Toothache

Toothache

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Irritation at the nerve root of a tooth is characterized as toothache. Dental pain is caused primarily by injury, decay, infection or tooth loss. Pain that is believed to be in the tooth could actually be from the temporomandibular joint, cardiac or ear problems.

Physical Examination

• Tooth mobility

• using the back ends of two mouth mirrors, test the tooth’s mobility

Other (Teeth)

• mobility tests
• percussion
• electric pulp tests
• thermal tests

Chest X Ray

• test for sinusitis

Other Imaging Findings

• Transillumination can be used to show fractures in tooth structure
• Dental radiographs

Differential Diagnosis of Causes of Toothache

In alphabetical order.

• Angina Pectoris
• Barodontalgia from high altitudes
• "Dental Migrane"
• Dry Socket (osteitis)
• Headache
• Otitis Media and /or mastoiditis
• Periradicular or periapical pain
• Pulpaglia
• Salivary gland disorders
• Sinusitis
• Temporomadibular Joint Syndrome pain (TMJ)
• Traumatic occlusion
• Traumatic tooth injury
• Trigeminal neuralgia

Treatment

Acute Pharmacotherapies

• Penicillin for infections
• other oral antibiotics for sinusitis
• Pain relief for migranes/migrane specific medications

Surgery and Device Based Therapy

Abscess

• incision and drainage will relieve pain immediately

Irreversible pulpitis

• root canal/tooth extraction

Reversible pulpitis

• filling or crown

Primary Prevention

TMJ

• avoid to gum disorders and bruxing use a bite blocker

Brush and floss teeth

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