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Dental Pain

It is important to be aware of common dental problems and diseases that result in dental pain so you can help manage your patients’ symptoms, as well as encourage patients to see dentist.

Pain to temperature

If a patient reports that changes in temperature causes pain that lasts for several seconds or minutes, it is likely associated with an inflamed pulp. If the pain is of short duration, it is likely reversible with proper attention and treatment. Several causes can be dental caries, tooth hypersensitivity or dentin exposure. As inflammation progresses and symptoms worsen, the prognosis of the tooth will also worsen. The sooner that the patient sees the dentist the better the probability that the tooth can be treated with minimal consequence.

Pain to pressure

Pain due to biting pressure can be attributed to several causes. Providers should ask their patients for a detailed history of symptoms. If the pain is sharp and of short duration, it could indicate a loose filling or cracked tooth. Sharp, throbbing pain that lingers may indicate pulpal inflammation or necrosis. If the patient describes a dull, nonspecific, throbbing pain, the cause may be grinding, food impaction, or periodontal issues.

Pain with swelling

Intraoral or extraoral swelling necessitates an urgent referral to the dentist due to an acute infection. The pain usually has a rapid onset and will occur spontaneous without any additional stimuli. A fluctuant swelling in the gingiva can usually be found by the affected tooth with or without suppuration. If an antibiotic is prescribed, inform your patient that the prescription will not get rid of the infection completely and treatment by a dentist is necessary.

Sinus pain

Maxillary sinusitis can present itself as tooth pain or vice versa. Patients may describe a unilateral or bilateral constant, dull pain that worsens when biting down on posterior teeth. If you suspect the sinus infection is of odontogenic origins, then refer your patient to their dentist.

Other Considerations

Often, treatment of acute pain with opioids can lead to long-term use. Dental pain may lead to a patient’s first encounter with opioids. It is important to identify the source of pain in order to reinforce the need to seek definitive treatment at a dental office.

Resources

https://www.cdc.gov/acute-pain/dental-pain/index.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886920/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186276/

https://my.clevelandclinic.org/health/diseases/10957-toothache