treatment later down the line.

Here are some of the early signs and symptoms to watch out for:

  • Broken/chipped teeth and fillings
  • Gum bleeding
  • Bad breath
  • Bad taste
  • Sensitive tooth
  • Sharp pain when biting down

Late Signs to look out for

  • Lingering pain to cold things
  • Spontaneous pain
  • Swelling of the gum or face
  • Sour taste
  • Sensitivity to hot and cold things
  • Pain at night
  • Throbbing pain

COMMON DENTAL EMERGENCIES

Cracked and Broken Teeth

With stress being on the rise, cracked and broken teeth are becoming more prevalent. Night time grinding (Bruxism) is among one of the most causes of cracking a tooth. Signs of bruxism can usually be detected early. A night guard can help prevent such an occurrence. A sharp pain when biting down (Particularly when you release the bite) is an indicator that there may be a hairline fracture within your tooth.

Nonetheless if you have cracked a tooth, your dentist would need to do an assessment to determine whether or not the tooth is salvageable. If the tooth can be saved, the status of the nerve inside the tooth would need to be assessed. Treatment could include a crown, with or without root canal treatment or an extraction if caught at a much later stage.

Throbbing Gums

A sudden throbbing pain coming from within the gum could indicate a trapped food particle. If this was to pass on its own, the pain usually subsides and no treatment is required. In some cases this could lead to a gum infection in which case your dentist would need to carry out some gum treatment and in some cases prescribe some antibiotics.

Repeated episodes of gum infections from your wisdom tooth however, could lead to more serious infections which may cause difficulty in opening the mouth, swelling on the face, bleeding and in more severe cases-difficulty breathing. This would be considered a dental emergency and would need immediate attention.

Spontaneous and Prolonged Sensitivity

Everyone can experience sensitivity from time to time. When sensitivity is prolonged and lasts longer than a few seconds, or if the tooth starts to hurt spontaneously, this could indicate an inflamed pulp (nerve and blood vessels within the tooth). Late stages of pulpal inflammation would be pain at night time and sometimes a temporary cessation of pain due to pulpal necrosis.

All cases would need to be assessed. Early and a root canal treatment is usually the only remaining option to save the tooth.

Pain When Biting Down

In some cases the infected pulp tissue spreads outside the tooth causing pressure around the tooth itself. Someone may experience pain when they apply pressure onto the tooth. In some instances you may notice an abscess- a puss filled sac appearing on the gum near the offending tooth. This again would indicate more complicated treatment is required, usually in the form of root canal or extraction.

Traumatic Injury

In the more unfortunate event that you find yourself in an accident, perhaps you’ve tripped over and knocked your front tooth, The goal is to always protect the nerve inside the tooth from bacterial infestation. As worrying as it can be, same day crowning options are available to ensure that the tooth is restored in the most optimal yet aesthetic fashion. In situations where the tooth is too broken down and an extraction is indicated, an immediate same day implant may be the solution.

Irrespective of the origin of the discomfort, It is always important to seek help early. A reduction in the intensity of pain does not equate to a resolving issue. When the nerve inside the tooth dies; the pain temporarily subsides. However, a dead nerve or any dead piece of tissue in the body for that matter, is a source of infection. What tends to follow is swelling and infection of the surrounding structures. The structures residing close to the teeth and the gums hold great significance. Such structures include the airway, sinuses, neck, jawbone and blood stream. When the infection spreads to any of these sites it can quickly change from a dental emergency to a medical emergency!

Here at The Dental Studio, we are a dedicated team of highly trained professionals who are devoted to addressing all your dental needs.

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About Author

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Dr Kiran Kaur Arora

Dr Kiran Kaur Arora is an experienced clinician known to be dedicated to providing a comprehensive approach to patient care. Her expertise spans emergency dental services, urgent care, pain management, removal of wisdom teeth as well as dental aesthetic treatments such as smile designs, veneers, crowns and bridges. She holds postgraduate certifications in advanced operative techniques and is also a certified Nutritional Therapist who has an appreciation for the mouth-body connection and a genuine passion for oral health and well-being.

Dr Kiran Kaur Arora practises at The Dental Studio @ Tai Thong (Potong Pasir | Sennett Estate).

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