Pain Management

Pain Management

Patient comfort is always a top priority of ours. During treatment there are several options available to reduce anxiety and keep patients relaxed, depending on the treatment. But as anybody who's had a toothache knows, dental pain isn't always limited to discomfort during treatment.

Sources of Pain

Most people will suffer the unpleasant effects of dental pain or toothaches during their lifetime. Every year nearly half of the population will experience some form of dental pain or discomfort, and 25% will eventually be driven to seek emergency treatment. Low grade, chronic dental pain is debilitating, and severe dental pain can be totally incapacitating. In both cases the first priority must be to make an urgent dental appointment for diagnosis and treatment by a dentist. The early warning signs should never be ignored.

It is easy to understand the reason for such unpleasant symptoms. The nature of the teeth and their association with the jaws are part of a complex sensory mechanism with short nerve pathways to the brain. This particular sensitivity of the mouth makes it one of the body’s most important early warning systems.

Toothache

The teeth and the tooth attachments may give rise to painful symptoms as a result of decay, abscess, gum disease (called periodontal disease), or eruption problems. The pain may vary from an intermittent or fleeting sensitivity, to a sensitivity to hot and cold that may indicate the early onset of decay, to the most dreadfully acute throbbing pain caused by advanced decay or dental abscess. In this latter case it may be impossible even to touch the teeth together in bite contact, making eating very difficult.

Post-Operative Pain

Pain may occur following dental treatment. It is not uncommon after a very large and deep filling has been placed or a dental extraction has been carried out. The degree of pain is related to the damaged dental tissues; for example, the surgical removal of an impacted wisdom tooth can be associated with several days of pain or discomfort. Patients can therefore expect to be given suitable medication and to be advised to follow procedures aimed at promoting rapid healing whilst reducing discomfort to a minimum. It is most unusual for post-operative pain to last for more than 10 days. In the vast majority of cases medication will not be required for more than 3 days.

Dental/Facial Pain

There are other causes of dental pain that can simulate a toothache in people who otherwise may have good oral hygiene and excellent teeth (e.g. a condition called sinusitis can cause pain on one or both sides of the face, similar to an aching tooth). Trigeminal (facial) neuralgia can bring stabbing pains that cause serious incapacity. Deep-seated aches in the jaws may also indicate the presence of disease. Diagnosis may not be easy or certain. It is imperative to see a dentist, who in turn may have to refer to a consultant for further tests.

Dental Pain Control

There are many factors that influence the choice of a successful regime for dental pain control. The young and the old require extra care, together with those who may already be taking medication for other medical or dental conditions, and also pregnant or nursing mothers. The assessment of the physical and psychological make-up of the patient, together with their past experiences with various forms of pain control, are key to future choices. Allergies, asthma, other contra-indications, and short term personal or business activities may also have to be considered.

In the vast majority of emergencies dental pain can be controlled in the short term by simple medicines such as paracetamol, aspirin, and ibuprofen. These over-the-counter medicines can be purchased without the need for a prescription. Only a minority of dental cases will need access to more powerful prescription-only medicines which can only be supplied by a general medical or dental practitioner.

Paracetamol

Effective in pain relief in a wide variety of situations such as headaches, muscular pain, neuralgia, influenza, and dental pain, paracetamol also reduces raised body temperature. It has remarkably few side effects and is well tolerated in those situations which aspirin has to be avoided, including in young children.

Aspirin

Aspirin is a well-known, useful, safe analgesic with blood-thinning properties. The fact that aspirin modifies the blood clotting mechanism has to be recognized as an unwelcome side effect for some patients, particularly those who suffer gastrointestinal problems. It also must be avoided by those with peptic ulcers, pregnant women, and even some of those in post-operative situations as it could delay healing. It should not be given to children under the age of twelve, to asthmatics, or to those with a tendency towards allergic reactions. An old-fashioned practice claims placing an aspirin tablet beside a painful tooth is useful for pain management, but this can actually cause burns and bleeding of the gum, so such a practice is discouraged.

Ibuprofen

An anti-inflammatory, Ibuprofen is effective in lowering a fever and relieving pain. It is useful in dental pain control as many dental conditions have an inflammatory element. However, it should not be used in situations that involve gastrointestinal problems, asthma, or after surgery.

And a General Warning

The use of such over-the-counter medications may often be sufficient to bring immediate pain relief, but when necessary other drugs may be needed to provide effective comfort. Consult with your dentist and doctor as necessary. And please remember that manufacturer’s instructions should be read and followed carefully, and that medication is only a short-term remedy and not a long-term cure for acute pain.