Toothache: what to do while waiting for the dentist?

What the pain is trying to tell you

Tooth pain is a signal, not a diagnosis. Even so, its type, its duration and what triggers it give the dentist valuable clues. Before your appointment, try to note:

• The trigger: cold, heat, sweet things, chewing, or pain that comes on by itself for no obvious reason?
• The duration: a few seconds after the trigger, or pain that lingers for many minutes?
• The timing: is the pain worse at night or when lying down?
• The location: one specific tooth, or a diffuse area spreading to the ear or temple?
• Associated signs: swelling, fever, a bad taste, a tooth that feels longer than the others.

This information quickly guides the examination and X-rays. It also helps distinguish simple sensitivity from a situation that needs prompt treatment.

The most common causes

Behind toothache there is usually one of a few well-known situations:

• Tooth decay that is progressing: at first, brief sensitivity to sweet things or cold; when deeper, the pain lasts longer. Early cavity treatment remains simple.
• Inflammation of the nerve (pulpitis): intense, sometimes throbbing pain, often at night, that lingers after cold or heat. This is the classic severe toothache.
• An infection or abscess: pain when chewing, a tooth tender to touch, sometimes swelling of the gum or cheek.
• A cracked tooth: sharp, brief pain when biting, hard to pinpoint.
• Exposed tooth roots due to receding gums: sensitivity to cold and brushing.
• A wisdom tooth coming through, with inflammation of the gum covering it.

Pain felt in the upper teeth can also come from sinusitis, and jaw pain may be linked to teeth clenching.

What to do while waiting for your appointment

A few simple measures can help you cope until you are seen, but they do not replace a consultation:

• Take an over-the-counter painkiller, strictly following the leaflet and the doses, and taking into account your other medication and medical history. If in doubt, ask your pharmacist or doctor.
• Keep the area clean: gentle brushing, floss if food is stuck, rinsing with warm, slightly salted water.
• Avoid very cold, very hot or very sweet foods that trigger the pain.
• Chew on the other side.
• Raise your head slightly at night if the pain gets worse when lying down.
• Apply something cold to the outside of the cheek, for short periods, if there is swelling.

Relief does not mean the problem is solved. Decay or infection keeps progressing even when the pain settles.

What not to do

Some common practices can make things worse:

• Placing an aspirin tablet directly on the gum: it causes a chemical burn of the soft tissues.
• Applying heat to a swollen cheek: heat can encourage an infection to spread.
• Taking leftover antibiotics from a previous course or without a prescription: they do not treat the cause, can mask the signs and encourage resistance.
• Lancing an abscess yourself or prodding the gum with objects.
• Exceeding the dose of painkillers or combining several medicines containing the same active ingredient.
• Waiting for it to pass for weeks: pain that suddenly disappears may mean the nerve is dying, not that the tooth has healed.

If in doubt, a phone call to the practice often makes it possible to assess how urgent the situation is.

When should you seek urgent care?

Some situations should not wait several days. Seek care quickly, at the practice or via our dental emergency page, if you have:

• swelling of the cheek, jaw or under the chin;
• fever together with tooth pain;
• severe pain that does not respond to your usual painkillers;
• a tooth that has been broken, displaced or knocked out after an injury;
• bleeding that will not stop after an extraction.

Difficulty swallowing, breathing or opening your mouth, or swelling spreading quickly towards the eye or neck, is a medical emergency: go to a hospital emergency department without delay.

What happens at the practice

The dentist starts by listening to how you describe your pain, then examines the suspected tooth. Simple tests (cold, light tapping) and an X-ray help pinpoint the cause.

Treatment depends on the diagnosis:

• a shallow cavity is treated with a filling;
• when the nerve is irreversibly damaged or infected, root canal treatment often makes it possible to keep the tooth;
• a tooth that is too badly damaged or fractured below the gum may need a tooth extraction, followed by planning for its replacement;
• an abscess may require drainage and, depending on the case, medication prescribed by the dentist.

The first aim is to relieve the pain. Full treatment can then be completed in one or several sessions, depending on the situation.

Prevention rather than cure

Most severe toothaches are the end result of decay that went unnoticed. Regular check-ups, with X-rays when indicated, make it possible to detect early decay between the teeth or under old fillings, before it reaches the nerve.

Brushing twice a day with a fluoride toothpaste, cleaning between the teeth and limiting sugary snacks complete this prevention.

German Dental Clinic, located in Agdal, sees patients from Rabat from Monday to Saturday. If you are in pain, call the practice so the situation can be assessed, or book an appointment for an examination.