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Find A Dentist To Help You Answer Why I Have A Toothache

There are many causes of toothache and pain in the area of the mouth. When experiencing pain and/or swelling, it is important to see your dentist to have the area evaluated. The pain and/or swelling is most often related to a disease process that originates within a particular tooth.

The pulpal tissue within the tooth can be irritated by bacteria, external traumatic events, repetitive or extensive dental care procedures, or even periodontal disease causing a toothache. When this irritation occurs, the pulpal tissue reacts by becoming inflamed.

Since the pulpal tissues and the tissues supporting the tooth have a rich supply of nerve fibers, the inflammatory process can cause pain as these nerve pathways are stimulated. Additionally, the pulp tissue is encased inside tooth structure and it cannot swell and expand in reaction to injury like tissues in other areas of the body.

When the injured pulp tissue attempts to swell within the confined root canal space, the pressure buildup can cause a significant toothache.

Pain originating from the dental pulp can be either "spontaneous" or "elicited." Spontaneous pain occurs without an identifiable stimulus, whereas elicited pain occurs only in specific situations. Elicited pain requires a specific stimulus such as drinking cold or hot fluids or biting on the tooth.

As is typical anywhere in the body, the initial stages of a disease process do not always cause symptoms. Millions of teeth have irreversible pulpal disease yet the patients have no clinical symptoms.

Most of these situations will become evident when the dentist obtains a thorough history, does a clinical examination, performs specific tooth tests, and takes a series of well-angulated radiographs. It is important to note that pulpal disease can refer pain to other areas within the head and neck.

If the results of the endodontic examination indicate that root canal disease is not the source of the patient's toothache, then the dentist must consider other possibilities. When attempting to identify the source or cause of facial pain and/or swelling, the dentist must consider that the symptoms could actually originate in a tooth (endodontic disease), the gum tissues (periodontal disease), the muscles (myofacial pain), the joints (TMJ), the sinuses (sinusitis), or even the surrounding vascular (blood vessels) or nerve tissues.

Facial pain requires an accurate diagnosis so that the proper treatment can be recommended. At times, various medical and dental specialists may need to be consulted before an accurate diagnosis can be determined.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

General Dentistry Frequently Asked Questions

Q. Why do you need to have regular dental care check-ups?

A. Regular check-ups are needed to monitor your overall dentistry health. In addition to checking for cavities, your dentist examines the health of your entire mouth and surrounding soft tissues, checking for pre-cancerous or cancerous lesions, oral sores, and gum disease.

Your oral health is connected with your general health. General dentistry check-ups can alert the dentist to other medical conditions that have symptoms in the mouth such as diabetes, nutritional deficiencies, and hormonal irregularities. Regular dental visits are vital to prevent tooth decay, gum disease, and other conditions affecting your mouth.

Q. What can you do to feel more relaxed during a dental appointment?

A. With the combination of modern anesthetics and new technology and techniques, many procedures only have minimal discomfort or are now entirely painless. Dental care providers want their patients to have maximum comfort and approach their treatments with a relaxed attitude.

There are a number of ways to increase relaxation:

• Tell the dental staff your concerns. Studies have shown that talking about your fears of possible discomfort actually reduces pain.
• Use visualization to picture yourself relaxed, or repeat messages that have a calming effect.
• Play your favorite music on a Walkman you bring with you (some dental offices are equipped with walkmans, too.)
• Arrange a signal with the dental staff, such as raising your hand, if you need a break or feel discomfort.

Some dental offices are now offering patients new options for stress-relief: hypnosis, self-hypnosis instructions, relaxation tapes, soft lighting, warm gel-filled eye masks, scented candles, and massaging pillows. These are helpful in reducing stress and anxiety in dental patients. Be sure to avoid the use of stimulants such as caffeine prior to your visit.

Q. Aromatherapy has a relaxing effect for many people. Is this effective for patients undergoing dental treatment?

A. Research studies conducted at Case Western Reserve University have noted that the use of aromatherapy has a significant positive effect on anxious dental patients. Two-thirds of the patients receiving aromatherapy were more calm and relaxed than those patients without exposure to the scented fragrance oils.

Dentists are concerned about your comfort. Ask your dental provider if aromatherapy is available in the office, or if you can bring your own for your dental visit. Essential fragrance oils are available in health food stores, spas, and some grocery and drug store outlets.

Q. Are dental patients who are considered at risk for bacterial infections advised to take antibiotic medication prior to their appointments?

A. Certain medical conditions, such as heart valve problems or a recent total joint replacement, are considered at risk for infection at the site of the cardiac abnormality or joint replacement. This infection results from bacteria from the mouth entering the bloodstream and working its way to these vulnerable areas.

Consequently, dental care procedures likely to result in bleeding from the gums or mucous membranes will require patients to take antibiotics prior to that procedure. Such procedures could include, but are not limited to, extractions, implant surgery, incision and drainage for oral infection, and professional teeth cleaning.

Guidelines have been established by the American Heart Association and the American Dental Association to provide dentists and physicians with information regarding appropriate regimens for antibiotic therapy. It also outlines those situations when antibiotic therapy is or is not indicated.

There also are other medical conditions warranting antibiotic therapy prior to dental procedures. Be sure to update your dentist regarding your medical history. Your dentist and/or physician will advise you of any special needs.

Q. Where can you receive dental services if you do not have the money to cover the related expense?

A. If you do not have eitherdental insurance or the money to pay for general dentistry visit, you should inquire about financial aid from various sources within your community.

You may need to make several calls, but the local dental society, the local public health department, or social service agencies may be able to direct you to sources of assistance. Also, check local hospitals, dental schools, and outreach clinics that may be able to provide dental services at a reduced fee.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.