Michael E. Foster, D.D.S.
Foster Family Dentistry
5704 Hwy. 290 West
Austin, TX 78735
512-892-2273
http://www.fosterfamilydentistry.com/DrFoster.htm
Transcript: The problems with toothaches
Frequently a patient will come in and they’ll have a tooth that bothers them. It’s a toothache. It may something mild. It may be intermittent. It may have become chronic or acute as of recent. And patients will come in and the doctor/the dentist may take a look at them.
The dentist is typically going to see two things. One a tooth that has absolutely nothing apparent wrong with it and at other times there will be a tooth with either a large filling, possibly crown which he has no idea what’s underneath or possibly decay. And so the dentist has two different problems here. A patient is telling him that they have a toothache with a tooth that has no obvious clinical signs. That can be very tricky.
There are times where a tooth can be dying. It could sustain some injury in a fall, an accident, some sort of an injury that is not apparent. It might have happened six months ago. It might have happened as much as two years ago. And sometimes a tooth just starts to spontaneously die. So that is a classic toothache.
There are other times patients come in and we see what looks well there’s a filling, there’s decay. And it’s real easy to say “Well this is the problem the reason this tooth is hurting.”
Both of these situations sometimes are masking a trigeminal neuralgia problem. So, I would say probably 99% of the time if there’s an obvious clinical problem, that a toothache can be diagnosed as a root canal need or extraction or whatever. If there are no obvious clinical problems then don’t be real quick to demand that your dentist do something at that point because frequently, it’s not a tooth problem and it can be a neuropathic problem. So if he seems to be unsure of the diagnosis, work with him. And sometimes the best thing to do is to wait and see. He may put you on some medication. He may do something minor and suggest you come back in a few days or a week or so. He’s only doing that to try to insure that you make the correct diagnosis.
So, one of the most difficult things in dentistry is to differentiate a true toothache when somebody actually has trigeminal neuralgia. So just don’t fall into the trap of demanding that you get something done right then and there because it may be the wrong treatment.