Family Health Magazine - DENTAL HEALTH
Sore Mouth, Aching Jaw
When should you see a dentist?
When you are in pain, it can be difficult to think about anything else. A visit to the dentist may seem inconvenient and costly. However, pain in your jaw, head or neck may indicate a serious health problem. Understanding possible symptoms can help you to decide whether it is worth the trip.
Although we know the importance of oral health, people still show up at the dentist’s office with some pretty scary and often neglected problems. Sometimes, visiting a pharmacist may be a good first step in managing the pain until a dentist can be consulted. Certain signs mean that you should seek care from a dental professional or go to emergency as soon as possible.
When deciding whether you should visit your dentist, consider the symptoms you are experiencing. If one or a combination of these symptoms appears and doesn’t resolve in a few hours, it is a good idea to see a health professional.
- Pain – This is nature’s way of telling us that something is amiss. If your teeth are hurting you, pay attention to what you are experiencing. It will help your dentist to know whether the pain is constant, throbbing (with each heartbeat), dull, or triggered by hot or cold drinks. Pain on chewing could mean a cracked tooth or perhaps an abscess.
- Swelling – This can mean an infection, an abscess, or perhaps a hematoma (a local collection of blood). Inflammation can also cause swelling.
- Fever – This tell-tale sign means that the body is trying to deal with a problem. A rising temperature signals a general infection. For instance, an abscessed tooth may have leaked into the blood stream or lymph system. Your immune (defence) system will kick in, trying to fight off infection.
- Discharge – Unusual fluid may be bloody or contain pus. If you have an abscessed tooth, the pain may ease greatly if it begins to drain. However, the abscess will remain until properly treated.
- Change of colour or coatings on the tongue – This can occur for a variety of reasons, such as a lack of certain vitamins or a fungal infection.
- New growth of tissue – Pay attention to bumps or tissues that are growing. If you can feel an enlarged area with your tongue or fingers, it could mean a salivary or sebaceous gland is enlarged, or even signal a tumour.
- Changes to your sense of smell, taste or sensation (feeling) – Numbness can occur along with swelling, or with a nerve problem. A change in sensation, bad breath or foul smelling discharges can indicate periodontal disease or gingivitis (gum disease). The tongue has many sensory functions that can help diagnose what is happening.
Injuries to the head and neck
Head and neck injuries are serious, and can include damage to soft tissues, the jaw and surrounding bone structure. These guidelines can help you decide if you need immediate professional help.
- A tooth that has been knocked out (avulsed) – if the tooth is completely out of the mouth, and emergency dental services can be accessed within an hour or so, drop the tooth into a small container with some cow’s milk or water covering it. The dentist can assess the situation with X-rays to see if re-implantation may be possible. If a child’s front tooth is knocked out, a professional evaluation can determine whether it is a baby tooth or a permanent one.
- Cracked or chipped teeth – A damaged tooth can be very uncomfortable. This is especially true if the pulp chamber inside the tooth is open, exposing the tooth’s nerve. Sometimes a blow to a tooth will cause the tooth to split or crack. It may look fine, but you feel pain when chewing or touching the tooth at a particular angle.
- Concussions – We are beginning to realize that concussions are not to be taken lightly. Symptoms like headache, loss of consciousness or confusion following a blow or jolt to the head or body mean that professional assistance from qualified medical people is needed. In the sports world today, the guidelines for treating concussions are strict. Whether the injury happens during sport or not, take concussion very seriously. Anyone who has had a trauma to the head and neck should be checked immediately, and reassessed later. Often the injured person is not aware of the possible danger with this type of injury. If you suspect concussion, take the lead in making sure that person gets proper care as soon as possible. To better understand, prevent and treat concussion, access the Keep Your Head in the Game article online at familyhealthonline.
- Jaw injury – The jaw joint (temporomandibular joint or TMJ) is the most complex joint in the human body. Blows to the face can fracture the jawbones or the supporting facial bones. Sometimes the jaw joint partially or completely absorbs the blow, resulting in soreness and inflammation because of damage to the supporting tissues of the joint.
- In a head or face injury, a disk of tissue in the TMJ joint can move or be damaged. If the jaw does not open or close or moves to the right or left during opening or closing, professional help is needed. Evaluation and X-rays can assess the damage, so proper treatment can begin. In some cases, treatment can be as simple as moist heat packs and pain medication.
- Damage to soft tissue – Bruising, tears and cuts can affect both the inside or outside of the mouth. Have these injuries checked and properly cleaned. Stitches may be needed for proper healing and to minimize scarring.
Prevention is always
the best treatment.
Daily dental hygiene
is your first line
It is not unusual for people who have had a tooth removed to bleed immediately afterward, and slightly for 72 hours. If bleeding does not completely stop two to three hours after extraction, it is considered prolonged.
With this type of problem, it is important to know whether a blood thinner or even aspirin has been taken. Such medications can have something to do with the prolonged bleeding. In this situation, remember basic first aid. Most bleeding from tooth sockets will stop if the following steps are taken:
- Keep calm and quiet.
- Sit upright and apply cold packs to the affected part of the face.
- At the same time, bite down firmly on gauze sponges, a clean, damp cloth, or a black tea bag wrapped in gauze. Keep up the pressure for 30 minutes.
- Next, change the gauze inside the mouth and reapply the cold pack.
Repeat these steps for at least two hours.
If you take blood thinners or anticlotting medication, it is always a good idea to phone the dental surgeon or nurse. If bleeding seems extreme, make the trip to an emergency clinic or local hospital where a dentist is on call.
Sometimes the healing clot may be lost from a tooth socket. This can result in a condition called dry socket, which can be very painful. Packing the tooth socket with analgesic (pain killing) gauze for a short time can help control the pain. This is a task for a professional.
If you take pain medication, always follow the instructions on the label. Too much acetaminophen or ibuprofen will not help your health or even reduce pain in some cases. If the pain persists, seek professional advice. Your pharmacist is an excellent source of information.
Cavities and gum disease
With dental cavities (caries), often there may be no pain until the process has gone so far that the tooth cannot be saved. In other cases, some discomfort following chewing can signal problems with the teeth, gums or supporting tissues. If these problems are not detected or treated properly, even perfectly healthy teeth with diseased supporting tissues or caries can reach a point where they cannot be salvaged. For this reason, it is wise to see your dentist regularly.
These common issues with oral health require professional advice and care. However, no one rule applies to every situation. If pain persists, bleeding continues, swelling does not subside, taste and feeling are changed, or the jaw does not move as it should, see your dental care provider – the sooner the better.
Remember, prevention is always the best treatment. Daily dental hygiene is your first line of defense. Stay aware of your mouth and supporting structures. As well, always follow instructions when teeth are removed and after any kind of oral surgery.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6 [GO_FHcd15]