Dental pain Causes, Types, symptoms and treatment.

Dental pain
Causes

  Dental pain (toothache) has several causes. It is not a symptom of a self-limiting condition and requires referral in all cases.
  Toothache is due to infl ammation of the pulp or periodontal membrane of a tooth. Both structures are well supplied with nerves, which send impulses to the cerebral cortex where pain is perceived.
Causes of toothache include:
dental caries (tooth decay): often as a result of poor oral hygiene and failure to have regular dental check-ups
dental abscess: arising from an infection in decayed dental pulp
pericornitis: infection in the soft tissue covering impacted wisdom teeth. It occurs in young adults between the ages of 18 and 25 years
dry socket: due to poor healing and infl ammation following dental extraction
gingival recession: starting from early middle age the gums begin to recede from the base of the teeth, exposing nerves which are very sensitive to stimuli such as heat, cold or sweetness
trigeminal neuralgia (see above): attacks can sometimes occur following dental treatment.
Signs and symptoms
  dental caries: continuous, throbbing pain
  dental abscess: severe continuous pain with localised swelling; the affected tooth may be slightly raised from its socket
  pericornitis: localised soreness in the soft tissue overlying the impacted tooth, developing into pain if not treated
  dry socket: localised continuous pain in the area of the socket
  gingival recession: localised sharp pain of short duration on exposure to heat, cold or sweet stimuli.
Symptoms and circumstances for referralReferral
is necessary in all cases, although analgesics can be recommended until a dentist or doctor can be seen.
Treatment In theory, ibuprofen and aspirin are the most effective analgesics as they act at the site of the pain, rather than centrally, in the manner of paracetamol and opioids. But many people fi nd that paracetamol, perhaps in combination with an opioid, is more effective for them.
Even so, OTC analgesics may provide little relief from severe dental pain. Tooth tinctures and clove oil have a counterirritant effect, producing a sensation of warmth that masks pain for a short period. However, they can cause burns to the gums if used repeatedly.