How to care for a toothache…

toothache

So all the snow has meant some snow days for our office which has me snowed in at the pink house, and after eating every carb in the place, snuggling with my precious pups and my even cuter baby (definitely check out our Instagram @junkpony to check him out if you’re not already following us), I’m left thinking about the flood of toothaches that we’ll likely see on Monday; 1. because Mondays are always notorious toothache days and 2. because anytime we’re away from the office for an extended time, toothaches start to pile up as patients are waiting to get in.  In response to this, I wanted to take the time before hitting the hay tonight to make a blog post to help others care for their toothache while waiting for their dental appointment (although I’m hoping you’re not snowed in with a throbbing tooth).

Below you’ll find how to care for a toothache until your scheduled dental visit (*NOTE- You need to schedule with a dentist as these suggestions will help with your symptoms until your visit but will not alleviate the problem, since in the case of true toothaches, generally a root canal or extraction of the offending tooth is the only treatment to “fix” your problem):

  1.  OTC combo therapy: I find that some patients think that prescription painkillers are the only way to knock the pain from a toothache.  This is false.  In fact, it has been proven in study after study that OTC pain relievers alternated actually help with the pain more than narcotic meds.  We suggest patients alternate extra strength tylenol (follow suggested dosing on the bottle) and ibuprofen (up to 800 mg since ibuprofen helps swelling most at this higher dose).  Tylenol will keep an associated fever down and ibuprofen helps with swelling (which is what causes that throbbing associated with a toothache).  The key is alternating every 4 hours between the two to stay on top of the pain; for example, if you start with tylenol, then 4 hours later you would take ibuprofen and 4 hours after that you’d again take tylenol alternating between the two.  *Note- only do this regimen IF you medically can take tylenol and ibuprofen (i.e. you have no medical problems and/or are taking no meds that cause this OTC regimen to be contraindicated).  
  2. Stay ahead of the pain: Just because that throb is easing off, do not slack on the above suggested meds. The pain is easing because of the meds.  It is much easier to hold off pain by staying ahead of the pain.  It’s no fun to start all over because you got lazy with the OTCs.
  3.  Apply cold packs and warm heat:  Most patients think that an icepack to the cheek of the affected side will help ease the pain of a toothache and forget to alternate with heat.  Warm heat (warm washcloth or heated rice-bag) is actually suggested too.  Alternate every 15 minutes between the two and avoid extreme temperatures.
  4. Keep your head elevated:  Sleep/rest propped up on a couple pillows instead of flat or on your stomach.  This will help reduce swelling and may help with draining of the site dependent on the location of the offending tooth.
  5. Avoid chewing in the area: chew soft foods and predominately chew on the opposite side.
  6. Avoid eating extremely hot or cold foods: Stick with luke warm foods and drinks as to not assault the tooth further.
  7. Call your dentist ASAP:  Nothing makes the dental community more mad than a patient that expects us to make his/her toothache a priority in our schedule only to learn after seating you that the tooth had been hurting for weeks or months prior to your scheduling.

Below are things to avoid in treating your toothache (regardless of what your neighbor’s cousin’s wife suggests):

  1. Topicals are pretty useless:  Topical medications do nothing for an actual toothache and only numb the gums sometimes resulting in burns to the gums and therefore resulting in a compound problem now.
  2. Don’t use someone’s left over meds!  You don’t know that these meds are appropriate for you or your situation.  This is dangerous!
  3. Avoid holding aspirin or any other medications against the site!  This, like topicals, does nothing for the toothache and can burn the gums resulting in a compound problem.
  4. Don’t hold liquor or whiskey against the tooth! Why?  See #1 and 3 in this section.  Same concept.
  5. Don’t google your problem! There’s great info on the web.  There’s also terrible information out there.  Somehow when we;re sick, we always believe or listen to the terrible advice.  Just save yourself the time and trouble and instead spend that time working on bullets in the first list and resting.
  6. Do not cancel your appointment because your tooth suddenly feels better! Keep your dental appointment.  True toothaches don’t just resolve.  Nerves inside your tooth may die meaning that the tooth no longer hurts but the infection/potential for infection is there and needs to be addressed by a professional.  Just remember that if it’s not treated this go around, it will blow up again and the dentist you stood up may not be so quick to get you back on the books, or you may be out of town, or your dentist may be out of town.  Bottom line, the problem always returns and usually with vengeance.  See also #7 in the first list.

Lastly, report straight to the nearest ER if…

you have swelling that is approaching your eye

OR

you have swelling below your chin that is affecting breathing at all !!!

 

Next blog post will cover what causes toothaches and how to prevent them.

XOXO, Dr. H

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