Symptoms & diagnosis
Diagnosing toothache in Burton upon Trent
Toothache is an unreliable narrator. It names the wrong tooth, refers pain to the other jaw, and sometimes has nothing to do with teeth at all. A diagnostic appointment sets out to answer two questions properly: which tooth is responsible, and what — if anything — does it need?
What the pain is telling you
A brief twinge with cold that is gone within seconds usually means an irritated pulp that can recover, with a filling, with treatment for gum recession, or sometimes with nothing at all. Pain that lingers for half a minute or longer after hot or cold, or that starts of its own accord, points to inflammation that will not reverse. A dull, constant ache made worse by biting, with or without swelling, suggests a dead pulp and infection in the bone. A sharp pain only on biting, especially on release, is typical of a crack. These are patterns rather than rules — which is exactly why the tooth is tested rather than assumed.
What the appointment involves
- Your description. What the pain is like, what triggers it and what soothes it, how long it has been going on and what has been tried so far. This is the most useful information of all, so it is given proper time.
- Examination. Teeth, fillings, gums and bite are examined under magnification, and swellings, gum boils and cracks are noted.
- Testing. A cold stimulus and an electric pulp tester show whether each suspect tooth is alive and how it responds. Tapping and gentle pressure reveal inflammation around the root. A bite test identifies cracked cusps.
- X-rays. Small digital X-rays show infection around the roots, hidden decay, the state of any earlier root filling and the shape of the canals. A three-dimensional scan is arranged occasionally when a plain film cannot decide the matter.
- Diagnosis and plan. The problem is explained in plain terms 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: pain is relieved first and the assessment completed once you are comfortable.
Where it may lead
- 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 and split teeth.
- Referral back to your dentist for a filling, a bite adjustment or gum care, because the cause is not endodontic.
- Monitoring, where the tooth is irritated but likely to settle.
- Reassurance that no treatment is needed — the guide sensitive teeth or something more serious? covers the difference.
About antibiotics
Antibiotics have a place when infection is spreading or you are unwell, but they cannot cure a dead or infected tooth and they do not relieve pain. If you have had a course and the problem has come back, the tooth needs treatment, not another prescription. See abscessed tooth treatment.