Dental Pain Management​

Depending on weather the pain is in a single tooth or in the entire jaw and face and whether it occurs only while eating or perhaps exaggerates when you sleep at night, the treatment approach may differ.

Dental Filling

Dental Filling

A dental filling is a procedure where a material is inserted into a damaged or decayed tooth to restore its original shape and function.

Fillings are most commonly used to prevent further damage to a tooth when decay is present. By removing the bacteria and closing the affected area off, no further tooth decay can occur.

How should I care for my teeth with fillings?
To maintain your fillings, you should follow good oral hygiene practices — visiting your dentist regularly for cleanings, brushing with a fluoride-containing toothpaste, and flossing at least once daily.

Root Canal

When decay (caries) invades the deeper nerve tissue (pulp) inside root, it results in root infection. The tooth at this stage is still savable. RCT involves Cleaning and Filling the infected space within the root called the Root Canal. RCT involves 3 basic steps – Access, Cleaning & Shaping, and Filling. Depending on the severity of your condition these steps can done in a Single Visit or may take individual visits.

Step 1

Removal of decay & creating an opening to the space inside the root (root canal).

Step 2

Complete cleaning & removing of infected debris inside the root canal.

Step 3

Filling the root canal with gutta percha and Sealing the access with tooth colored filling.

Wisdom Tooth Removal

Wisdom Tooth Removal

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may

Grow at an angle toward the next tooth (second molar)

Grow at an angle toward the back of the mouth

Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone

Grow straight up or down like other teeth but stay trapped within the jawbone

You'll likely need your impacted wisdom tooth pulled if it results in problems such as:

  • Pain
  • Trapping food and debris behind the wisdom tooth
  • Infection or gum disease (periodontal disease)
  • Tooth decay in a partially erupted wisdom tooth
  • Damage to a nearby tooth or surrounding bone
  • Development of a fluid-filled sac (cyst) around the wisdom tooth
  • Complications with orthodontic treatments to straighten other teeth

Risk

Most wisdom tooth extractions don’t result in long-term complications. However, removal of impacted wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:

  • Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
  • Infection in the socket from bacteria or trapped food particles
  • Damage to nearby teeth, nerves, jawbone or sinuses
  • Complications with orthodontic treatments to straighten other teeth

During wisdom tooth extraction, your dentist or oral surgeon:

  • Makes an incision in the gum tissue to expose the tooth and bone
  • Removes bone that blocks access to the tooth root
  • Divides the tooth into sections if it's easier to remove in pieces
  • Removes the tooth
  • Cleans the site of the removed tooth of any debris from the tooth or bone
  • Stitches the wound closed to promote healing, though this isn't always necessary
  • Places gauze over the extraction site to control bleeding and to help a blood clot form

Cracked Tooth

A tooth fracture is a break or crack in the hard shell of the tooth. The outer shell of the tooth is called the enamel. It protects the softer inner pulp of the tooth that contains nerves and blood vessels. Depending on the type of fracture, the tooth may not cause any problems or it may cause pain.

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Types of tooth fractures include

Craze lines

shallow cracks that cause no pain and require no treatment

Fractured cusp

breaks in the chewing surface of the tooth

Cracked tooth

the tooth cracks from the chewing surface down toward the root of the tooth

Vertical root fracture

cracks begin in the root and move up toward chewing surface

Split tooth

cracks down through the root, separating a section of tooth

Symptoms

Not all tooth fractures cause symptoms. For example, craze lines rarely cause problems.

Other fractures may expose the sensitive pulp to fluid, food, and bacteria in the mouth. It can cause irritation or infection in the pulp. This can lead to:

  • Pain with chewing
  • Chewing only on one side of your mouth to avoid discomfort
  • Sharp pain when you bite down
  • Pain with cold or hot air or food
  • Random pain

Vertical root fractures may not be noticed until a bone or gum infection develops.

Treatment

Teeth cannot heal. The treatment goal is to protect the tooth and the pulp interior.

Options may include:

  • Crown—A cap is placed over the tooth. A temporary crown will be placed at first to make sure it corrects the problem. A permanent crown will eventually be placed.
  • Dental Veneer—A thin covering that is placed over the tooth if you have small chip in the surface.
  • Root canal—May be needed if there is severe damage to the pulp. A root canal clears out the damaged pulp and places a new filler in the tooth.
  • Tooth extraction—The tooth may need to be removed if the crack extends below the gum line.
  • Removal of the fractured portion—May be possible in vertical root fracture.

Orofacial pain

Orofacial Pain

Orofacial pain is a field of dentistry which deals with the diagnosis and care of nondental pain that presents in the head, face or neck, or inside your mouth. These types of disorders all have unique causes and treatments.

Orofacial pain is associated with a number of conditions. Some of the most common are musculoskeletal disorders like temporomandibular disorders (TMD). TMDs are disorders involving the temporomandibular joints (TMJs), which help control the jaw. They also affect the muscles used to chew and talk, as well as other associated structures.

A form of TMD, known as myofascial pain, presents “referred pain.” This is where pain is felt in a different part of the body than where it’s originating. For example, if your teeth hurt and your dentist did not find a dental cause for your pain, the pain may be “referred” from other muscles in your face or head.

Another facial pain disorder is trigeminal neuralgia. This is where brief, sharp, shooting, electrical and severe pain can be triggered by actions that don’t normally hurt. For example, lightly touching your face, brushing your teeth, talking, chewing or shaving can all trigger pain in trigeminal neuralgia.

Burning mouth syndrome is another facial pain disorder. It involves a burning feeling inside your mouth and, commonly, in the tongue.

Migraine can sometimes resemble pain in the facial area. This means that patients with migraine localized in the face may confuse it for dental or other orofacial pain. In addition, TMD and headache disorders commonly occur together, with migraine being the most common headache disorder for TMD patients. TMD symptoms can amplify migraine and may increase the likelihood of it becoming chronic.

Treatment of Orofacial pain

Guided home care, jaw exercises, medications, acupuncture, ultrasonic pain therapies can be used to manage these orofacial pains.

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