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/

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