“Ouch!!! Chewing Causes Me Pain” By Dr Ama Amaning-Darko

If you have a mouth, you should read this.  In today’s article, we’ll be talking about toothache: causes, presentation and what you need to do.

Toothache may be caused by a cavity, trauma(resulting in a cracked tooth) or a disease condition around the roots of a tooth. When bacteria in your mouth act on food it creates an acidic environment that demineralizes your tooth. After eating, your saliva (which contains some ions) creates a basic environment to neutralize(buffer) the previous acidic environment, allowing the tooth to be remineralised. Mind you, these natural processes occur every time you eat. So, imagine what happens when someone always has a toffee, remants of a sticky food  or sugary chewing gum in his or her mouth for long periods. It means the teeth will be getting demineralized over longer periods without getting the chance to remineralise. Once the balance is offset, a cavity develops. (Dental caries)

A cavity (carious tooth) or a cracked tooth (from trauma) may initially present as sensitivity. If it is left untreated, it starts presenting as a sharp pain brought about by taking in sweet, hot or cold meals. This pain would cease when the stimulus is removed and you may not be able to tell exactly which tooth it is coming from. After a while, the toothache may stop – it is a trick. Bacteria will continue acting on the softer inner parts of the tooth creating an even bigger hole and spreading deeper into it. If said tooth cavity is still left untreated, the pain will return with a vengeance. Once the “hole” gets closer to or enters the pulp of the tooth, the infection will spread till it reaches the root of the said tooth and its surrounding bone. The toothache at this stage will be spontaneous, be pulsatile in nature and disturb your sleep at night. In some cases, cold meals will soothe the pain temporarily whilst warm meals aggravate it. The pain may linger after the stimulus is removed. In defense, the person will stop eating in the region altogether. It is at this point that most people finally visit the dentist.

Smokers and people with reduced saliva production (sometimes because of a condition or the use of some medications) have a high susceptibility to caries. Some immunocompromised people may have the “simple” tooth infection either becoming cellulitic or forming pus which spreads throughout the jaw and soft tissues, resulting in swelling, inability to open their mouth or swallow, compromising the airway, sometimes spreading into the chest and even the brain! This is where a “simple” toothache suddenly becomes life-threatening. Trust me, people have died from its complications.

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To prevent cavities from developing, brush twice daily with a fluoride containing toothpaste. The fluoride creates a layer around the tooth providing extra protection from caries. Also, (if you absolutely must) it is best to have the sweets with your meals, rather than snacking on something every now and then. After meals, swish water round your mouth to pick up food remnants and swallow. Also avoid using your teeth as tools. Do not use your teeth as a bottle opener. Accidents may be unavoidable sometimes but report to your dentist the moment you crack your tooth. Report to your dentist the moment you notice a cavity (whether it is painful or not). Seeking early treatment not only saves you the discomfort, it saves you money as well. It saves you from losing your teeth! How important is a tooth anyway? Try chewing, speaking or eating without any… and get back to me


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