Not everyone has experienced toothache, but people who have are left with a clear memory of the unpleasant sensation and a certain fear of dental procedures. This often leads to fewer visits to the dentist and to problems getting worse – problems that could have been solved less painfully if action had been taken in time.
What are the most common causes of toothache?
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Tooth decay – in this disease, the tooth structures are damaged by the bacteria in plaque, or more precisely by the acids they produce. Beneath the protective layer of enamel lies the dentine. It is made up of tiny tubules that contain nerve endings. With decay, these nerve endings become exposed to irritants such as food and drink. The pain this causes is the tooth's signal that it has been damaged.
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Similar sensations are typical of all conditions in which the enamel layer is broken – enamel worn away by hard brushing, chipped pieces or cracks in its structure. The pain can be brief or last longer, for as long as the irritant is acting.
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Inflammation of the dental nerve – the nerve is located in a cavity inside the tooth. Bacteria can reach it when the dentine is deeply destroyed – deep decay, a tooth fracture that involves the nerve, or inflammation of the tissues that hold the tooth in place. The pain can be severe, sharp and long-lasting.
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There are also nerve endings in the bone that surrounds the tooth roots. When inflammation reaches the bone, it also causes pain – long-lasting and dull.
The exact cause of the pain can be found when you visit your dentist. To keep you calm and comfortable during treatment, your dentist may use anaesthesia. Dental anaesthesia is not always necessary, but it is usually preferred. It is injected into or near the area that needs to be numbed – this is local anaesthesia. To reduce the unpleasant feeling of the needle, the area can first be sprayed with a topical anaesthetic.
Which patients are suitable for anaesthesia?
Anaesthesia can be given to both children and adults. Before giving you an anaesthetic, your dentist will ask you a number of important questions that will help them choose the right anaesthetic for you.
What does your dentist need to know before giving you an anaesthetic?
- Whether you have any allergies. You must tell your dentist about any allergy you know of. A positive reaction to other medicines or foods may mean you are also allergic to dental anaesthetics. In that case you will need to see an allergist, and the dental procedure will be postponed if possible.
- Whether you have high blood pressure and take medication for it. This affects the choice of anaesthetic.
- Whether you take any medicines regularly, and which ones. Possible drug interactions are taken into account.
- Whether you have liver disease – many anaesthetics are broken down by the liver.
- Whether you have had a heart attack in the last 6 months. During this period, dental procedures are contraindicated except in an emergency.
- If you are pregnant – it is best to consult your gynaecologist beforehand.
- For children – any allergies and conditions, such as asthma or diabetes. The child's age and weight are taken into account when deciding how much anaesthetic to use.
In almost all cases, anaesthesia can be given so that dental problems can be treated smoothly and calmly. This reduces fear of the dentist, and patients are less likely to put off their visits for long.
This article is for information only and does not replace an examination by a dentist.
