My tooth hurts, so what symptoms should I report to my dentist?


Where, What and When probably is the short answer.Patients come in every day reporting that a tooth is hurting. I ask them questions involving where, when and how? Approximately where in the mouth does the pain originate from. I may ask them to point to the tooth they think is hurting. I ask what makes it hurt? It definitely helps the dentist to know what makes your tooth hurt. Sensitivity to cold? Sensitivity to hot?Sensitivity to biting, sharp pain on biting or dull pain? Throbbing sensation?Swelling in gums? Pain on touching the gums? Something loose in your tooth?Pain after eating? Pain after sweets?

After evaluating a patients reported symptoms and asking some of the questions above, I ask my assistant to take appropriate radiographs of the area that the pain seems to be originating from.  (usually at least one periapical view that shows the apex of the tooth where endodontic infections tend to best show up).  Depending on what sort of problem I suspect a patient may have,  I also  may tap on the teeth, feel the adjacent gums or apply ice or heat to the area in order to see what the patient feels. I look for lines on the biting surface of the teeth that may be indicative of a crack. I may have them bite on a plastic microapplicator or on the wooden handle of a Q-tip to see if that causes a positional pain on biting.

Finding a patients problem is often involves inductive reasoning and using a process of elimination. What doesn't cause the pain? Sensitivity to cold eliminates teeth that have had root canals or a tooth that is non vital and needs a root canal. Intermittent sensitivity to chewing can be caused by a crack or a loose filling. Sometimes diagnosis is process with multiple possibilities and the exact diagnosis may not always be possible to ascertain with just one visit. Although radiographs are a tool that dentists use, not all tooth problems can be seen on radiogaphs.

If I am not sure what exactly is causing my patients pain, I may advocate a wait and see approach. It may sound overly simplistic, but the pain may stay the same, get worse or get better. If the pain gets better or worse, that may be helpful in coming up with an accurate diagnosis.



from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/03/my-tooth-hurts-so-what-symptoms-should.html - http://lspindelnycdds.blogspot.com/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of
Read more

Tongue Ties: What Parents Need to Know

Image
For a long time, people just didn’t seem to know much about tongue ties. In the early years of my practice, few of my patients had ever heard of a tongue tie. When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them. When I told them that a tongue tie might actually be the root cause of their oral myofunctional issues, or even their sleep apnea , I’m sure that some of them thought I was crazy. But in the last few years, things have changed so much! Initially, there was a small increase in the number of patients who were contacting me specifically about tongue ties. Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment. But in the last year or so, that little bit of interest has become a surge of awareness. Tongue ties and their effects on health and craniofacial development are finally becoming mainstream.
Read more