Ask Your Dentist

Ask Your Dentist

“Doc, something’s bothering
me and I can’t quite put my
finger on it. Can you help me?”

Routine dental visits and obvious problems generally make up the majority of dental patient visits. However, in the course of a career, a dentist may be repeatedly asked this question by a patient seeking help for a not so obvious painful condition, often creating a situation that will either completely frustrate the dentist and the patient or end with both being ecstatic with the findings and outcome. To attain the latter result, a calm, systematic, and educated approach must be utilized by the dentist.

First, a detailed history of the pain or discomfort must be taken, including onset, duration, location, severity, methods of relief, causative agents, and any other useful information from the patient. A medical history is also important to insure accuracy of the evaluation.

From there the dentist will make a decision whether the pain is of tooth origin or whether there may be another cause, such as soft tissue inflammation, muscular inflammation, joint pain, sinus pain, nerve irritation, or an underlying condition such as oral cancer.

On occasion, the culprit can be very apparent to the dentist simply by visual examination of the teeth. An area of decay, fractured tooth, defective restoration, gum tissue recession or inflammation, evidence of excessive wear on the teeth, or a soft tissue lesion may be readily and easily identified.

In other instances, further diagnostic tests may be needed, such as appropriate x-rays, temperature testing, pressure tests for detection of fractures of teeth, and even laser illumination of teeth to identify otherwise undetectable cavities.

X-rays, in particular, can often identify an otherwise invisible problem and it’s cause. If these efforts do not lead to the identification of the problem, a referral to a specialist may be in order to aid in achieving a diagnosis.

Once the problem is identified, appropriate treatment may be initiated to hopefully alleviate the problem and eliminate the cause of the pain. Methods of treatment, both by the general dentist and/or the specialist could be addressed in a future article.