Ever had a toothache? A throbbing pain so close to your brain you can’t think straight? Toothache can range from the mild pain of teething in children to an excruciating one that some women report is worse than that of childbirth, says Dr Raymond Lee Kwong-wah of Pacific Dental Care in Hong Kong. The most common cause of toothache , he says, is tooth decay caused by food debris and bacteria collecting over time, leading to a cavity. “Once the cavity reaches the inner layer of the tooth (the dentine) the tooth becomes very sensitive. This type of pain is usually a nagging ache that comes and goes,” he says. Why you need good teeth and how to get a million-dollar smile Left untreated, the bacteria can travel to the tooth pulp and cause infection around the tissue and even the bone surrounding the tooth, sometimes leading to swelling – an abscess. This type of pain is agonising and pulsating. Toothache can also be the result of tooth fractures, Lee says. “During the pandemic, we saw an uptick in patients with cracked teeth , fillings and crowns. Stress and anxiety can manifest itself as grinding of teeth at night, which many people don’t realise they do, for others it’s an unconscious clenching of teeth. “Both can wear teeth down and, in extreme cases, lead to cracks in the tooth.” Hong Kong dentist Dr Sandeep Jain, of Diestel & Partners, says his office has seen a substantial increase in the number of people cracking their teeth recently, usually by grinding at night – a condition known as bruxism. “In the last two years, due to stress caused by Covid-19 , many more people are grinding their teeth severely and cracking them. Dentists have even given them a term, ‘Covid cracks’,” Jain says. “I actually thought we were the only ones seeing them but this seems to be happening worldwide. In 30 years of dentistry I had never seen so many cracked teeth before. We have gone from seeing one cracked tooth in a week to almost a crack a day.” Periodontal disease – or gum disease – is another culprit in toothache, says Dr Jason Wu of the Conrad Dental Care Centre in Hong Kong. Both cavities and gum disease can cause pain and discomfort in the oral cavity. Pain from cavities, he says, is often stimulated by extremes in temperatures (hot/cold) and by sweet, sour and spicy foods and drinks. A hole or fractured portion of a tooth may be signs of a cavity. Pain from periodontal disease is often stimulated by biting and pressure on the teeth of the affected area. Redness and bleeding are telltale signs of gum disease. Try to identify the food /drink that leads to the onset of the tooth pain and avoid it, Wu says. Take note if the temperature of the food/drink – hot coffee, cold ice cream – affects the pain intensity. He generally advises patients with toothache to avoid foods that are naturally acidic, such as tomatoes and oranges, as these may aggravate it. “Similarly, fizzy drinks which have a high sugar content can worsen pain,” he says. Some old-fashioned home remedies may bring short-term relief until you are able to see a dentist, Lee says – including a salt water rinse. “Salt is a natural antiseptic and anti-inflammatory and can help to release food particles stuck between teeth.” Good dental hygiene can improve overall health Cold compresses might be helpful, too, to help reduce swelling and relieve pain. Toothache sufferers often notice pain is bearable during the day but excruciating at night. One reason for this, says Lee, is “because lying down, blood rushes to the head. This may increase the pain and pressure that people feel from a toothache. Elevating the head while sleeping can go a little way to reducing the throbbing toothache.” Clove oil has long been used to treat toothache. It contains a chemical called eugenol, says Lee, widely used in dental materials, that acts as an anaesthetic and antibacterial agent which can help numb and reduce pain. Dilute a drop in a carrier oil, such as olive oil, and place on the tooth – but do not swallow it. Vanilla oil, used in ancient times, is sometimes still employed at home and is probably effective simply for its relaxing scent and the numbing effect of the alcohol it contains. Other pantry ingredients effective to alleviate toothache include cooled peppermint tea (for its soothing, antibacterial effect), aloe vera gel (for its antibacterial properties), brandy (because it numbs), ginger (because it contains anti-inflammatory agents raffinose and gingerol) and turmeric for the natural antiseptic and analgesic (pain relieving) curcumin it contains. We also benefit from a range of safe over-the-counter scientifically tried and tested remedies. Ibuprofen is particularly effective for dental pain, as it also eases inflammation and swelling. However, it’s in a category of medications called NSAIDs (non-steroidal anti-inflammatory drugs), along with aspirin and naproxen, which thin the blood, so seek the advice of a pharmacist or dentist before taking it, says Lee. What are superfoods and what are their health benefits? Do not be seduced by the old wives’ tale that placing an aspirin on your tooth or gum relieves pain. “Aspirin can be caustic to the gums and harm the tissue leading to burns,” he says. Dental gels that contain 10 per cent benzocaine anaesthetic can also temporarily numb the pain. Wipe the area dry before applying so the gel can stick to the affected area, to avoid it being washed away by saliva. Until you see a dentist, says Wu, avoid any stimuli that will exacerbate the pain of a cavity, and keep the gums as clean as possible if they’re the cause of pain. “Brush and floss the area as well as possible even if there is gum bleeding … the bleeding is actually because of the lack of good hygiene in the area, which causes the gum disease,” Wu says. You may experience temporary relief using home remedies, but they won’t cure the underlying cause of your pain, warns Lee. See a dentist – especially if the pain does not go away despite painkillers, you have a fever, you experience a foul taste in your mouth, or if your jaw or cheek swells. To avoid this painful unpleasantness, Lee says looking after your teeth is key. Cut down – or eliminate – sweet foods and drinks from your diet, brush your teeth twice daily, use dental floss, visit your dentist at least once a year, save your gums by not smoking , and use a night guard if you grind your teeth in your sleep. Like what you read? 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