TYPES OF PAIN AND THEIR CAUSES

• A Typical Toothaches
• Toothaches
• Tooth Sensitivity
• Gum Infection
• Mouth Ulcers
• Impacted Wisdom Tooth
• Jaw Disorders
• Facial Nerve Pain

A TYPICAL TOOTHACHES 
 
I feel pain on some of my teeth. I had checked it out with my dentist and found no cause for it. I am still having the mild pain and am irritated by it. I want to extract those teeth. Why is my dentist refusing to do it?

A less common condition is the atypical toothache. The pain is chronic and usually, there is no identifiable cause for it. Extracting the teeth usually does not solve the problem as the pain tends to stay.

Features:
 - Distressing continual pain condition from a tooth or teeth
 - Pain stays longer than 4 months
 - Tooth / teeth and surrounding gum and bone looks normal

Management:
 - Medication is the treatment of choice

FACIAL NERVE PAIN (NEURALGIAS) 
 
I suffer from spontaneous sharp, electric-like pain on my face. This can be a number of times a day, of a very short duration. So far the condition has not improved and can even happen when I wash my face or mouth. Is this common?

This could be an uncommon condition of the nerves which tends to affect the older age groups. Most common of which is a condition termed Trigeminal Neuralgia

Features: 
 - Sudden pain of varying intensity on the face or jaw. Pain is triggered by jaw movements or touch
 - Pain is of short duration and can recur several times a day
 - Pain can be excruciating but often comes and goes

Causes:
 - No known cause, commonly taken to be due to nerve instability postulated

Management:
 - Medication is the treatment of choice
 - Imaging of the head to rule out brain lesions is often indicated.

GUM INFECTIONS  

I have very severe pain, ulcers and bleeding gums for the past 3 days. My whole mouth is sore and I cannot eat properly. My spouse tells me I have bad breath. What could I be suffering from?

The condition you described is termed Acute Necrotising Gingivitis. You will need to see a dentist for gum treatment or if necessary, be referrred to a gum specialist. 
 
ACUTE NECROTISING GINGIVITIS

 
  
I have pain and gum swelling near my tooth for the past few months. It lasts for a few days and then disappears. Why is this so?

What you have is gum abscess, commonly referred to as "gum boil". Most gum diseases are without symptoms. However, 2 conditions feature pain predominantly:

1) ACUTE PERIODONTAL ABSCESS; and
2) ACUTE NECROTISING GINGIVITIS 
  
 1) ACUTE PERIODONTAL ABSCESS

Features:
- Localised gum swelling, red and tender to touch
- Sudden onset
- Increased mobility of tooth
- Tooth can be tender on biting
- Soreness at site leading to throbbing pain
- Pus discharged from the gums
- Loss of supporting bone (Detectable from X-ray)
  
 2) ACUTE NECROTISING GINGIVITIS

Features:
- Ulcers on tips of gum between teeth and along gum line
- Bleeding gums
- Sudden onset and pain
- Foul odour
- Increased salivation
- Metallic taste

Repeated infections lead to bone loss or periodontitis, with additional features:
- Enlarged gum margins
- Triangular gaps between teeth
- Gum recession (teeth appear longer)

Causes:
- Bacterial infection
Factors which increase your risk:
- Poor oral hygiene
- Smoking
- Systemic diseases eg. Diabetes
- Stress
Management:
- Proper tooth brushing and mouth rinse
- Professional cleaning of gum areas
- Antibiotics
- Oxidizing antiseptics
- Gum surgery
 
 
IMPACTED WISDOM TOOTH

My last tooth in my lower jaw is causing some discomfort. I can only see part of the tooth and food gets trapped in the overlying gum. Occasionally, the overlying gum swells a little and the side of my neck appear swollen too. Do I need to remove this tooth?

Wisdom teeth appear during early adulthood and in some, the jaw size does not allow its proper eruption. This leads to impaction against the tooth in front of it. Surgical removal of wisdom teeth is a common procedure.
  
INFECTIONS DUE TO IMPACTED WISDOM TEETH

JAW OR TEMPOROMANDIBULAR JOINT DISORDERS  
 
In the past, my jaw clicks and appear lopsided when I open my mouth. Recently, I noticed my jaw was rather stiff in the morning and my muscles tend to ache when I chew my food. I fear my jaw may lock on me. Sometimes, I also suffer from headaches. Is this a serious condition?

Not all clicking sounds need to be treated. However, a worsening click, difficulty in opening the mouth and muscle pain may warrant a visit to the dentist. 
 

 
MOUTH ULCERS  
 
I suffer from recurrent mouth ulcers. This affects my eating and even tooth brushing. The discomfort lasts about a week. Is there any way I can hasten the healing? Does gargling with salt solution help?

Ulcers in the mouth can take some time to heal due to constant abrasion with the ulcer site. Application of a gel or paste prescribed by your dentist may help to protect the site from further abrasion. Gargling with mouth rinse or salt solutions will help reduce contamination of the ulcer site. 
   

TOOTH SENSITIVITY  

When I eat food, drink water or suck air through my teeth, I feel a sharp pain on my teeth. This pain lasts for a few minutes or can remain for a while. What could be happening?

A likely cause could be tooth sensitivity.
 
   

 
TOOTHACHES  

I had a sudden toothache on one tooth. The gums are slightly swollen. I feel the tenderness when I touch it. After a few days, it subsided and I ignored it. A few days later, I had the same toothache, what can I do about this?

Sudden excruciating pain or toothache may indicate the deep spread of decay in the tooth. Often, root canal treatment I necessary. If you note mild symptoms on the teeth, a check-up with your dentist will help prevent a bigger problem from occuring.