Common Dental Complaints/Emergencies


Pain upon chewing


If your tooth has a large filling, it is possible that over time cracks have occurred in the tooth. Every time you bite down and release, the tooth flexes which causes fluid in the tooth to move causing pain.

If you recently had a filling this sensation is normal for up to six weeks, however, if the problem persists it is possible there is a space between the layers of the white filling and may need to be replaced.


Pain with hot or cold


Decay/cavities causes a breakdown in the protective enamel which exposes the underlying, nerve rich dentin to outside stimuli.

A newly placed resin (“white”) filling can also cause some temperature sensitivity for a few weeks following placement. You should not be concerned unless it persists for more than six weeks.

If a tooth is more sensitive to hot, it can be related to a deeper nerve pain and should be checked by the dentist before it worsens.
 

Pain that is spontaneous, throbbing and radiating


Pain that occurs spontaneously, throbs and can only be managed with pain medication is an indication of deeper involvement of the nerve of the tooth. Once decay reaches deep into the tooth, the nerve becomes inflamed and can no longer be healed by removing decay and placing a filling. Teeth with this response will need to have root canal treatment or removal to eradicate the pain. Antibiotics and pain medication can only temporarily quell the discomfort and are not the recommended treatment.
 

Swelling in gums or face


An infection of the nerve of a tooth can cause swelling in the gums and face. An infection will try to drain but sometimes there is no outlet so there will be a collection of fluid close to the site of infection.  In these cases an antibiotic is needed to reduce swelling and spreading of the infection, but the tooth itself will also need to be treated to solve the problem.

Swelling can occur from blocked salivary glands as well. Pain will occur right before eating when the saliva duct attempts to expel the saliva to digest the incoming food. Common ducts are under the tongue, next to the second upper molars in the cheeks.
 

Bleeding Gums


If you have not had a professional teeth cleaning in some time, plaque and tartar can build up, causing chronic inflammation of the gums. Many people stop flossing believing that they are causing the bleeding by flossing, however, it is the lack of proper hygiene and flossing that causes the bleeding. Therefore it is recommended to increase flossing and see a dental hygienist immediately to remove the hardened tartar that can not be otherwise cleaned.
 

Bad Breath


Some people unfortunately have a condition called halitosis, that means regardless of impeccable oral hygiene they are plagued with bad breath. These people must carry breath mints or gum to mask their problem. For the majority of us, bad breath is due to poor oral hygiene and large accumulations of tartar. Tartar is calcified plaque that no tooth brush or floss or mouthwash can remove. The tartar causes the body to release chemicals that attempt to fight these accumulations, causing inflammation, sometimes pus and a terrible odor. Therefore, it is important to receive semiannual professional cleaning to keep your gums, teeth and breath healthy.
 

Ulcers


These are very painful usually round/oval whitish/yellow lesions that can be found throughout the mouth. The most common cause is trauma to the delicate oral tissues from sharp food or objects. These lesions will go away on their own in 10-21 days. Symptomatic relief can be accomplished at the dentist or with an over the counter pain relief gel like anbesol.

Ill fitting dentures can also cause rubbing on the gums causing ulcers. The denture should be brought to the dentist to be adjusted.
 

Bump on gums


An abscess can form for a variety of reasons. If you have poor oral hygiene, pus can accumulate and cause a “bump” on the gums.  A thorough cleaning is needed. During pregnancy hormones can cause bumps on the gums. Again, a good cleaning is needed to keep plaque from accumulating.
 

Chipped Tooth


Fractures on teeth, especially front teeth as common and can usually be treated with a filling.  However, if there is pain, the tooth will need to be further evaluated to determine the status of the nerve and whether or not further treatment is warranted. A large fracture should be addressed quickly even without pain to prevent further deterioration of the tooth and possibly more complicated and costly treatment.
 

Trauma to mouth and or teeth


If people do not protect their teeth with protective mouthguards during sports, there is an increase in damage to the teeth and gums. If a tooth is knocked completely out of the mouth your dentist should be contacted immediately. If you can place the tooth back into the socket that is the best thing to do. However, if there is too much swelling or you can’t place it properly, put the tooth in milk or have the person hold it in their mouth under their tongue until you get to the dentist. Mobile teeth can usually be splinted by the dentist to prevent loss or further movement.  Many times, traumatized teeth need to have root canal therapy to prevent them from causing infections. A followup visit with x-rays will be done 3 weeks after the incident. Lacerations to the gums/lips should be treated by an ER doctor or an oral surgeon.