Dental pain – causes and treatment

Dental pain – causes and treatment

Dental pain and sensitivity are quite common after some treatments or procedures performed in the dental office. This does not mean that you should give up regular visits to the dentist, but you should be informed about the possible causes of the pain and know what to expect.

During a filling, we fill the holes created by dental cavities with substances such as composite or amalgam. It is a simple and fast procedure but afterwards, it leaves many patients with sensitive teeth. Some of them may even experience minor dental pain, especially when brushing or flossing, breathing in cold air, drinking or eating hot or cold liquids and foods. These go away naturally within a few days or several weeks. If you want to speed up the process, your dentist may advise you to take anti-inflammatory drugs, avoid foods and drinks too hot or too cold, chew on the opposite side of the mouth, or use a special toothpaste and brush gently.

You may also experience some dental pain after having a crown placed. It is not unusual, and it normally goes away in one to two weeks. If it does not do so, then you should see the dentist and investigate possible causes. One of the reasons of the pain might be tooth decay under the crown. It could be an infection or a pulpal inflammation, especially if you did not have a root canal treatment before the crown. The most common signs of infection are pain when you bite, sensitivity to extreme temperatures, gum swelling and sometimes a fever. Depending on the cause and intensity of the pain, your dentist will prescribe medications or other treatments. In extreme cases, the affected tooth may need to be extracted.

Thanks to modern anaesthetics, tooth extractions have become pain free procedures. Occasionally, after the anaesthetic wears off, some patients experience sensitivity, pain, swelling or bleeding. After a tooth has just been extracted, these reactions are normal and controllable part of the inflammation process, as the body is making efforts to restore balance in the affected area. The tissues begin the healing process with the help of blood circulation and the dental alveoli narrows. A blood clot forms to close the incision site.

Sometimes, the blood clot fails to develop, or it dislodges or dissolves before the wound has healed. We call that alveolar osteitis or dry socket. It usually occurs within three to five days of an extraction. Symptoms of dry socket may include severe pain that often radiates to the ear or temple, bad smell and taste in the mouth or visible bone at the extraction site. These are clear signs that you should see your dentist as soon as possible in order to alleviate the pain and speed up the healing process. The dentist will flush out the mouth with a saline solution to remove any debris that could cause pain or infection and then apply a medicated gel or dressing to the area to ease pain quickly and permanently.

Dental pain is not something that you should ignore. There are multiple causes that can determine it, but after we figure out which one is it, Pacifica Dental professionals will apply the best treatments for you to have a rapid and successful recovery. We specialize in pain therapy and we offer emergency appointments for patients that are in pain.

Pain therapy – endodontics and/or extractions

Pain therapy – endodontics and/or extractions

Have you ever had a toothache that has kept you up all night? Not to worry- you can be pain free by the end of the day so you can have a good night’s sleep. Call us right away and you can have a same day emergency visit.

The first step is coming into the office so we can determine the cause of the pain. Our team at Pacifica Dental will gather information about your medical and dental history, as well as an accurate description of the pain. A certified dental assistant will take care of the required diagnostic aids and tests, such as radiographs, photographs, study models, and digital scanning. The dentist will perform a dental examination including an extra-oral evaluation as well as an intra-oral evaluation of soft tissue and dentition. You can expect questions such as “when did the pain start?”, “is it spontaneous?”, “is it lingering?” “did it wake you up?, “how would you score the pain, on a 1-10 scale?”, “are there any factors that make the pain worse or reduce it?”, and “is it triggered by temperature changes?”. In most cases, additional specific examinations are required in order to come up with an accurate diagnosis.  Ice and heat will be applied to your teeth and you will be required to grade the level of the pain/sensitivity. Percussion and palpation will also play a role in diagnosis. A bite test might be performed, if a cracked tooth is suspected. If necessary, referrals will be made to specialists at the dentist’s recommendation.

A diagnosis is made from the review of the data that was collected and recorded during the clinical examination, supplemented by the necessary radiographs and/or study models and/or the results of any tests or consultation. The dentist will provide you with a treatment plan consisting of urgency and order of treatment, the options for materials and methods,  alternatives (including no treatment), all recommendations, instructions and advice, risks and complications associated with each treatment, financial implications, and arrangement for payment options.

Once you have made a decision with respect to the choice of treatment and informed consent has been obtained, we will proceed with treatment.

Dental pain is most often due to tooth decay, or an inflammation or infection of the pulpal tissue. Performing endodontic treatment can significantly reduce the pain.

Studies have shown that pulpotomy and pulpectomy treatments alleviate pain and can restore the health of the tooth.

During a pulpotomy, a dentist/endodontist removes the coronal pulp (the pulp above the gum line, within the main part of the tooth). A pulpotomy can only be completed on a tooth that is still alive, meaning that it responds to temperature and has sensation and vascular flow. For this procedure to be successful, it is important there is no abscess in the area. In approximately 90% of cases, pulpotomy treatment reduces pain symptoms within a day.

A pulpectomy is a procedure that entirely removes the pulp from all parts of a tooth, including the root system. The main goal of the procedure is to clean the entire root canal, protecting it from further infection and to prevent it from spreading the infection into the surrounding apical bone. Root canal treatment can sometimes be combined with an incision for drainage and occlusal reduction. All these procedures are performed under local anesthesia.

Once root canal therapy is completed, your tooth should be examined periodically (the time between appointments will be recommended by your dentist). This allows us to ensure that the tooth has healed and/or is healing properly. Since an abscess may take 2 or more years to heal, the tooth should be re-evaluated once a year for at least a few years after treatment.

In many cases, patients come to us only when the tooth is too damaged to be saved. Then we   need to perform an extraction. The extraction can be non-surgical or surgical, depending on the tooth’s roots, surrounding bone and how badly damaged the tooth is.

One of the various tooth extraction techniques is called alveolotomy. An alveolotomy involves removing part of the alveolar and cortical bone in some complicated cases. It is performed whenever there are elements of difficulty and involves a minimal, controlled loss of supporting bone, avoiding uncontrolled fractures and accidents during extraction.

At Pacifica Dental, we believe in providing our patients with access to the best dental technology available. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been clinically proven to help patients heal faster with fewer complications after dental surgery and other procedures.

Did You Know?

PRP and PRF can help you:

  • Heal faster and get back to work and other activities quickly after a surgical dental procedure.
  • Reduce your need for strong pain-medication and anti-inflammatories following dental surgery.
  • Greatly lower the risk of infection after oral surgery.

Best of all, PRP and PRF are 100% natural.

In general, after a simple extraction, the recovery period is 5-10 days, until the resorbable sutures are dissolved. After a surgical (more complicated) extraction, the recovery is within 2 weeks,  however, the nonresorbable sutures and membranes will be removed after a month during a follow up appointment. We highly recommend that patients do not smoke, drink alcohol, swish, suck, or rinse the mouth on the day of the extraction. Icing is recommended for 2 days in order to avoid swelling and decrease bruising.

If you are in any kind of dental pain, don’t waste any time and schedule an emergency appointment with Pacifica Dental. We will take care of you as soon as possible and we will make sure you have a quick and successful recovery.