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Severe Tooth or Mouth Pain

Any injury to the gums or teeth can be very painful. At other times, you may have dental pain and not know why. For example, sudden pain may be caused by pieces of food that come in contact with a decayed area of the tooth. Food, heat or cold may create pressure near the nerve and cause pain. The nerve inside the tooth also may be exposed if you lose a filling or crown. Dental pain can be the result of a cracked tooth. A cracked tooth can be the result of a fall or an injury to the face and teeth. A cracked tooth can also develop if you grind or clench your teeth. Adults often can suffer from dentine sensitivity when they brush the side of the tooth too hard for many years. This causes a groove from tooth abrasion at the “neck” of the tooth by the gum line. Some people experience tooth erosion from the chronic use of acidic beverages and candies or even from acid reflux from the stomach into the mouth. Teeth with severe erosion can be very sensitive.

Pain that gets worse over time can also be caused by food that's stuck between your tooth and gum. If you don't brush and floss well, the bits of food remain. Bacteria multiply in this area, and an infection of the tooth and gum may develop. This type of infection is called an abscess. It can be at the root end of the tooth (in bone) or in the gums. An abscess can be a serious health problem if it is not treated.

Pain when you bite or chew can be a sign of an abscess, especially if you also notice a bad smell or a bad taste in your mouth.

What You Can Do

First, call your dentist and make an appointment.

In the meantime, here are a few steps you can take at home to try to relieve the pain:

  • Take an over-the-counter pain reliever, such as ibuprofen (Motrin) or acetaminophen (Tylenol). Even if this helps, you still need to see your dentist. If you medicate the pain and don't get treatment, the infection can spread. It could even become life threatening. Taking one acetaminophen pill (500mg) with two non-prescription ibuprofen (200mg) pills is also very effective in reducing dental pain. It is safe to combine acetaminophen and ibuprofen. An upset stomach is a common side effect of the use of ibuprofen, so it is advisable to take ibuprofen with a meal to avoid stomach discomfort. If you have liver or kidney disease or are taking non-steroidal anti-inflammatory drugs (NSAIDs), blood thinners or are pregnant you should not take these medications. Discuss the use of these pain relievers with your dentist or pharmacist.
  • Rinse your mouth with warm salt water every hour or so. Mix one-half teaspoon of salt in 8 ounces (1 cup) of water. This won't heal an infected tooth, but it may ease the gum swelling.
  • If the pain is caused by food stuck in a cavity, brushing and using dental floss in the area may remove it.
  • If you've lost a filling or crown, dip a cotton swab in clove oil and apply it to the exposed part of the tooth. You can buy clove oil in drugstores and supermarkets. You also can use a topical gel or liquid anesthetic, such as Anbesol, Hurricane or Orajel. Topical anesthetics typically contain benzocaine or lidocaine. These products can be used for temporary relief from tooth or gum pain.
  • If you will be traveling in an airplane, the changes in pressure may make the pain worse. Try to get dental treatment before traveling by air.

What Your Dentist Will Do

Even when dental problems cause a lot of pain, the problems, and the treatments, often are relatively simple if you seek help right away.

The first thing your dentist will do is take an X-ray. If you have a cavity, your dentist will remove the decayed part of the tooth and place a filling. Once the inner part of the tooth is protected, the pain will usually diminish and may go away completely.

If your problem is related to pieces of food stuck under your gums, your dentist will remove the pieces. If you have an infection, you may be given a prescription for antibiotics. Take your antibiotics exactly as directed, even if you start to feel much better after only a day or two. If your gums are inflamed this is called gingivitis. You can use an over-the counter rinse like Listerine or your dentist may prescribe an oral rinse called chlorhexidine to reduce gum inflammation. It is usually prescribed as a rinse that you use twice a day, however if the gum inflammation is localized your dentist may suggest that you also dip your toothbrush into the chlorhexidine liquid and then gently brush the area where you are experiencing gingivitis. In addition, the use of floss to clean the tooth in the area of inflammation may also help to reduce the gingivitis and provide pain relief.

An abscess in the tooth will require root canal treatment. An abscess in the gum may need to be drained. If the tooth is very damaged, it may have to be removed.

If you have pain from tooth abrasion caused by toothbrushing, your dentist and dental hygienist will recommend the use of soft toothbrush and show you how to brush to reduce further damage to your teeth. A filling can also be placed on the side of your teeth to repair the abrasion. The dental clinicians often coat the sensitive area with a type of fluoride product called a varnish. In addition, your dentist can prescribe a home fluoride gel to reduce the possibility of developing cavities in this area. The gel can be applied with a toothbrush or with a custom-made trays that you put the gel in and then place in your mouth for a few minutes each day.

If you are developing cracks in your teeth from grinding or clenching your dentist can made a custom made occlusal nightguard out of acrylic or silicone. This will prevent you from grinding and clenching and often provides relief or a reduction in painful tooth symptoms. It can also help to reduce pain related to the jaw joint and muscles.

Last updated November 20, 2020




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