Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.

If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.

If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.

Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.

Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.

If you would like more information on the sources of mouth pain, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”

For most dental procedures you’re usually back to your regular routine in no more than a day or two (or even hours) afterward. For the most part, the mouth heals rather quickly.

But there may still be a short period of discomfort after tooth extraction, gum surgery or similar invasive procedures. The good news is you will most likely have no need for strong narcotic painkillers — milder, over-the-counter pain relievers are usually sufficient to manage your discomfort.

The most common of these are known as non-steroidal anti-inflammatory drugs (NSAIDs). This group of pain relievers — which include aspirin and ibuprofen — block the release of substances in the body known as prostaglandins that stimulate inflammation that increases pain in damaged tissues. They’re much preferred for mild to moderate pain because they don’t have the side effects of steroids or narcotics like morphine or codeine. They also tend to be less costly than these other prescription drugs.

But while they’re reasonably safe, they can cause problems if you exceed the recommended dosage or use them for prolonged periods. Their blockage of certain chemicals reduces the clotting mechanism in blood leading to a blood-thinning effect. Not only will this increase bleeding, it can also damage the stomach lining and cause ulcers if used over a period of weeks. Improper dosage of NSAIDs has also been linked to miscarriages and repeat heart attacks, which is why they’re not recommended for use during pregnancy or with patients with a history of heart or intestinal problems.

But if taken as directed by your physician or dentist — usually no more than 2,400 milligrams a day and only for a few days — such side effects are quite rare. The benefit is much more common: about five hours of pain relief from a single dose for most people. With the help of ibuprofen or similar drugs, you’ll be on your feet after your dental work in no time. 

If you would like more information on managing pain after a procedure, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Pain with Ibuprofen.”

Visiting the dentist for regular cleanings and needed dental work can do wonders for keeping your teeth and gums in tip-top shape. But if you’ve seen or heard about infections occurring in healthcare facilities, you might be a little concerned that your trip to the dentist might expose you to one. Don’t be! You and your family will be out of harm’s way because your dental team has made protection from viruses, bacteria and other infectious agents a top priority. To highlight this effort, the American Academy of Oral Medicine commemorates each September as “National Dental Infection Control Awareness Month.”

As a healthcare provider, dentists have a legal, moral and ethical obligation to protect patients (and staff members too) from infection through what are known as “standard precautions.” These include barrier protection, disinfection and sterilization practices, and safe disposal of contaminated items.

But dentists and their professional organizations don’t stop with the minimum requirements—they’re committed to a higher standard when it comes to infection control. The bedrock for this commitment is adherence to an infection control checklist developed by the U.S. Centers for Disease Control (CDC), updated regularly. This in-depth checklist recommends several best practices and protocols, including:

• Creating a written infection control plan that outlines all practices and procedures to be followed by the provider and staff;
• Barrier protection, including the wearing of disposable gloves, face shields or gowns by providers as appropriate;
• Proper disposal methods for used items;
• Proper hand washing and other hygiene practices before and after treatment procedures;
• Proper disinfection and sterilization of instruments and equipment;

Most licensing bodies also require that dentists and their staff undergo continuing education in infection control, usually every two years.

Because you as a patient have a right to know the details about your medical and dental care, you have public access to infection control guidelines and requirements. You can also ask your dental provider about what steps they take to protect you and your family from infectious disease. They’ll be glad to answer any questions you have to put your mind at ease about your safety.

The dental profession’s commitment to patient and staff safety has drastically reduced the risk of any infection. Rest assured, your dental visit will be beneficial for your oral health—and safe for your general health too.

If you would like more information about infection control in the dental office, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Infection Control in the Dental Office” and “Shingles, Herpes Zoster: A One-Sided Facial Rash.”