Symptoms & diagnosis
Toothache assessment in Nuneaton
Toothache is unreliable. It can point to the wrong tooth, to the wrong jaw, or to a cause that is not a tooth at all, and the loudest pain is not always the most serious. An assessment appointment exists to find out exactly which tooth is responsible and what — if anything — it needs.
What different pains tend to mean
A short, sharp sensitivity to cold that disappears within seconds usually points to a pulp that is irritated but recoverable — by a filling, by treating gum recession, or sometimes by nothing more than time. Pain that lingers for half a minute or more after hot or cold, or that starts on its own, suggests inflammation that will not reverse. A dull, continuous ache made worse by biting, with or without a swelling, usually means the pulp has died and infection has reached the bone. Sharp pain only on biting, especially on release, is more typical of a crack. These are patterns, not rules, which is exactly why the tooth is tested rather than guessed at.
What the assessment involves
- Your account. What the pain feels like, what provokes and relieves it, how long it has been going on and what has been done so far. This is the most useful part, so it is given time.
- Examination. The teeth, fillings, gums and bite are examined under magnification, and any swelling, gum boil or crack is noted.
- Tests. A cold stimulus and an electric pulp tester check whether each suspect tooth is alive and how it reacts. Tapping and gentle pressure test for inflammation around the root. A bite test identifies cracked cusps.
- X-rays. Small digital X-rays show infection around the roots, hidden decay, the quality of previous root fillings and the shape of the canals. A three-dimensional scan is occasionally arranged when a plain film cannot settle the question.
- Diagnosis and plan. You are told what is wrong, in plain language, and what the options are. Everything — diagnosis, recommendation, outlook and fee — is given to you in writing.
The appointment takes about 45 minutes. If you are in severe pain, say so when booking: pain is relieved first and the assessment is completed once you are comfortable.
Possible outcomes
- Root canal treatment or retreatment, where the pulp is irreversibly inflamed or infected.
- A cracked tooth plan — protection, treatment or, occasionally, extraction — following a cracked tooth assessment.
- Referral back to your dentist for a filling, bite adjustment or gum treatment, because the problem is not endodontic.
- Monitoring, where a tooth is irritated but likely to recover.
- Reassurance: not every toothache needs treatment, and you will be told when that is the case.
About antibiotics
Antibiotics have a place in treating a spreading infection or when 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 come back, the tooth needs treatment, not another course. The guide antibiotics for toothache: what they can and cannot do explains why.