Hi, I have been experiencing some weird tooth pain.  It comes as quickly as it goes and does not seem to last long( a few seconds) and has happened three times in the last 2 days.  It is not a throb pain, more a constant pain if that makes sense.  It feels like someone is touching ice cream to my tooth in the whole tooth but 10x worse, and is one of the worst pains I have ever experienced.  I am going to the dentist, I am just curious on your opinions.  Had a cavity filled in the tooth a couple months ago so not too sure why it would hurt all a sudden.  Thanks in advance.

Answer:

Thanks for submitting your question with us.  Now, the main piece of information that will determine the diagnosis of your tooth is:

Is the Pain provoked?

• Does the pain have a trigger point?  For instance, is it painful when you eat hot or cold food or drinks.
• Does the pain occur sporadically and unprovoked?  Does the pain come and goes as it pleases with no trigger point?  For example, the tooth becomes painful randomly throughout the day.
• Does the pain come when you bite down into food?  Or does the pain come when you open your mouth after biting down on food?

You’re probably wondering, why all the questions?  But believe it or not, answers to these simple questions can guide us down the right path to a correct diagnosis.  Let’s examine each answer:

Yes, the pain is provoked by eating cold/hot food or drink.

Then you have reversible pulpitis.  This means that you have slight inflammation of your pulp inside of your tooth.  This is caused by

• Bacteria/decay
• A recent deep filling without a protective base (Deep restorations need a protective layer underneath it to protect the tooth nerve/pulp)
• Recent deep cleaning

Reversible Pulpitis Treatment

Luckily, this can be easily treated by making a slight adjustment to the filling

No, the pain is not provoked by anything and occurs on its own

You may have irreversible pulpitis.  This means the pulp is damaged beyond repair.  This means that bacteria have leaked into your tooth nerve/pulp and are now irritating the tooth and needs to be removed to avoid serious infection.  Some signs of irreversible pulpitis include:

• Spontaneous, unprovoked pain
• On and off pain
• Continuous pain
• Pain lasts even after food/drink/or stimulus is removed
• Lying down or bending over produces pain

Irreversible Pulpitis Treatment

The treatment for irreversible pulpitis is a root canal treatment.

I feel pain when I bite down

Again, this indicates reversible pulpitis and can be treated by adjusting your filling.

I have pain when I open up after biting down

This indicates a fracture of the tooth.

Fractured Tooth Treatment

Treatment for this depends upon the extent of the fracture and can include anything from a new filling, or a root canal, or even an extraction.

For more information on tooth pain, check out our article here.

Also, see below for a descriptive chart of how to diagnose tooth pain.

We hope this helps and good luck,

Save My Smile Team

I had a root canal done and it abscessed. I haven’t got it finished all the way yet. Can I safely pull the tooth, and be done with it.

Answer:

Now before you think about pulling the tooth, let’s think about some other factors that will come into play down the road.  Once that tooth is gone, the tooth behind it and the tooth across from it (in the opposite jaw) will begin to slowly drift into the open space.  This will cause the other teeth to drift also, resulting in open spaces amongst your teeth.  You will eventually have to replace the space with either a bridge, implant, or partial denture which are all pretty costly.

Root canal procedures don’t have a 100% success rate, sometimes they do fail.  However, retreatment is always an option and definitely cheaper as compared to some of your other options.  Being that your procedure wasn’t finished, the pathway for bacteria wasn’t completely blocked meaning it had an opportunity to repopulate or wasn’t completely removed.

If would be best, in the long run, if you were to return to have the procedure completed or retreated.  Yea, it may be cheaper and easier to pull the tooth now, but believe us, you may regret this decision down the road.

Good luck with your decision,

SaveMySmile Team

After a tooth is pulled out (extraction) from the bone, a blood clot typically forms.  As with any other scar on the body, the blood clot is the first step to healing and serves as a framework for the replacement tissue (bone, etc).  But sometimes, this blood clot can be removed too early!  This condition, called alveolar osteitis, significantly delays healing and be an uncomfortable and painful condition.

Dry socket occurs in about 1-3% of extractions and 25-30% of surgical extractions (used if you had an impacted tooth).

Signs of Dry Socket

Most symptoms for dry socket occur a couple of days after the extraction and can last for up to 40 days if not treated.

Symptoms include:

• Severe pain in the area of the extraction
• Dull, aching pain that radiates to the ear
• Swelling around the tissues in the area
• Foul mouth odor (bad breath)
• Foul taste
• Swollen lymph nodes (only happens occasionally)

Causes of Dry Socket

• Most often unpredictable and not related to a specific cause
• Excessive trauma during the extraction
• Patients on birth control have a higher chance of dry socket
  • If you are on birth control, it’s best to have an extraction performed between days 23 to 28 of your menstrual cycle (days without estrogen supplementation)
• Smoking
• A history of dry socket in the past
• Not following the post-op instructions given to you by the dentist/staff

Treatment for Dry Socket

• Return to the dentist as soon as you experience this pain.  The following steps will be taken:
• The socket will be rinsed out to remove extra debris
• The dentist will insert medicated gauze into the opening.  The medicated gauze contains:
  • Eugenol
  • Topical anesthetic
• You will be advised to change the gauze every 24 hours for the next 3 days.
• Then change the gauze every 2-3 days until the clot forms and you do not experience anymore pain

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

My tooth hurts whenever I eat hot or cold food or drinks.  If feels like a sharp pain, then it goes away.  What does this mean?

Answer:

This is a sure sign of reversible pulpitis.  The feeling that you are experiencing is caused by exposed dentin.  Remember that dentin is normally covered by enamel (see article on tooth anatomy), if for some reason a portion of dentin is left uncovered, you will usually feel sensations of short, sharp pain when exposed to hot or cold substances.  Exposed dentin can be caused by a cavity, a defective filling/restoration, or recent dental work.  The good news is that this problem can be fixed easily, the dentin just needs to be covered.  Your dentist will be able to give you a filling, simply fix your existing filling, or a pulp cap if necessary.  However, don’t wait too long.  Reversible pulpitis, if left untreated, can turn into irreversible pulpitis.  Unfortunately, irreversible pulpitis can only be treated with root canal therapy, which costs a lot more in the end.  So be sure to act now by visiting your dentist.

Good luck!

Help!!  The tooth under my crown is hurting.  What does this mean and what should I do?  I’ve only had this crown for one year!!

Answer:

Sorry to hear that your tooth is in pain.  This can mean a number of things.  Let’s take a look at the many reasons for pain under a tooth crown:

Carious lesion/cavity under your crown

Sometimes, bacteria are able to find its way under the margins of crowns if not cleaned properly (see article on brushing).  If this happens, it could result in a painful situation, especially if the tooth nerve still remains in the tooth.

Bacteria not completely removed while preparing tooth for crown

In order to prepare a tooth for a crown, alot of tooth structure must be removed.  However, sometimes bacteria may still remain on the tooth structure that cannot be visibly seen by the dentist.  If this occurs, pain will occur at a later time.

Crown not being correctly adjusted in mouth

It could be “too high”, which means your bite could be off, and may need to be reduced by the dentist.  It could also mean that the crown isn’t adjusted to tightly “hug” the tooth and seal off the margins.  If the margins aren’t tight and snug, bacteria could easily creep in and eventually cause tooth crown pain.

Be sure to visit the Dentist to fix the problem

Your best bet is to go to the dentist to evaluate your options.  First, make sure the dentist runs a couple of tests to ensure that the pain is indeed coming from that tooth.  Sometimes, pain in one area is projected to a nearby area, this phenomena is called referred pain and occurs quite frequently.  If the dentist identifies this tooth as the source of the pain, then you’ll have a couple of options.  The crown may just have to be readjusted, which will only take a few moments, or it may have to be removed and the situation assessed from there.  Depending on the extent of bacterial invasion, you may just need the crown re-prepped, a root canal, or even an extraction.  Also, depending on your dentist’s office polices, he/she may offer to re-do your crown for free.

Good luck!

Bruxism, or grinding of the teeth, is a fairly common condition that affects a majority of the adult population (estimates range up to 85%).  It usually occurs while sleeping and the individual is completely unaware that he or she is grinding his teeth.  Unfortunately, this bad habit can lead to a host of other dental problems.

How would I know if I grind my teeth?

• Teeth appear worn down or damaged
• Enamel has been worn down exposing a yellow layer (dentin)
• Experience headaches or migraines in the morning or right after waking up
• Frequent earaches
• Ringing in the ears, especially in the morning
• Sensitive teeth
• Have a loved one observe you in your sleep, grinding of the teeth will occur quite frequently throughout the night
• Facial Pain

What causes teeth grinding [bruxism]?

Causes of bruxism are still under investigation.  However, the most common causes are as follows:

• Stress
• Anxiety
• Alcohol
• Sleep disorders
• Malocclusion

How can I treat bruxism?

Effective treatment is still in the research phase.  The best way to prevent and control grinding of the teeth is to wear a nightguard.  This can be purchased over the counter or provided by your dentist.  Also, try to find ways to reduce the amount of stress in your life.  Activities such as deep breathing and yoga have found to be successful in reducing one’s stress level.

Please do not hesitate to visit the dentist if you suspect brusixm.  Grinding of the teeth can lead to several other dental problems including TMJ issues, the need for fillings, crowns, root canals, bridges, and even extractions.  Eventually, once the grinding becomes bad, the teeth can loosen and will need to be removed.  This is definitely not an issue to take lightly.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

Type of pain

• Brief, short pain
• Pain when eating or drinking cold food/liquids or exposed to air
• Long lasting pulsating pain
• No sensation/tooth discoloration

Brief short pain:

If the pain only occurs occasionally, such as when drinking cold liquids, this is a sure sign of reversible pulpitis.  Depending on the extent of bacterial invasion and condition of tooth structure, this condition can usually be treated with pulp cap.  The good news is that the pulp of the tooth can likely be saved.

Long lasting pulsating pain:

Long lasting lingering pain is usually indicative of irreversible pulpitis.  This means the bacteria has invaded the tooth’s pulp and, depending on the extent of invasion, the entire pulp or portion of the pulp may have to be removed.  If the amount of bacterial invasion is extensive, or if a substantial amount of tooth structure has been destroyed, the tooth may have to be extracted.  The treatment options for irreversible pulpitis include:

• Extraction
• Pulpotomy/Pulpectomy
• Root Canal Therapy

No sensation/tooth discoloration:

If you noticed a major discoloration of the tooth in question, necrotic pulp is probably the culprit.  This means the pulp of the tooth is dead.  If the pulp is dead, the tooth is dead and it needs to be removed.  If substantial tooth structure remains, the dentist may be able to retain the tooth by performing root canal therapy.  The only treatment for necrotic pulp is extraction or root canal therapy.

Keep in mind that a series of tests must be performed by the dentist before a diagnosis can be reached.  Tooth pain can also indicate a fractured root, impacted tooth, gum disease, or even problems with the temporomandibular joint.  So, if you experience any type of pain with a tooth or any structure in your mouth, be sure to contact your dentist as soon as possible for the best possible treatment options.