Toothache with Neuralgia, Sinusitis and other Conditions
Toothache may sometimes occur without any previous injury (major or minor) in any part of the head and neck region. There might be a toothache associated with the altered state of one’s mind like depression or sometimes even with high blood pressure. Certain conditions which are not related to any pathology associated with the tooth, also present as tooth ache. These conditions are as follows:
- Trigeminal Neuralgia or Trigeminal Neuropathy,
- Acute and Chronic maxillary sinusitis,
- Cluster headache,
- Myofascial pain of masticatory muscles
A thorough evaluation of one's past clinical history, along with the nature of this kind of pain are few of the initial steps taken by a dental professional. A series of tests and questionnaires might be undertaken by the dentist before arriving at a final diagnosis.
Some of us might experience a sudden sharp ache or discomfort in the teeth (one or more) when consuming hot or cold substances. This kind of discomfort can be seen generally in many teeth or a single tooth. The condition is commonly called as Tooth Sensitivity. It is caused due to exposure of the nerves present in our teeth into the oral environment. Tooth sensitivity has many treatments commonly available. The treatment chosen by your dentist depends on the severity of the condition.
- Does the pain feel close to a tooth or does it feel like it is spread in a certain area in the mouth including the gum or any area of the jaw?
One might not be able to always figure out the exact location of the pain. The pain might be spread over a certain part of the jaw or the gums. A dentist will usually look for any associated swelling in such cases or might check for an inflamed tissue in the mouth. Infections associated with the wisdom molar teeth are often felt as generalized pain or pain spread over all the teeth present in that region. Besides the wisdom molar, any injury to the underlying nerves of the jaw region or major or minor tumors or other pathologies can also present as generalized or localized pains.
The choice of treatment depends on the underlying cause. Wisdom molar infections might be located in the gum surrounding the wisdom molar. In such cases, a thorough cleaning or curettage of the surrounding gums might help. Incision and removal of a small part of the gums tissue surrounding the wisdom molar (Pericoronotomy ) can be considered. If the extent or severity of infection is widespread, extraction of the wisdom molar should be recommended.
- Is there any pain in the ears or while opening or closing your mouth? Is there any associated limitation of opening or closing of your mouth?
Pain or clicking in the ears or on opening or closing of the mouth might suggest a possibility of a problem with the Tempro-mandibular joint (TMJ). A clinical evaluation by a dentist along with Lateral cephalogram/ OPG is the initial investigation that might be recommended by the dentist. Treatment of the TMJ disorders varies on the type of problem of the TMJ. The problem could be a disc-dislocation of the TMJ or any problem with articular surfaces of the joint. Possibility of an infection should also be ruled out by a dental professional.
- Was there any fever/pus/bleeding that was associated with the onset of pain?
A severely infected tooth might lead to a low grade fever amongst few individuals. There might be limited mouth opening or one might feel a certain part of the mouth swollen for a shorter or longer duration. Such infection in the tooth needs immediate attention as the spread of the pus to the surrounding tissues of the tooth can be potentially harmful to the other healthy tissues as well. Drainage of the pus might be undertaken to provide immediate pain relief in many cases. In cases of low lying infection, a course of antibiotics and anti-inflammatory drugs might be considered before treating the offending lesion.
- Did you receive any dental treatments done for the tooth in question or in any tooth near it in the past?
Many patients complain of pain in a tooth which recently underwent or is undergoing a restoration, endodontic, orthodontic or any other treatment. There might be pain in the teeth which are part of dentures or bridges. Sometimes pain can be felt in the tooth adjacent to the site of tooth/teeth which were extracted or received any other dental treatments. This kind of tooth ache should be reported to the dentist so that the cause of the pain might be confirmed and treated accordingly.