Toothache when pressed: why does it occur and what to do?

Mechanical damage to a tooth due to injury without violating its integrity is called a bruise. This type of injury is common in children and adults, especially athletes. According to statistics, among all injuries to primary teeth, bruises account for 2.5%; bruises of permanent teeth account for 1.5% of the total number of traumatic injuries in the permanent dentition.

Even if the tooth looks unchanged after a bruise, it is necessary to visit a dentist to prevent the development of complications associated with the injury.

Symptoms

A strong blow to a tooth is accompanied by damage to periodontal tissue, and some fibers and small blood vessels rupture. There are no visible structural damage to the tooth; upon visual inspection, it appears intact. After a bruise, the tooth remains motionless, and minor mobility is rarely observed. The gums in the area of ​​the injured tooth swell.

In the first hours after the impact, patients experience pain in the tooth, which intensifies when biting; the pain is aching in nature. The tooth feels high, and slight bleeding may occur from under the gum near it. When a bruise occurs, the neurovascular bundle of the tooth can be damaged, that is, the pulp is injured, and hemorrhage occurs in the pulp chamber, and the enamel becomes pink in color. A severe bruise can lead to the death of the pulp.

Often, when a bruise occurs, cracks appear on the tooth enamel, which can only be detected with a special examination.

Why is it important to see a dentist urgently?

If a molar tooth is loose, it is very important to consult a dentist so that he can make a diagnosis. In cases of periodontal disease, it would be more than advisable to perform a deep cleaning of the gums. This brushing will eliminate bacteria buildup and help restore tooth mobility.

If a molar tooth is loose and hurts, it is extremely important to consult a doctor in a timely manner and follow preventive measures.

If you have any questions, our dentistry in Kazan provides free consultations, and we will be happy to help you, explain everything and provide dental treatment.

Diagnostics

• Patients with a tooth injury are referred for x-ray diagnostics to exclude a root fracture. To obtain information using targeted radiography, it is sometimes necessary to take several images from different angles, which is undesirable for the patient.

The most accurate information about the condition of the roots is provided by computed tomography - an x-ray examination method that allows you to obtain a three-dimensional image of the tooth. The examination results are displayed on the computer screen and must be transferred to a CD or USB flash drive.

An X-ray examination of a tooth bruise reveals a slight widening of the periodontal fissure.

• The condition of the pulp after injury is monitored using EDI - electroodontodiagnosis. The method consists in determining the reaction of the nerve endings of the pulp to the influence of electric current. The level of electrical excitability of the pulp depends not only on its condition, but also on the degree of formation of the tooth root.

The examination is carried out 2 or 3 days after the injury, since on the first day the pulpal response may be reduced due to traumatic neuritis. Be sure to perform an electrical test on adjacent healthy teeth to compare sensitivity levels. 3-4 weeks after the injury, EDI is repeated.

• Another method of examination for a tooth bruise is transillumination, the essence of which is to pass a beam of cold light through the tooth and evaluate shadow formation. If there are cracks in the enamel after an impact, they will be clearly visible in the stream of light; The technique also helps to detect pulpitis. In modern clinics, all dental units are equipped with light guides for transillumination examination.

When mobility is normal

Tooth mobility can also be a completely normal physiological phenomenon, due to the peculiarities of our anatomy and the functionality of the maxillofacial apparatus. Normally, when we chew food, our teeth spring slightly and move slightly in order to protect the ligaments and connective tissue from excessive stress and help distribute it evenly across the jaw.

Slight tooth mobility during chewing is normal.

In fact, they perform not only a chewing function, but also a shock-absorbing function, and can deviate within an interval of no more than 1 mm - this is called natural mobility. But such a physiological phenomenon is completely invisible and does not cause any discomfort. And we, of course, don’t see this.

But if the teeth really shift and wobble, you can lift them with your finger, tongue or move them, then this indicates pathological mobility caused by various circumstances. Here you need to think not only about how to strengthen them, but also how to eliminate the root causes that led to such an unpleasant situation.

Complications after injury

With bruises, the prognosis is usually favorable, but in some cases the injury can lead to the following complications:

• Darkening of the enamel. After a bruise, the cause of darkening is hemorrhage into the pulp chamber: the pink color of the tooth darkens over time, the enamel acquires a brownish or gray tint. Depulped teeth tend to darken due to the fact that metabolic processes in them stop, the teeth become “dead”, and the enamel becomes dull.
• The death of the pulp leads to the development of pulpitis: the pulp decomposes, inflammation develops in the tooth, which without treatment turns into periodontitis.
• Periodontitis is inflammation of periodontal tissue. It can be: post-traumatic, occurring a short time after the injury; chronic, develop as a consequence of pulpitis. When a purulent infection occurs, there is a high risk of tooth loss and purulent blood poisoning.
• The appearance of a post-traumatic odontogenic cyst at the root apex during the development of post-traumatic periodontitis.
• Stopping the development of roots of permanent teeth in children.
• In case of injury to milk teeth, the following are possible: disruption of the formation of the rudiments of permanent teeth, their death.

Rinse for painful sensations

Rinses are also widely used - both homemade and pharmacy. For example:

• 100 ml of water, a teaspoon of soda, a teaspoon of soda, iodine - 5 drops. Used to relieve swelling and remove purulent contents
• 1 spoon of sage per glass of boiling water (decoction), anise - 10 drops. Provides pain relief and has an anti-inflammatory effect.
• 1 glass of warm water, 1 tablet of furacillin. Powerful antibacterial effect, reducing swelling.

The drug chlorhexidine has a good aseptic effect; so-called dental elixirs can be used to relieve pain.

It is important to understand that all the methods listed above are only first aid for toothache; if you stop there, you will soon inevitably need tooth extraction!

To eliminate pain, it is necessary to identify and eliminate the cause of the problem. This can only be done in a dental clinic, where modern equipment ensures comfortable and painless treatment.

Treatment

• For mild bruises, treatment consists of resting the tooth for 3-4 weeks by reducing the load during chewing: the menu includes soft and semi-liquid foods, and a blender is used to grind hard foods.
• To ensure rest for baby teeth, temporary bite separation with the help of mouth guards is used; if a permanent tooth is bruised, splinting is performed. The splint allows you to immobilize an injured tooth and redistribute the load during chewing onto healthy teeth.
• If the pulp dies due to an impact, the tooth cavity is opened and the pulp is removed, after which the root canals are filled and a permanent filling is installed. If the crown of a tooth darkens, it can be whitened.
• When a baby tooth is bruised, grinding of the cutting edge of the crown of the antagonist tooth is used to prevent tooth contact and reduce pain. This method is not used for permanent teeth.
• To relieve pain, it is recommended to take an anesthetic tablet (ibuprofen, ketorolac, nimesulide) and apply an anesthetic gel (Dentol, Kamistad) to the gums around the tooth.
• When swelling of the soft tissues of the face accompanies a bruise, cold compresses are applied: a plastic bottle with cold water (not lower than +4°C) is wrapped in a cloth and held on the area of ​​swelling for 15-20 minutes.
• A course of magnetic laser therapy is carried out - a combined effect on injured tissue of a magnetic field and low-intensity laser radiation. The method helps improve healing processes, relieves swelling and inflammation. The course consists of 10 daily procedures lasting 5 minutes.
• UHF therapy is indicated to accelerate tissue regeneration.

Is it possible to save a loose tooth?

If the cause of mobility is pathological processes in the gums (for example, periodontitis, gingivitis), then the doctor determines the infectious or non-infectious etiology, removes plaque and stone, and prescribes a course of therapy. If the cause of unsteadiness is an incorrect bite, they resort to orthodontic treatment (wearing trainers, braces).

Many patients wonder whether a loose molar can be saved with splinting. This is an effective technique that helps strengthen loose teeth by fixing them in one position. It comes in several types:

• extracoronary (the structure is applied and fixed with cement);
• occlusal (involves the use of an overlay or mouth guard);
• intracoronary (includes drilling a hole into which the splinting element is attached).

Most often, during the procedure, the doctor makes a small groove along the dentition into which the splint is placed. It is made of durable fiberglass and is hardly noticeable in the oral cavity. The doctor carefully closes the groove with photopolymer filling material, which allows maintaining aesthetics and functionality.

Splinting is divided into temporary and permanent. Temporary involves fixing structures for a specific period of time so that periodontal tissues have time to recover. The composition of splinting mixtures includes components that allow you to quickly restore stability to the dentition.

Prevention

To prevent dental injuries, you must:

• Observe safety precautions at work, arrange the workplace and carry out potentially hazardous work in accordance with established rules.
• Properly equip playrooms for children and supervise children while playing.
• Follow traffic rules and use seat belts when traveling, as even minor emergency braking of the car carries a high risk of injury.
• Avoid conflict situations that lead to fights.
• Ensure the safety of sports games using special equipment (helmets, masks, dental guards).
• Carefully select sports grounds: they must comply with safety requirements.

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Firming massage

Strengthens loose gums by improving blood flow through massage. Hands must be clean or wear sterile gloves and finger caps. The effect is enhanced by adding pine needle paste, honey or a suitable essential oil.

Grab the jaw with the 1st and 2nd fingers of the hand and massage the loose gums along the jaw in smooth circles for 5–7 minutes, without applying pressure. After the massage, rinse with an antiseptic.

You cannot massage if there is gum bleeding.

Hidden caries (both under a filling and on a “healthy” tooth)

As a rule, such caries develops asymptomatically, for more than one month or even a year, it does not manifest itself in any way, but destroys the tooth tissue from the inside. And at some inopportune moment, a part of the tooth, thinned by caries, breaks off.

What to do?

Treat the tooth at the dentist: remove all tissues affected by caries and restore the tooth (with a filling, ceramic inlay or crown, depending on the degree of its destruction). And be sure to check all other teeth for hidden caries!

How to avoid?

See your dentist for preventive examinations more often in order to promptly detect hidden caries at an early stage, when treatment is easier, faster and cheaper.

The treated tooth hurts when pressed after canal filling

Working with roots requires precision and accuracy from the doctor. If he incorrectly assessed the depth of the canals, then the following complications cannot be excluded:

• a tooth without a nerve hurts when pressed if the filling material extends beyond the apex of the root, gets into the gum and puts pressure on it;
• when the channels, on the contrary, are not completely filled, inflammation may begin in the voids over time. If a lot of time has passed after visiting the doctor, and the tooth aches and hurts, then the problem is the unsatisfactory filling of the canals.

Causes

Like any other injury, a tooth bruise can have a wide variety of causes. This could be an accidental hit in the jaw with a ball or other sports equipment, an unfortunate fall, a strong blow in a fight, or the consequence of a road accident or riding a bicycle. All these reasons have one thing in common - a strong blow of a mechanical nature.

Children and athletes are the most vulnerable to such injuries. It is these two categories of patients with a similar diagnosis that are the most frequent visitors to dental clinics. However, household injuries, as a result of which a person accidentally or recklessly hits a tooth, can cause a bruise. In this case, the most unprotected and weakest anterior and lateral incisors on the upper jaw most often suffer due to the anatomical structure and overhang of the upper jaw over the lower jaw.

Consumer Reviews

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