Tooth pain

If it hurts, it’s an emergency!
We aim to help all people with dental pain on the day they call our practice.
Call us now on
98671252

98671252

For after-hours contact, complete the Emergency eForm. This eForm service is monitored very regularly – in most cases we will respond without delay.

The latest dental technology and 30 years of experience means we are skilled at handling all emergencies including toothache, gum ache, denture repairs, broken or chipped teeth and painful wisdom teeth.

Relief is only a call or click away

Teeth pain is a very complex area. This makes it very difficult to categorise – particularly so that it will make sense to anyone who’s not a dentist.

We’ve devised two ways of looking at this problem:

Symptom List

Our symptom list is drawn from dental pain emergencies we regularly treat.

Match your symptoms to those in the list to discover more about the conditions we treat.

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Severity List

Is your pain mild and fleeting or is it more severe and long lasting?

Toothache (Mild, fleeting pain)

The following are examples of conditions whose pain symptoms are often sporadic, mild and of short duration.

1

Moderate decay, broken teeth and dental restorations

  • Fleeting pain after biting or having hot or cold food or drinks generally suggests the problem is not too serious.
  • There may be very little or no pain – the only thing you notice may be food trapping around the defect, or a sharpness to the cheek or tongue.
  • The type of dental repair you chose will depend on the amount of solid remaining structure and what sort of longevity you need from the treatment.

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2

Cracked tooth

  • Cracked teeth suffer sharp pain when chewing and may experience extreme pain with hot or cold foods or drinks.
  • The symptoms generally first appear quite suddenly.
  • Pain can quickly escalate with little provocation or warning as the crack spreads.
  • Deep complex fractures may end up being difficult or impossible to fix.
  • If you suspect a fracture, call us straight away to improve your chances of avoiding more complex treatment.

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3

Sinus toothache

  • If the pain is in the upper back teeth and they are tender to bite on, you may have a sinus toothache.
  • The pain may worsen as you tip your head forward.

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4

Wisdom teeth

  • Most of the time pain associated with wisdom teeth is actually gum pain.
  • An impacted tooth is one that only partially emerges from under the gums.
  • The remaining portion trapped under the gum tissue collects debris and bacteria.
  • A minor flare-up of this condition can cause tenderness in the area behind the last tooth, difficulty in opening and closing and sometimes a bitter metalic taste is present.
  • This pain should be assessed as soon as possible as such an area can quickly flare up to become serious pain and swelling, or even develop into a medical emergency.

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5

Pain after dental treatment

  • A new restoration may feel slightly different initially, but should feel quite normal after a few days. Slight residual tenderness or sensitivity often suggests a minor bite adjustment is required.
  • Pain after tooth extraction, root canal treatment (RCT) and early stages of orthodontics usually follows a predictable and recognisable pattern. Strategies can be put in place to prevent or minimise any suffering.

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6

Root surface sensitivity

  • Gum disease or trauma can cause the gums to shrink away from the crown of the tooth to expose the root surface.
  • The root surface is actually porous and irritants running over this area can stimulate the nerve inside the tooth.
  • Sensitivity may be to hot, cold or sweet foods or drinks and will generally not linger.
  • A number of approaches may be taken to stop this sensitivity but no one remedy is predictably or universally effective.

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Toothache (Severe, Lingering pain)

The following are examples of conditions whose pain symptoms are more severe, constant and may have associated swelling.

Dying nerve (Irreversible pulpitis) and dental abscess

  • Internal swelling related to a dying nerve or external pain from a dead nerve can cause severe pain in a tooth.
  • The pressure building up within the tooth has nowhere to go and causes intense irritation to any remaining nerve tissue within the root system.
  • Pain may have slowly worsened in the recent past and is suddenly intense – it may be impossible to sleep.
  • The infection from within the nerve space of the tooth has progressed so far that it now involves the bone and tissues that surround the tooth.
  • A tooth in this condition requires immediate attention and will eventually require Root Canal Treatment (RCT) or extraction.

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Periodontal abscess

  • A gum abscess is the result of underlying periodontal (gum) disease that has probably been present for a long time.
  • It presents as a reddened swelling on the gum next to the affected tooth.
  • Pain can vary from severe to almost none.
  • It may be slightly loose and a little tender to bite on.

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Wisdom tooth abscess

  • Most of the time pain associated with wisdom teeth is actually gum pain.
  • An impacted tooth is one that only partially emerges from under the gums.
  • The remaining portion trapped under the gum tissue collects debris and bacteria.
  • A major flare-up of this condition can cause severe tenderness and swelling in the area behind the last tooth, difficulty in opening and closing your mouth, and sometimes a bitter metallic taste is present.
  • Rarely, the swelling can spread to cause problems with swallowing or breathing.
  • There may also be associated ear pain or a headache and at times jaw movements can be effected.
  • This pain should be assessed as soon as possible. Rarely this can develop into a medical emergency.

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When you have severe toothache, two broad treatment options are generally available:

  • to save the tooth,
  • to remove the tooth.
Saving a painful tooth
Why save a tooth?

Stability and function

Surrounding and opposing teeth will drift into the space, become non-functional and may even cause speech problems.

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Appearance

Not only will it be an aesthetic issue if visible, but if multiple teeth are removed, muscle tone will be effected and thus the facial appearance will be effected.

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Cost

Extraction may seem initially cheaper, but in the long run they may be more difficult and costly to replace, particularly if the surrounding teeth drift or become damaged. Also, other replacement options may be quite inconvenient or more difficult to maintain.

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Some emergency treatments we may recommend to save teeth:

Medications to settle infections and manage the pain in the short term

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First stage of root canal treatment (or, “Open and drain”)

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Splinting or rebuilding of broken down teeth to return strength and rigidity

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Gum therapy. Diseased gums are a major cause of tooth loss

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Removing a painful tooth – Tooth Extraction

Unfortunately, sometimes a tooth cannot be saved or you just may not wish to do so.

If the remaining structure of the tooth is too compromised or the gum support remaining is limited, removal may be the best course of action.

In almost all circumstances it is best to replace the tooth that is being removed.

This is to maintain function and stability. Adjacent and opposing teeth will drift into a gap left by a missing tooth. This can eventually lead to severe disruption and collapse of the bite in the area.

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Wisdom teeth are commonly removed as they are mostly non-functional and can cause significant damage to surrounding teeth and gums.

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How will the tooth be extracted?

Effective pain relief

Local anaesthetic is placed using gentle techniques that keep discomfort to an absolute minimum. This is where 30 years of experience shines through.

The effectiveness of the anaesthetic is closely assessed before taking any action. We will not move on until pain is completely eradicated.

Further relaxation techniques like Nitrous Oxide (Laughing gas) or light oral sedatives can be used.
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If you feel that you will need to be completely asleep during the procedure, we can refer you to an excellent oral surgeon. We have only ever received back positive reviews about Mr Peter Allan.
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Non-surgical

The tooth is removed in one single piece.

On many occasions this can happen surprisingly quickly.

Surgical

A surgical technique is used if the tooth is severely broken down or the roots are very splayed and must be divided into multiple pieces before being removed.

While it may take slightly longer, much less pressure is usually required to remove smaller pieces.

When will the tooth be removed?

Immediate removal

If this is your preference, and the levels of swelling surrounding the tooth are not excessive, we can often move the tooth right away. You could be on the road to recovery today!

Or

Delayed removal

1) Antibiotics are prescribed to first settle the infection and painkillers are used to manage the pain in the short term.

2) Once the infection is settled (usually at the end of the course of antibiotics) the tooth is removed. This is carried out either in our practice with an effective local anaesthetic, or by referral to our excellent oral surgeon for removal under general anaesthetic or sedation.