What Do I Do to Stop Tooth Pain and Facial Swelling?

There are two groups of nerves that can cause your teeth to be painful. The nerves on the outside of your teeth along your roots and the nerves found inside your teeth. The nerves found on the outside of your teeth can cause pain due to recession, clenching or grinding your teeth. A crown or filling that is too thick can also cause bumping of other teeth. Usually your teeth will only be sensitive to cold such as iced tea.  Brushing your teeth can also be sensitive if it is the outside nerves that are affected. If your tooth has a large cavity or a deep crack that reaches the nerves inside your tooth, it can become very painful. If this is the case, your tooth could be sensitive to cold and hot foods, sweets such as candy, and pressure just from biting down. If the nerves found inside your teeth are affected, a root canal will be needed to save the tooth and make it stop hurting.

Before you panic out at the thought of a root canal, let me explain what I mean by this. First, I want to admit that there was a time when root canals were not a pleasant experience. They were down right painful, but that was twenty years ago when just about everything in medicine hurt. Things are very different now and if handled early enough root canals can be done with little to no discomfort. Still don’t believe me? Let me explain what a root canal is and how it is done today.

Every tooth has a hollow center and a canal that runs through the root. This is where the nerves and blood supply to your teeth are found. If a cavity or crack reaches the hollow part of your tooth and contaminates your nerves, the blood vessels swell and cause pain. The cavity or crack allows bacteria to enter the hollow part of your tooth and the bacteria can travel down the hollow roots of your tooth and get into your bone. When this happens the tooth is now abscessed. If left untreated the bacteria can eat a hole though your bone and cause what looks like a pimple on your gum tissue. The pimple may pop and go away only to come back a few days later. Or the bacteria may eat a hole through you bone and enter your cheek. When this happens your face may swell and bruise.

When you go to your dentist the first thing he/she will do is take an x-ray. This will allow the infected tooth to be located and determine whether or not it is abscessed. Depending on the size of the abscess the root canal can be done at that appointment or you may be asked to take antibiotics for a few days. The antibiotics will reduce the size of the abscess and make the tooth easier to treat if the abscess is very large. In my practice I do 9 out of 10 root canals the same day. This provides my patients the fastest relief. It used to be that dentist did not have anesthetics that could get the teeth completely numb, not any more. Dentist now have several anesthetics and techniques to choose from to make sure the tooth is completely numb before starting.

Next, a hole is made in the top of the tooth to reach the hollow part of the tooth. The cavity has usually already done this for the dentist. The canals within the roots are then located. Teeth usually have 1 to 3 canals depending on the size of the tooth. This used to take forever to find the canals because they are sometimes as small as a hair. But with the use of microscopes it is easy to find them. Small, flexible files are then used to clean out the canals. The canals are then sealed off with sterile rubber. An x-ray of the tooth is then taken to make sure the roots are sealed off properly. Depending on the number of canals to be cleaned a root canal appointment can take 15 minutes for a front tooth to just under two hours for a molar tooth way in the back of the mouth. Some of my patients prefer to be sedated for these appointments regardless of the length. Some teeth have very curved roots or something that would make it difficult for your family dentist to do quickly. In this case you may be referred to an endodontist who is a dentist that specializes in root canals.

If an abscessed tooth is left untreated, the infection can cause you to lose your tooth and the infection can spread to other parts of your body. Please see your dentist or contact our office immediately if you have a tooth ache.