Toothache
Hopefully you’ll be spared…
Some people consider even minor discomfort to be toothache. Others, in a panic, still avoid the dentist, even when their eyes are watering.
Let’s look at this topic from different perspectives!
If you constantly have toothaches, you’re probably rather unpleasant to be around. You’re irritable, have bad nights, and are therefore less productive and unable to concentrate. This, in turn, increases your dissatisfaction! The risk of depression shouldn’t be underestimated! Talking and laughing aren’t your strong suits right now. Eating and drinking aren’t much fun either.
What causes toothache?
The most common cause of toothache is a single tooth. The pain originates in the dental nerve. How is that possible? Well… I need to explain a bit more:
Inflammation is actually a positive reaction of our body, because it’s a repair process. Without inflammation, there’s no repair. Got it?
When the “software” of inflammation is activated, several processes occur automatically (you learned about this in biology class):
- There is increased blood flow (hyperemia), leading to reddening of the area, which makes sense so that more nutrients and “building blocks” reach the site of the damage.
- There is increased permeability of the blood vessels in that area, which serves the purpose of having more “building blocks” directly available at the site of the damage. This is accompanied by swelling of the tissue (edema).
- There is an increase in temperature. The tissue becomes warm. An increase in temperature of just three degrees Celsius doubles the reaction rate of enzymatic processes… that is, the actual repair process. Nature has arranged it quite cleverly.
This works perfectly well in the human body… except in the brain and teeth! And why not? Because the brain is surrounded by solid bone, and the dental nerve is surrounded by dentin and enamel.
So, when edema sets in, the tissue can’t expand.
- This leads to increased pressure in the tissue.
- This leads to reduced blood flow.
- This leads to increased inflammation.
- This leads to increased edema.
- …and this continues until the tissue is no longer supplied with blood and therefore dies.
This process sometimes causes no pain at all in the tooth, in other cases it’s pure hell!
I probably don’t need to mention that this is life-threatening in the brain.
Back to the tooth.
What can trigger inflammation of the dental nerve in a single tooth? A deep cavity, of course… you should have gone to the dentist sooner! While repairing small cavities carries relatively low risk for such inflammation, the risk increases even with a perfect repair by the dentist. I have also seen cases where someone with an intact tooth bit down on a cherry pit, resulting in the nerve dying.
What can you do now?
Call immediately and make an emergency appointment. And what do you do if it’s the middle of the night? – Apply intermittent cooling… like a 15-minute ice pack, then 15 minutes of doing nothing. Under no circumstances should you apply heat or use infrared light… you’ll only make that mistake once! You’ll see!
You can also place a clove in the cavity or in your cheek next to the tooth. But don’t expect it to make you pain-free. It will provide some relief. You can’t expect more than that!
Other causes of toothache can include:
- Infected gum pockets, including those around wisdom teeth
- Cracks and fissures in a tooth
- The effects of grinding and/or clenching your teeth
- Effects of sinusitis
- …etc.
As an emergency patient in the practice
As a patient, you define “emergency” quite differently than we professionals do. An emergency means unbearable and persistent pain. Everything else is not an emergency, but rather a minor inconvenience: a sharp edge on a tooth, a crown that has fallen out, tooth sensitivity, etc.
Since our practice is not a walk-in clinic, all appointments are booked in advance. Emergency patients mean significant stress for us and often overtime for our staff, despite scheduled buffer times. So, if you call because of an emergency or a minor inconvenience, please communicate this clearly on the phone so that the friendly voice on the other end can accurately assess the situation.
Please don’t assume you can choose an appointment today. We’ll see where we can fit you in. You might even have to forgo your preferred dentist. And please be patient.
So, what will be done now?
Everything will be done to eliminate your pain. A final therapy is usually not possible because it is far too time-consuming.
For the future
If you want to be on the winning side, then you should visit your dentist regularly for checkups and preventative care. This allows us to identify potential problems early on and address them proactively whenever possible. We’ll also explain your weaknesses in brushing your teeth (even dentists have them!) and how you can improve. And this isn’t something you’ll hear from a health columnist in the newspaper, but from someone who is an expert in the field!
Author: DRW
If we are unavailable
Outside of our office hours, if you have toothache, you will need to visit the dental emergency center in Stuttgart. You can find the contact details here! … only in german! No appointments, just walk-in!
Regular visits to the dentist cannot completely prevent toothache, but they can significantly minimize the risk.