If you are self-isolating and unable to leave the house, then the last thing you want is to develop toothache. Most practice phone lines are open for emergencies for their own registered patients.
There are a few things you can try to manage the pain until you can be treated.
It is unclear at this point when normal service will resume.
If you have a swelling on your face or difficulty swallowing, this requires urgent professional attention so don't be afraid to contact your dentist for advice.
Pain from teeth.
Decay is a bacterial infection of a tooth. If the bacteria get close to the nerve in a tooth, it can cause the tooth to be acutely sensitive. As the infection causing inflammation of the nerve gets worse, the ligaments holding the tooth in position can also get inflamed which causes pain on biting.
If the tooth is acutely sensitive to temperature, antibiotics will not fix this. The decay needs to be removed to allow the tooth to heal. If the bacteria have caused irreversible damage to the nerve in the tooth, then a root filling is required, or the tooth needs to be extracted.
To help manage toothache until you can visit us, there are a few things that may help reduce the pain
• If there is a cavity in the tooth, a temporary filling material can be packed into this space. These temporary filling kits are widely available from supermarkets or pharmacies.
• Anti-inflammatory tablets (NSAIDs) can reduce the sensitivity. A combination of ibuprofen and paracetamol has been found to be beneficial if you can take them both - however, there are some reports that Ibuprofen may increase the symptoms of COVID-19 so Paracetamol alone is probably best if you have symptoms. Make sure you don't exceed the recommended dosage!
o Don't stop taking the anti-inflammatory when the pain stops (or it will come back again!) You are wanting to reduce the inflammation of the nerve in the tooth which is causing the pain.
• Desensitising toothpaste such as Sensodyne repair and protect or Colgate sensitive pro relief can help.
• Anaesthetic gel such as Orajel applied to the area can help to numb the pain.
• Clove Oil - This essential oil can be found in health food stores and you can apply it onto the painful tooth with a cotton bud. This works well if there is an exposed nerve due to deep decay but for it to work, you need to place it onto the exposed nerve
• Keep your head elevated at night-time When you lie down to go to sleep, the blood pressure in the tooth can increase which increases pain. An extra pillow at night-time can help
• Keep the area cold- reducing blood flow to an area will reduce the inflammation and pain. Do not apply ice directly to a tooth as this can increase the pain as toothaches are quite sensitive to hot and cold temperatures.
If there is an infection - a swelling next to the tooth or pus discharging.
• Rinse your mouth with warm salty mouthwash to try and draw out the infection into your mouth. Dissolve a spoonful of sea salt in warm water and rinse around your mouth/ hold it in your mouth next to the infected area. Repeat several times until the pain subsides.
o Never put heat externally on your face as this can draw the infection into the tissues in your face causing external swellings.
Pain from gums
• If there is bacteria or food debris trapped between the gum and the tooth, this can cause pain.
o Thoroughly clean the area with floss or a te-pe interdental brush. You could put corsodyl gel onto the brush to help clean the area
o Rinse thoroughly with Corsodyl mouthwash can help (but Corsodyl will stain your teeth so we don’t recommend this for long term use)
Pain from ulcers
Mouth ulcers can be a sign of underlying medical conditions such as iron deficiency so shouldn't be ignored. Any mouth ulcer which doesn't heal in two weeks should be checked by a dentist.
• To reduce the discomfort, you can try a topical anaesthetic gel such as Orajel
• To help with healing of ulcers, Gengigel can be effective as well as soothing the pain.
If a tooth or filling has chipped or cracked, this can cause sensitivity from the tooth being exposed or pain to your tongue from sharp edges.
The sensitivity can be reduced by rubbing a de-sensitising toothpaste onto the tooth or placing a temporary filling material over the broken corner until a more definitive filling can be placed.