Symptoms & diagnosis
Tooth pain assessment in Kettering
Toothache is a poor guide to its own origin. It can point to the wrong tooth, to the other jaw or to something that is not a tooth at all, and the most dramatic pain is not always the most serious. An assessment appointment exists to establish, properly, which tooth is responsible and what — if anything — it needs.
Reading the pain
A quick, sharp reaction to cold that disappears within seconds usually indicates an irritated pulp that can recover — with a filling, with treatment for gum recession, or sometimes with time alone. Pain lingering for thirty seconds or more after hot or cold, or arriving unprovoked, points to inflammation that will not reverse. A dull, constant ache made worse by biting, with or without a swelling, suggests a dead pulp and infection in the bone. Sharp pain only on biting, particularly on release, is typical of a crack. These are tendencies rather than rules — which is why the tooth is tested rather than guessed at.
What the assessment involves
- Your account. What the pain feels like, what sets it off and what eases it, how long it has been there and what has already been tried. This is the most valuable part of the appointment and is given proper time.
- Examination. Teeth, fillings, gums and bite are examined under magnification, and swellings, gum boils and cracks are noted.
- Tests. A cold stimulus and an electric pulp tester show whether each suspect tooth is alive and how it responds. Tapping and gentle pressure test for inflammation around the root. A bite test identifies cracked cusps.
- X-rays. Small digital X-rays reveal infection around the roots, hidden decay, the quality of earlier root fillings and the shape of the canals. A three-dimensional scan is arranged occasionally when a plain film cannot settle the question — see X-rays and CBCT scans in endodontics.
- Diagnosis and plan. The problem is explained in plain language and the options are laid out. Diagnosis, recommendation, outlook and fee are given to you in writing.
Allow about 45 minutes. If you are in severe pain, say so when booking: the pain is relieved first and the assessment finished once you are comfortable.
Where it leads
- Root canal treatment or retreatment where the pulp is irreversibly inflamed or infected.
- A plan for a cracked tooth — protection, treatment or occasionally extraction — see cracked tooth pain.
- Referral back to your dentist for a filling, bite adjustment or gum care, because the cause is not endodontic.
- Monitoring, where the tooth is irritated but expected to settle.
- Reassurance, because not every toothache needs treatment.
About antibiotics
Antibiotics help when infection is spreading or you are unwell, but they cannot cure a dead or infected tooth and they do not treat pain. If you have had a course and the problem has returned, the tooth needs treatment rather than another prescription. See infected tooth treatment.