Toothache in the elderly is a common symptom, and many seniors are troubled by it. The causes of toothache are numerous, and treatments vary accordingly.
Causes of Toothache:
(1) Acute pulpitis. Commonly seen in patients with deep cavities, bacteria enter the pulp chamber through the cavity, causing congestion and inflammation of the tooth nerve. Toothache is often spontaneous, worsening at night, and becomes more severe after cold or hot stimulation. Pain can also radiate to the face, temporal region, and ear. In cases of suppurative pulpitis, the patient experiences increased pain upon heat stimulation, while cold stimulation may alleviate or eliminate the pain.
(2) Acute periapical periodontitis. Caused by the progression of acute pulpitis or trauma factors. The affected tooth exhibits persistent pain, a floating sensation, and difficulty chewing. Patients can accurately identify the affected tooth; tapping on the tooth will cause pain. At this stage, due to the necrosis of the tooth nerve, there is no provoked pain.
(3) Acute periodontal disease. The nature of the toothache is similar to acute periapical periodontitis. The affected tooth not only shows chewing pain and a floating sensation but also forms a periodontal pocket and tooth mobility. The gum tissue may experience repeated swelling, pain, and bleeding.
(4) Periodontal abscess. Further development of periodontal tissue inflammation can lead to suppurative inflammation. When an abscess forms, the pain is severe. After the formation of the abscess, local fluctuation can be felt. After the formation of the periodontal abscess, the pain can significantly decrease or subside.
(5) Dentin hypersensitivity. Often caused by gum recession, exposure of the neck of the tooth, and dental defects. At this time, cold, hot, sweet, sour stimuli can all cause pain, but the pain disappears when the stimulus stops.
(6) Food impaction pain. Food can become trapped between teeth gaps, leading to toothache, known as food impaction pain.
(7) Dry socket syndrome. Often occurs 2 to 4 days after tooth extraction, causing spontaneous continuous severe pain. Upon examination, poor clot formation and foul odor can be found in the extraction wound.
(8) Others. Such as gingival and jawbone tumors, as well as trigeminal neuralgia, can also cause pain in the corresponding areas of the same-side teeth.
Treatment for Toothache:
Treatment for toothache should be based on different causes for appropriate handling.
(1) For acute pulpitis and acute periapical periodontitis, pulpotomy and drainage should be performed. Placing camphorated phenol and clove oil cotton balls in the cavity can relieve pain; acupuncture at the Hegu point or toothache point can provide temporary pain relief before further treatment at the hospital.
(2) Acute periodontal disease and periodontal abscess. When an abscess has not formed, clean the dental plaque, take periodontal tablets, antibiotics, and apply iodine glycerin externally; if an abscess has formed, incision and drainage should be performed, while using antibiotics to control the infection.
(3) Dentin hypersensitivity. Avoid brushing horizontally and avoid overly forceful movements. Use vertical brushing methods. Choose anti-acid toothpaste, herbal toothpaste, desensitizing toothpaste, or brush with 10% sodium bicarbonate glycerin, which can have some effect. Alternatively, visit the hospital for desensitization treatment.
(4) Food impaction pain. Remove the trapped food residue with dental floss.
(5) Residual roots, residual crowns, and teeth that cannot be retained should be extracted as soon as possible, followed by installing dentures (false teeth) after two months.