Acute toothache

– one of the most difficult to bear pain, which is determined by a rich mixed (somatic and vegetative) innervation. Dental pain often radiates (the spread of pain beyond the affected area or organ), which leads to diagnostic difficulties.

Symptoms of Acute dental pain

Dental pain often radiates (the spread of pain beyond the affected area or organ), which leads to diagnostic difficulties.

In the pathology of molars, pain can spread to the temporal region and the lower jaw. Damage to the molars can cause pain with irradiation to the larynx and ear, parietal area. In the pathology of incisors and premolars, pain may occur in the forehead, nose and chin.

On the other hand, a number of somatic diseases can simulate dental pain: trigeminal neuritis , otitis media , sinusitis, and some other diseases, including myocardial infarction .

The nature of pain in the defeat of hard tissues of the tooth depends on the depth of the process.

With superficial caries, when the defect is shallow, the pain is short-term, occurs under the influence of temperature and chemical stimuli.

With average caries, when the dentin is also affected, the pain from irritants, including mechanical, is longer, and disappears after the source of irritation is eliminated.

With deep caries, the dentin layer covering the tooth pulp becomes very thin and the phenomena of pulpitis can be attached .

Pulpitis is characterized by more intense pain than caries, which occurs for no apparent reason. The duration of the attack depends on the duration of the inflammatory process. At the beginning of the disease, it is a short, lasting several seconds, pain. Over time, it becomes almost permanent, increasing at night.

Pain can be provoked by temperature, chemical and mechanical stimuli. Sometimes it is painful to bite on a damaged tooth. There is a wide irradiation along all branches of the trigeminal nerve. Acute pulpitis can become chronic . Then the pain is weaker and is caused by temperature and mechanical influences, a frequent complaint is the occurrence of pain when inhaling cold air.

Periodontitis . Periodontitis is characterized by constant pain, the intensity of which depends on the stage of the inflammatory process. Acute periodontitis it occurs with severe acute pain, often localized in the diseased tooth.

There is a painful biting on the tooth. Sometimes enlarged, painful submandibular lymph nodes are palpated. The clinical picture of chronic periodontitis is less bright, may be accompanied by constant aching, bursting pain in the affected tooth, and some forms are asymptomatic. Chronic periodontitis in the acute stage is similar in clinical picture to acute periodontitis .

In case of a traumatic tooth fracture, the pulp may be injured. Usually, the pain is localized in the area of the damaged tooth, has a permanent character, increases with food and from various stimuli.

Causes of Acute toothache

Inflammatory diseases of the oral cavity: caries, pulpitis, periodontitis, traumatic tooth fracture, etc.

Treatment of Acute dental pain

What should I do if my teeth hurt unbearably, and there is no way to get to a doctor?

• Walk around the room. Dental pain at night is aggravated largely due to the fact that a person is lying down, – says Elena Samokhina, a dentist of the highest category. Blood flow to the jaws increases, blood vessels fill with blood and create increased pressure in the pulp, and this, in turn, increases the sensitivity of the nerve endings.
• Rinse your mouth well. Aching tooth pain is most often caused by the fact that the tooth cavity is clogged with food remnants. It is best to rinse your mouth with a warm solution of soda (a teaspoon per glass of water) or an infusion of medicinal herbs – chamomile, sage, St. John's wort. This will relieve inflammation and reduce tissue irritation.
• Massage your hand. Stroking the base of the thumb on the palm side or the space between the thumb and index finger on the back side affects special points that regulate pain.
• Remove the bandage. Warming bandages on the cheek from the side of a diseased tooth for dental pain are categorically contraindicated – - says Elena Samokhina. Heat increases blood flow to the diseased tooth and worsens inflammation. It is better to apply a few ice cubes to the cheek – the cold narrows the blood vessels and reduces the swelling of the tissues.
• Take a painkiller. Modern medications guarantee protection from pain for 12 hours.

Non-narcotic analgesics are the most widely used for relieving tooth pain. According to who recommendations (Essential Drug List, 1995), paracetamol, acetylsalicylic acid and ibuprofen are recommended as non-narcotic analgesics. Their effectiveness, safety, long international experience and accessibility to the public allow us to recommend them for use in dental practice. Highly purified paracetamol has the best ratio of effectiveness and safety.

In dentistry, the priority of paracetamol is determined by the lack of its effect on blood clotting, which is important in terms of surgical interventions. Codeine and caffeine, which also have their own analgesic activity, enhance the effect of paracetamol.

The latter causes the widespread use of a combination of paracetamol with codeine and / or caffeine (solpadein: highly purified paracetamol 500 mg, codeine 8 mg, caffeine 30 mg; Panadol-extra: highly purified paracetamol 500 mg, caffeine 65 mg) in General medical practice and dentistry.

Non-narcotic analgesics begin to have their effect 15-30 minutes after administration and provide analgesic effect for 3-6 hours.