Dr. Silberman often gets asked the question: “Do I apply heat or cold to a toothache?” Watch our one-minute video to discover the answer:
Should you apply heat or cold to a toothache?
ALMOST NEVER APPLY HEAT to your face when experiencing a toothache. If you have an infection the heat may draw that infection out causing more swelling. Apply COLD! If you are experiencing a severe toothache the best thing is ice water in the mouth. You may have gasses trapped in your tooth. If you keep ice cold water in your mouth, the gasses will contract and pain either lessens or ceases.
“Inflammation is the body’s natural response to any infection. Heat increases inflammation. Ice helps to relieve inflammation.” —Dr. Paul Silberman, Dentist in Waldorf
What to do if you have tooth pain
- Get to your dentist as soon as possible.
- Putting it off will make it worse.
- Even if the pain eases, the underlying cause for the pain is still present and you will wind up experiencing pain again.
There are many reasons you may have a toothache. It can occur even if you have seen a dentist regularly. If you have a toothache and have not seen a dentist for a long time, do not be intimidated. Just go to a dentist as soon as possible if experiencing pain. Never worry about telling a dentist that you have not seen anyone for dental treatment for a long time. Your dental office must be a judgment-free zone. What is important is how you can start to achieve dental health now, not what you did or did not do in the past.
Are you experiencing tooth pain right now?
Call The Silberman Dental Group
Editor’s note: This post was originally published in July 2014 and has been revamped for comprehensiveness and timeliness.
I recently had two root canals. #’s 18 And 19. Both of which were broken and chipped. A week later I went in for temporary crowns. After one week the pain along my lower jaw from one side to the other was, on a scale of 1-10, at a ten! I recently went back to the dentist to have my bite adjusted. After 5 days, I still experienced pain, at a 10! I was not prescribed antibiotics or pain reliever. I called the dentist yesterday and insisted they give me antibiotics Incase there was bacteria within the teeth that went infected. Should the dentist, during my initial visit prescribed an antibiotic? I could have avoided all this pain!
Sylvia, I am sorry for this terrible dental experience you went through. You asked, “Should the dentist have, during my initial visit, prescribed an antibiotic?” This is very controversial.
I always prescribe antibiotics at the time I diagnose the need for root canal therapy and the patients never have post-operative pain. That is not what is taught in dental schools today. The treatment you received is considered the standard of care today, and unfortunately, the result you received occurs in one out of five patients. From my point of view, if the ratio was 1:5,000 or even 1:500, I might consider that approach. But because I know that one out of five is going to suffer, I pre-medicate with antibiotics. The downside is that some will have an allergic reaction to the antibiotic. I always tell the patient that if a rash or difficulty breathing develops, stop the medication and call me.
There is also concern about over-prescribing antibiotics and patients developing resistant strains of bacteria. While a valid concern, I still weigh that against what you had to go through. It’s not like I am suggesting antibiotics for the treatment of the common cold. If a tooth requires root canal therapy, bacteria are present. I want to reduce the number of bacteria before treatment. I want to “take the bees out of the hive before I stick my hand in it.” But I am in the minority. I hope that answers your question.
Hi i was seen today at the er for a tooth abscess that it causing tooth and ear pain. They gave me an antibiotic as well as 800 mg ibuprofen. However the ibuprofen seems to wear off after 5 hours and its killing me to wait 3 more hours for another dose. Can ai take tylenol too??
Hello Nichole, It is often helpful to alternate Tylenol and Ibuprofen every 4 hours. In other words, take 800 mg Ibuproven every 8 hours. Four hours later take two extra strength Tylenol (2 x 500mg) and take the Tylenol every 8 hours. Do not take either one more frequently. So every 4 hours you will be alternating 800 mg Ibuprofen with 1,000 mg of Tylenol. That should help with the pain. Tests show that is as effective as Codeine and not nearly as addictive. The antibiotics will take 48 to 72 hours to fully kick in. Once it does, the need for pain medication will decrease. I hope that helps. Dr. Silberman
I have been on amoxicillin for 36 hours but it seams like it is getting worse not better
Amoxicillin is not my drug of choice for tooth infection. Unless you have a history of GI issues, the drug of choice is Clindamycin. See if you can have your dentist switch you to this medication. Good luck. Doc
My gums are killing me. At first I thought it was my wisdom teeth but it has to be something else. I have to keep cold water in my mouth. As soon as it gets warm, I’ve gotta replace it. Orajel doesn’t help I’m taking my 600 mg ibuprofen from the doctor but it’s not working. I’m in so much pain. Please help
Hi Courtney, Your description is that of a tooth infection, not a gum infection. You have a tooth that has been exposed to decay or some other kind of trauma. Bacteria has made its way into the circulation inside the tooth and it has damaged the circulation that usually keeps the inner workings of the tooth healthy. The bacteria in the tooth has a byproduct of gas. The gas is trapped in the tooth. Gas expands in the presence of heat and contracts with cold. Your body heat is enough to make the gas expand and put pressure on the remaining nerve endings in the tooth and in the jaw. This causes the intense pain, and it explains why cold water takes away the pain. A dentist can numb the area and either extract the offending tooth, or open the chewing surface of the tooth to release the gas as a temporary fix in anticipation of doing a root canal treatment. Your options are either extraction or root canal treatment to save the tooth. I hope that helps. Good luck. Dr. Silberman
Hi I had 2 filling done early December on 22 and 12 it was not a deep filling but I’m feeling pain when I press where they cut I went again in January they did the filling again and put Dycal but still did not go away
Hello Elsie, If the fillings were not deep, it is unusual to have these issues. And yet, here you are. You “feel pain when you press where they cut”. If the fillings were on the cheek side of the teeth, is it sensitive to fingernail pressure? And to toothbrush bristles? This would be due to dentinal exposure that comes with smoothing and shaping the filling, and it should pass. You should avoid any toothpaste with a whitening agent as this would prolong the problem. Switch to a tube of desensitizing toothpaste, like Sensodyne, or Crest for Sensitive teeth, or Colgate for Sensitive teeth. Just be sure there is no whitening agent in the desensitising toothpaste either. The questions I would ask are: any sensitivity to hot or cold, is the ache spontaneous as well as when you apply the pressure, does it wake you, does it prevent you from falling asleep, does chewing on it bother you, is there swelling, is there tenderness pressing on the gum or just the teeth. Given the limited information, I am hoping that the desensitizing toothpaste fixes the problem, but it will take 4 to 6 weeks for the problem to quiet. If I am right, it won’t get worse while you are using the desensitizing toothpaste, but it will get gradually better. If I am wrong, your symptoms will get worse and be easier to diagnose. In that case, you might need root canal therapy. Unlikely, but that is why you must be patient with the desensitizing toothpaste. If you already use a desensitizing toothpaste, switch to a prescription one like Prevident 5,000 or Fluoridex. Ask your dentist for a prescription. Good Luck, Dr. Silberman
Hello,
I have moderate to severe pain in my mouth. On one hand, I have a few teeth with very progressive cavities and they throb often until I take ibprofen. But I also have a deep tight pain in my jaw and ear and occasionally into my sinus cavity. This tightness occasionally stops me from opening my mouth wide, talking, and sometimes produces a shock-like feeling that lasts about 20 second into my jaw and tonsil/throat.
Ice seems to cause more pain than heat. On a good day I take 600 mg ibprofen on bad days I can take up to 1200 mg a day. I can’t pin point what it is but I’m very scared of dentists.
Hi Desiree, Looks like you duplicated your question and I just wrote my response to you. I hope you follow up and find a good caring dentist who will address both your fears as well as your dental issues. You have your homework cut out for you. Start your Google search today, read lots of reviews, and make the best choice you can. After narrowing down the right dentist from the reviews, go to their website and see if it feels comfortable to you. Good luck, Dr. Silberman
Hi ive had a filling replaced and it was a very old one i wasnt experiencing pain before but AFTER this dentist replaced im in pain all in my jaw line as well as in between the tooth its just a red dot there its tender and at night it worsens with pain, at this point i just want to get the tooth pulled idk and all the dentist keeps saying is that its tender because of replacement
Hello Angie, From your description, it is difficult to determine if the source of the pain is coming from the red dot on the gum or if it is the tooth itself. You could do some investigating on your own. If the red dot is between the teeth at the gum line, it could be a minor gum problem. Go to the pharmacy and get some numbing (teething) gel to apply with a cotton swab to the red dot. If it helps to stop the pain, you are dealing with a gum issue. Assuming the dentist has checked the gums for pocketing and it is healthy, the red dot could be a sign of irritation. Keep using the numbing gel, but rinse periodically with warm salt water to help with the healing. You could also get some prescription mouth rinse called Chlorhexidine to speed up the healing process. If the red dot is on the cheek side of the tooth a half-inch to an inch below the gum line, it is an abscess that could be either gum or tooth. It would likely mean that the tooth needs root canal therapy or extraction. It would not be the fault of the dentist. If this is the case, the infection would have been dormant and was stirred up by the dentist, but would have happened eventually regardless. Another test along with the numbing gel would be a cold test. Take ice water and hold it in your mouth to see if it elicits a response from the tooth that was worked on. If it does not, and if you tap on the tooth and it is tender, this could indicate an infection in the tooth. If you get a response to ice but it only lingers a few seconds, this would indicate it is normal and that the pain is coming from the red dot. If you get a response to ice but it lingers for a minute, it is probably an infection in the tooth. Lots of information for you that I hope is clear. Good luck with your investigation. Dr. Silberman
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Hello Shirley, If your intent was to ask a question, it didn’t post. Feel free to write me back. Have a great 4th of July. Dr. Silberman
I put cold water and it helped my severe tooth pain. Now if I stop putting cold water, it’s worse. I can’t even sleep.
Hello Brandon, Unfortunately the only thing that will stop the pain right now is cold water. You need to keep ice water in your mouth and see a dentist as soon as possible. The infection inside the tooth has created a gas pocket that is trapped in the root. Your body heat is enough to expand the gas and put pressure on the nerves causing the pain. The ice water gets the gasses to contract and stop the pressure which stops the pain. A dentist will numb the tooth and make an opening in the chewing surface to allow the gas to escape. Once that is done, you will not need ice water any more and the pain will stop. Find a dentist who will see you today ASAP. Good luck. Dr. Silberman.
I am experience toothpain and itbfeels swollen and keeping me up at night how can i ease the pain.
Hello Brenda, Because you have swelling, that would indicate that there is infection. You need to take an antibiotic to treat the infection and the swelling. Go to a dentist as soon as possible. If you can’t see a dentist, go to an emergency room or urgent care to get a prescription. Once the swelling is controlled, they can treat the source of the problem. Let the dentist guide you to take proper care of your problems. Good Luck, Dr. Silberman
What insurance do you take if any and are you in Jacksonville fl?
Hello Kajuan, I am located in Waldorf, Maryland. It is interesting that a simple posting of my thoughts on not applying heat during a toothache has generated so many dental questions. Jacksonville to Waldorf is only 700 miles so you are welcome to come see me . My suggestion to you when looking for a dentist is to check out the reviews online. I like Google reviews better than Yelp, but that’s just a personal preference. Yelp has approached me to advertise with them and if I don’t, my five star reviews get hidden. I have 40 five star reviews, but Yelp shows my one star which I got because of a problem the patient had with her insurance and blamed my office. Anyway, good luck in finding a dentist. I hope that helps. Dr. Silberman
I had a root canal 1 1/2 years ago on a lower molar. My tooth started having pain a few months ago and I went to another endodontist for a re-treat. He went in 3 times to clean the inside over the course of 2-3 months. The pain had subsided and I felt good finally.
A week ago I went to my general dentist and they put the temporary crown. After a few days i started experiencing the same throbbing pain in the tooth just like before. I went back to the dentist and he said the temporary crown is not high and it shouldn’t be causing me any pain.
My endodontist doesn’t seem to want to do anything more.
Im so confused on what I should do .
Hello Rani, Sometimes when a root canal treatment is done and looks great on the x-ray, there could be a vertical crack in the root that can’t be seen on a two dimensional x-ray. The crack harbors bacteria that cause tenderness in the bone. If we know that the bite is right, there isn’t anything you can do except extract the tooth and hopefully replace it with an implant. Before doing that though, I would hit it with a round of antibiotics. If you have no GI symptoms (Crohn’s Disease, Irritable Bowel Syndrome, etc.), the best antibiotic would be Clindamycin 150mg taken four times a day for ten days. If there is no crack, but there is some residual bacteria in the bone around the tooth that can be eliminated with antibiotics, it’s worth trying. Good luck. Dr. Silberman
I am having really bad pain in one of my back tooth’s the pain is so bad were it has my head hurting
Hello Nyieshia, You aren’t providing me with much to go on. For pain, I would alternate taking Tylenol and Motrin every four hours. Take two extra strength Tylenol, and four hours later take three 200 mg Motrin (Ibuprofen, Advil), and four hours later back to the Tylenol, and so on. The most important thing is to get to a dentist ASAP and have the problem diagnosed and treated properly. I hope that helps. Good Luck. Dr. Silberman
Hi iv had a re root canal as i had a sinus tract pimple on my molar. The root canal was successful but its been a year and there is still a small white spot on gum endodontist has took a x ray last week the tooth is fine just slight inflammation shows up on x ray the tooth doesent hurt and had a crown on it the endodontist re treated the tooth through the crown and sealed it please help it was a private endodontist who used a microscope
Hello Shazia, The sinus tract is called a fistula. When there is an infection, the pressure builds up and creates this tract allowing the pressure to be released. The infection drains through the tract so there is no pain. The dentist will have root canal filling material that is called gutta-percha. It is a flexible rubbery substance that is about an inch long and shaped like a small toothpick. The dentist can insert the gutta-percha (size 35) into the pimple without numbing. The inside of the tract has no feeling. The gutta-percha will follow the twists and turns of the tract and end at the source of the infection. An x-ray should be taken with the gutta-percha in place. It will identify the problem tooth and the source of the infection. It could be the tooth that has been treated, or it could be coming from another tooth. The problem needs to be addressed because there is an infection present, even if it isn’t causing you pain. I hope that helps. Good Luck, Dr. Silberman
Good evening Dr. I am having tremendous pain on or in a filling on the upper right side. This is, I think, what has happened-I wear a bridge for 4 years and the hook on the upper right side has broken a price of old filling in the hook has grinded a hole on that tooth. Got great pain. Oradell, BC, Tylenol do nothing Got leftover tramadol, but scared to use it. Please help!!!
Hello Rob, If there is an infection in the tooth, it is possible that holding ice water in your mouth around the tooth will stop the pain. It is a temporary fix that you may need to do every few minutes, but it should at least give some relief. See your dentist as soon as possible. If the partial denture clasps onto this tooth, you don’t want to lose it and then have to remake the partial. It’s better and less expensive to save the tooth. It sounds like the tooth will need root canal therapy. Let the dentist make the diagnosis and get treatment ASAP. Good Luck, Dr. Silberman
Hi I’ve been receiving a lot of dental work for the past year resulting in 53000 dollars worth of dental bills but each time I go I have to worst pain and I’m usually prescribed pain meds but they never work so I usually add some extra ibuprofen to the mix which can be dangerous I know but it sometimes helps but not always sometimes the pain is just too much so I ice and some times when I don’t know what else to do I use heat which I know is wrong if it’s an infection but usually it’s not and because I’ve had over 14 root canals I m kinda able to tell the difference but my question is what do u do when ur already prescribed hydrocodone but are still in an unbearable amount of pain
Hello Nichole (or is it Maya?), It sounds like you have really been through the mill with your dental experiences. Let me suggest a few things. When I see patients going through multiple root canal treatments in an attempt to relieve facial pain, I always include alternative sources of pain in my differential diagnosis. By that I mean finding the source of your pain may not be strictly tooth-related. There could also be a neurologic origin to the problem. If the nerves leading to the teeth are inflamed, the patient’s perception is that it’s coming from a tooth. If you haven’t had much tooth decay or trauma or history of crowns and have undergone numerous root canal therapy treatments, the problem could be neurologic. You should consult with a neurologist to see if you have nerve inflammation. When a patient is diagnosed with needing root canal therapy, has the treatment performed, and then the pain doesn’t go away, I start thinking neurology workup. It is difficult to contol pain from an inflamed nerve with narcotic pain medication. A steroid injection may help you. Best of luck. I hope this helps. Dr. Silberman
Hi. I had horrible tooth pain the other day. I went to my dentist and he said there is definitely an infection near a tooth I had a root canal and crown done on years ago. I immediately started taking penicillin but I accidentally used warm compression and woke up to half of my face swollen I’m assuming bc of the warm compressions. Anything I should do besides icing the area and continuing the penicillin? How soon should the swelling start going down? Thank you
Hello Christina, Unfortunately, once a warm compress is placed on your face to “soothe” a toothache, the swelling that it causes is very difficult to get rid of. It just takes time and patience. The antibiotic will bring down the swelling, but it will take several days to a week. Applying cold compresses may help. I wish there was a magic potion but there isn’t. You might get faster results with Amoxicillin, Augmentin, or Clindamycin over basic Penicillin. Good Luck. Dr. Silberman
As a former patient with an abscess tooth I can tell you that my dentist at the time had me taking both Ibuprofen and Tylenol.
Hello Jenn, We in the medical / dental field are very sensitive to the fact that opioids were prescribed at a much higher rate in the past and that correlated with patients becoming addicted. We try to avoid prescribing narcotics whenever possible. Tests have shown that using a combination of Tylenol and Motrin (Ibuprofen, Advil) is as effective at controlling pain as a narcotic like codeine. Dr. Silberman
Ok so my lower back tooth is broken and it’ jus recently started giving me pain yesterday and was the worst pain I’ve endured. I’ve taken medicine and salt water and it’s helps a bit but it eventually comes back to a 10. I’m also trying to eat but I really don’t want it to hurt again, will I be fine if I jus eat on the opposite side?
Hello Jacob, You didn’t mention if you’ve been to a dentist? Certainly sounds like that would be your best option. For how long can you eat on the opposite side? See a dentist and have them diagnose the problem. You will likely be given options as to how to resolve the problem and estimates for each option. Good luck.
I’m curious as a dentist what do you think of my own personal toothache reliever? I mix cinnamon, cloves and whiskey together, I take a spice jar, put about a quarter of it full of whole cloves, about 3 cinnamon sticks and fill the container with whiskey and let it sit for a week, smells and tastes bad but can fully numb the pain instantly and for long periods of time.
Interesting combination for treating tooth pain, but the cloves is the key in my opinion. It is well documented that clove oil deadens tooth pain as well as dry socket pain following an extraction. The Cinnamon is also known to help with tooth pain but I don’t know if it is as effective as the cloves. I can’t attest to the effectiveness of the whiskey unless you take it systemically. LOL Dr. Silberman
By the way, if you were to drink the concoction all at once, it should stop any pain. Just sayin’. Best, Dr. Silberman
Hi Dr I can’t tolerate clydamicine will a Z-pack work!! If not what else is there as I am allergic to penicillin!! Please help
Hi Anna, Z-Pack is not a good choice for tooth infection. For patients who can’t take Clindamycin, I suggest Cephalexin (Keflex). For people allergic to Penicillin, there is a small percentage of the population who also react to the Cephalexin. If a rash or difficulty breathing develops with the Cephalexin, stop taking it. It’s rare, but can happen. Good Luck. I hope that helps. Dr. Silberman
So I started a root canal on tooth 30. Then we immediately had to go into a root canal on tooth 23. I had a pressure type issue with tooth 30 but then dentist cleaned it more and I was fine. Well recently it started again it feels like someone blowing a bubble and popping it quickly but in my tooth it’s super uncomfortable and nothing helps it go away. I went back to the dentist and he cleaned and drilled more today. It immediately started back when the novacaine wore off. What is happening?! I’m terrified of the dentist and I’m so uncomfortable PS I am on an antibiotic and rotating Tylenol and Advil.
Hello Kayla, It sounds like the root canal had not been completed. Once the canals of the roots are filled, the issues should resolve. It sounds like the dentist is cleaning out the roots in multiple visits, but I’m just guessing. The best bet is to clean out and fill the roots at the same visit. Also it is best for the dentist to reduce the height of the tooth slightly so that when you bite together, the upper teeth are not in contact with the lower root canal tooth. If I am right, you can get immediate short term relief by holding ice water in your mouth around that tooth. Have the dentist fill the roots ASAP and get this procedure finished! Good luck. Dr. Silberman
Ok I just had my top moller tooth pulled a week ago. When it was the for me to remove the gauz the blood clot was stuck to the gauz pad. I have called my dentist and they can’t do anything cause I’m currently 38 weeks pregnant , so long story short i am suffering. Yes I am having pain during the day but I am developing more pain at night to where I’m constantly going through a small bottle of vanilla extract just to keep my surrounding teeth and jaw from hurting more. I clean my mouth every time I eat to make sure nothing gets into the extraction site but I can’t bare this pain anymore I know I have a dry socket but what other home remedies can I use or pharmacy stuff can I use to help with this pain?
Hi Hope, This stress can’t be good for either you or the baby, so let’s get right to it. Clove oil or clove gel works like a charm at stopping dry socket pain. It is an over the counter medication that you can get an any pharmacy. If it is a lower tooth extraction, the clove liquid will work well because gravity will pull it down into the open socket. For an upper tooth, the gel works better because it won’t drain out of the extraction site like a liquid. The way it works: the clot that was lost was your layer of protection against exposed nerve endings in the jaw bone. If the clot was present, air couldn’t get to those exposed nerves and you wouldn’t be feeling any pain. The clove treatment quiets those exposed nerves very well. You will have to apply it for 7 to 10 days, as needed, until the gum tissue starts to grow over the exposed nerves. I hope that helps. Good luck to you and your baby. Dr. Silberman
i’m have a very bad toothache for 2 i taking amoxicillin which the doctor prescribed me with ibuprofen now it’s a abscess on it , is that normal for a toothache it came out the blue
Hello Emmanuel, It is not uncommon for a toothache to “come out of the blue”. Many times when there is a cavity, there aren’t any symptoms. Once the bacteria in the tooth decay grows into the nerve, the problems begin, sometimes intensely. The abscess is an indication that the bacteria from the decay have made their way through the tooth and into the jawbone. The antibiotic should help, and the tooth should either be extracted or treated via root canal therapy to save it. Another avenue for bacteria to enter the tooth is if there is a crack or trauma, but the outcome is the same as with decay. I hope that answers your question. Good Luck, Dr. Silberman
Help! I had sensitivity in the lower bottom left side of my mouth. Went to the dentist and she gave me a carbon paper which I bit down on and she determined it was my end tooth. She said it was cracked/fractured and needed a crown. Had a temporary crown put on in the tech adjusted it a little bit. As the days progressed I had more and more pain there. Went back and the tech took it off about three or four times and sanded it down. Went home the next day it hurt really really bad, especially when I was eating but I barely chewed anything. The next day went to the dentist and the dentist filed down the tooth and the tooth above it. Had an airline ticket and left the next day to visit my daughter. Pain wasn’t very bad at all and could be remedied with just a couple ibuprofen maybe once a day. Then today after I had some warm water the area top and below started hurting and hasn’t stopped for about 12 hours. She sent me on my trip with antibiotics and hydrocodone ibuprofen but don’t really want to take that. She mentioned that my ligaments might be all sore because the upper tooth kept hitting the lower tooth for over a week. Because of that I’m hesitant to take the antibiotics as I’m sensitive to them. No fever no swelling no pain in other areas. Have three more days before I go back home and then four more days till I see a dentist after that. Any suggestions please?
Hello Colleen,
You have provided excellent clues, so let’s get started solving the mystery. When you went to the dentist and a crack in your molar was identified, they did the right thing by placing a temporary crown. A crack in a tooth advances like a crack in a windshield. It extends to a certain point, and then you hit a bump in the road just right, and the crack extends a bit further. The same is true for your tooth. The crack begins in the center of the top of the tooth and works its way into the tooth towards the root where the nerve and circulation are located. Sometimes, the crack takes a turn towards the cheek or tongue and a cusp fractures off providing relief temporarily. Then a crown is placed. The other scenario is that the crack advances vertically into the nerve and circulation resulting in contamination by bacteria that are naturally present in the mouth. This is your situation. Because the dentist could not tell the extent of the crack, a temporary crown was placed to prevent the advancement of the crack. That was the right thing to do. If caught early, your symptoms would disappear and the crown would be permanently cemented at a later date. Your current symptoms confirm that the crack reached the nerve and circulation resulting in an infection in the tooth. The bacteria destroy the nerve and circulation center, reducing that tissue to pus and gas which are trapped with no exit. The clue that confirms this was your sensitivity to heat. The trapped gas in the tooth expands from any heat stimulus and causes pain on the remaining nerve and outside the tooth in the jaw bone. It is not uncommon for the pain to radiate to the opposing tooth when this happens, but there is no infection in the opposing tooth. It is just your brains’ misinterpretation of the stimulus. The next step would be for you to take the antibiotics to quiet the infection and the pain until a root canal treatment can be performed on the cracked tooth. Then the crown can be permanently cemented to prevent further cracking. A short-term fix is to hold ice water in your mouth to reduce the expansion of the gas trapped in the tooth. Remember to avoid heat. No hot foods and do not place any warm compresses externally. No direct sunlight. No hot tub. I hope that helps. Good Luck, Dr. Silberman
My uncle, whose daughter was also a very talented dentist, was not only our family dentist, but many of the same folks throughout our entire region. His empathy for his patients was off the “charts” (sorry!) &, outside of ethics, led almost his every decision outside of obvious dental training.
Dr, your comments quoting the “20% chance of patients having pain” stats is the absolute PERFECT example of the time he would have NEVER have even rolled the dice. They got them. Period.
I went to a dentist who’s around my age (mid 40s) near where he practiced for many years & prior to some major upper teeth replacement work, he performed (4) RC’s on me (this put me at 18 for total) on a Wednesday prior to Thanksgiving. During the procedure, he also drilled into a pocket & a sinus cavity / pocket was nicked & the “hottest” liquid ever came pouring into my throat. I won’t go into details, but I wasn’t sure if I could finish, and I’m not a wimp). Once I got done, I was up at the counter & there was no antibiotics (I would’ve be adamant w/o the sinus pocket hit, but 200% after).
He acted like he didn’t want to, & finally I CONVINCED HIM — like I was asking for a pocket full of high proof oxy whatever.
I said “I will PROMISE you, by Monday, this will turn into an infection of epic proportions. I know my body.”
By Saturday morning, I couldn’t talk. It was the worst sinus infection I’ve EVER had. I haven’t had one since, on a positive note. So…maybe that’s a cheaper version of that $8500 “elective” BS surgery to relieve each side of your nostrils.
You are a VERY good dentist. You care. Dentists have an advantage over many other docs — they can see many things other doctors can’t. (Not 100% but still) there’s no use to be jerks just because you’re “new skoool”, ya know?!
Thank you Stuart for the nice compliment, and for sharing your story. For those reading who didn’t see my “20%” reference, allow me to clarify. I have found that in patients who have a root canal treatment and do not pre-medicate with antibiotics prior to that treatment, one in five has pain and swelling. Not one in 500 or 5,000, but one in five! Of those patients who pre-medicate with antibiotics (preferably Clindamycin), resulting pain and swelling are almost non-existent. The antibiotics should be taken, at minimum, the day prior to the visit, the day of, and the following week. Having said this, you may actually be the exception to the rule. Most people do not have 18 root canal treatments in their lifetime. My 20% rule applies to those who have one or two, or go a year or two between root canal treatments. Overuse of antibiotics can lead to bacterial resistance. Some caution does need to be taken in the overuse of antibiotics. Only take it when a bacterial infection is present, such as is the case with an infected tooth requiring root canal therapy. Good Luck, Dr. Silberman
Please help I am getting a shock like pain in my tooth it’s my fang. But the one next to it is cracked I can’t handle the shocks how do I get rid of the shocks please
Hello Samantha, It is unusual to get the type of pain that you describe. I have seen in it my patients who have overdone teeth whitening. It is described as shocks or zingers that occur spontaneously. This usually passes within a few days. If the problem persists, you should be evaluated by a dentist. I hope that helps. Good luck, Dr. Silberman
I broke my left first molar to the gum and my dentist placed a crown over ot since the entire tooth could not be saved. She informed me that I needed to floss everyday since food can easily pass and get stuck. Been going well so far until one day I glossed and maybe cut the gum it bled but now I am left with pain to my gum which on scale 1-10 I give 6 and sensitivity to my sinus above the tooth and eye.
Could this be from the cut or do I now have an infection under the crown?
Noting there was no cavity to the tooth prior to breaking it.
I plan to go to my dentist but I am thinking they will have to remove the crown and the tooth already cannot be saved since it is broken.
Should she have done a root canal on the tooth before placing the crown?
What else can be done besides full removal.
Hello Genevieve, When a tooth cracks, it is hard to tell the extent of it. I usually put the crown on the tooth first and take a wait-and-see approach. 50% of the time, the tooth heals with no problem. When it doesn’t, it requires root canal treatment. If I can spare the patient an unnecessary root canal, I try to do so, and it sounds like your dentist is on the same page. If the crown was permanently cemented, an opening can be made on the chewing surface to allow the root canal treatment to be performed. This would be followed in several weeks by a filling. A post and core filling can also be placed to strengthen the tooth. A steel post inserted into the largest root can provide long-term stability. I don’t think your symptoms are consistent with being caused by flossing. Sounds more like an infection needing root canal treatment. I hope that helps. Good Luck,
Dr. Silberman
I Recently got a crack in my tooth filled. Why does my tooth and the whole front of mouth hurt? I’m in more pain now than before the filling.
Hello Tiffany, When a tooth develops a crack, it is difficult to determine how far the crack extends internally. It can’t be seen on an x-ray. The best we can do is place a filling or crown to eliminate any decay and prevent the crack from advancing any further. If the crack has reached the center of the tooth where the nerve and blood supply are located, it may not have any symptoms. But there are bacteria in the saliva that do not exist in this area of the tooth. Those bacteria can travel through the crack and infect this area causing an infection, and it can still be symptom-free. When the filling or crown is done, it stirs up the bees in the hive (the bacteria in the tooth) and the tooth hurts worse. Unfortunately, it seems that your tooth is infected. You will need root canal treatment and a crown to save the tooth. The dentist can put you on an antibiotic to quiet it for now. The filling was the correct treatment. We try the simple thing first and if it works, no root canal is needed. For you, it didn’t work. All is not lost. You just need to follow through with fixing the infection. Good luck, Dr. Silberman
Sounds to me like a “doctor” that cares for his patient first and being politically correct last THAT”S THE GUY I WANT !!!
Thank you Richard. Best, Dr. Silberman
I had a tooth infection last year and went to three different dentist and they wouldn’t give me antibiotics even though my tooth was infected⅘
Hi Sylvia (or is it Kevin), My response to your comment regarding treatment of tooth infection via antibiotics is that not all dentists are convinced it will help. Or if they think it will help, they don’t want the patient exposed to a medication that could cause an allergic reaction. My position is that is nonsense. If you have an allergic reaction, stop the medication. If you have difficulty breathing or a rash develops, stop the medication. Take some Benedryl and if the reaction is severe, go to an emergency room for care. The odds of that are so extremely low, it doesn’t make sense not to go with an antibiotic. The post-treatment discomfort after root canal therapy is almost zero when the patient is premedicated with antibiotics. This is one dentist’s personal experience from 40 years of practice. But I am in the minority in this regard. I suggest finding a dentist who will premedicate you prior to treatment. Good luck. Doc
Hey um I can’t afford to go to the dentist and I have a chipped molar and what I think is an absyss on my gums and it is causing me pain I have tried salt water(slightly worked) and ice cold water (increased pain) but the pain is still there I can’t sleep at all what do I do?
I suggest you look up your local and / or State Dental Society (Association) and ask them for advice. Depending on the State in which you live, there are State funded organizations that provide assistance to people in need for their dental care. In my area we also have Catholic Charities that provide 4 weekends a year where they have an open clinic in a high school gymnasium. They set up in four different locations around the state. It’s all volunteer and we see a thousand patients over the course of the weekend. I’m sure that has been put on hold since the Pandemic, but hopefully it will resume. Good luck and I hope that you get the help you need. Dr. Silberman
Hello I have a really bad toothache on one of my molars that is broken. They told me they couldn’t save the tooth anymore. They prescribed me with amoxicillin and Tylenol and later prescribed me clindamycin 150 mg and ibuprofen. I’ve gone to 2 different dentists because I want the tooth out already but they say they can’t do anything. Is it because it is too swollen? I feel the pain all the way to my throat and ear. Idk what to do. The pain is at a 10.
Hello Samantha, you need to go to an Emergency Room or Urgent Care if the throat symptoms include swelling that could jeopardize your breathing. IV Antibiotics may be necessary. Do not apply hot compresses or any form of heat to your face, which would make the swelling worse. If the pain is from the swelling, warm salt water holds in the mouth could help to get drainage and decrease the swelling. If the pain is from the tooth, holding ice water in the mouth could help with the pain. With this degree of infection, 300 mg of Clindamycin every 6 hours would help, but check with your dentist. Getting the tooth out ASAP is the goal but rely on the dentist for the right timing. Good luck. Dr. Silberman.
I have a abscess on my gums and canker sore inside lip and bad breath. Dentist said she couldn’t pull my tooth until the infection is gone but the ibuprofen and antibiotic they proscribed aren’t working. Can I rotate ibuprofen and Something else?
Hello Ee, Sorry to hear you are dealing with this. Tests now show that the effectiveness of alternating Tylenol and Ibuprofen is approximately equal to a narcotic like codeine without the side effects. Take 600mg of Ibuprofen (Advil, Motrin) and alternate with two extra-strength Tylenol (2 x 500mg tablets). This should help while the antibiotics are kicking in. This is probably all the treatment you need until you get the extraction. But for future reference regarding the canker sore, if you have repeated problems with them, the product I recommend is Debacterol. It is now over-the-counter and takes 90% of the pain away with one application. It used to be distributed in dental offices only because the method of application must be closely adhered to. Also, it’s not inexpensive. But it works. The key to avoiding canker sores (technically known as aphthous ulcers) is to avoid fingernail biting, chewing in foreign objects like pens and pencils, avoiding citrus and tomato products. And don’t let your toothbrush scratch you when you brush. Circular motions on the teeth helps prevent them. I hope this helps. Good luck with your tooth extraction. Dr. Silberman
Hello Dr. I’m experiencing between a 9 and 10 of pain on one of my lower right molars. A few years ago a dentist I had seen did a filling but just a few months ago that filling broke off and it took the entire innermost side of the tooth with it. A dentist I’m seeing did two crown preps for it and I have a temporary crown on now but the tooth never really hurt until a temporary crown was put on it, it didn’t hurt when it broke. Now the pain is almost unbearable and constant, and any pain that I feel from the tooth is mimicked in my jaw and my right temple. Is very sensitive to tapping on the tooth, and when I use the mouth wash I was prescribed (periogard) it causes pain that immediately shoots from that tooth, through my jaw to my right temple. Also being military we have no contact with our dentists until they call and schedule our appointments so I may be stuck waiting for awhile. What do you think is wrong and could you recommend any remedies while I wait if possible? Thank you.
Hello Brandon, If the original filling was large, the bacteria in the decay at that time could have contaminated the nerve and circulation inside the tooth. It is a long slow process for that infection to grow to the point where you have symptoms. Another possibility is that when the tooth broke this time, it created a hairline fracture that allowed bacteria in your mouth to reach the nerve and circulation starting the infection. In either case, the tooth is now infected. Any drilling on the tooth will accelerate the infection process that had already begun. The dentist will remove the temporary and do a root canal treatment and replace the temporary. This will stop the pain. Meanwhile, you could go to an Urgent Care and have them prescribe Clindamycin 150mg 4 times a day (if you have no GI issues). It is the best antibiotic for tooth infections. This will quiet the toothache. Take some pain medication as follows: Alternate Tylenol with Motrin (Ibuprofen, Advil). Take 2 extra-strength Tylenol, and four hours later take 600mg of Motrin. Alternate them every four hours. Good luck and I hope that helps. Dr. Silberman
Been to ER and a dentist. Pain and swelling on one side of face. Lower last back tooth I can not even touch cause it’s so painful. Dentist took X-ray of the tooth and saw no infection. What else could it possibly be. Could infection be in a different tooth but making that one hurt? I’m in so pain pain and don’t know what to do
Hello Jenny, Sorry to hear you are going through this. It could be a wisdom tooth erupting. This is common from age 15 to 30. If there is no evidence of tooth decay and no infection, I’m guessing this is the source of the problem. Wisdom teeth come up in spurts. They grow a little, the gum over top swells, the opposing tooth hits the swelling causing more swelling. That’s why babies cry when they are teething. I would take warm salt water and hold it over the area to help take the swelling of the gum down. I would have the dentist check to see if there is room for the tooth and, if not, either refer you to an oral surgeon to have it extracted, or let the dentist take it out him / her self if comfortable with doing so. I hope that helps. Good Luck, Dr. Silberman
Hello, I had a wisdom tooth extraction about a week ago. I have developed a slight infection. Pain, swelling on inside and outside but no pus. My gum is so swollen it is over my last molar. My doctor recommended heat pads, massaging the area and prescribed antibiotics (Amoxicillin and Clavulanate). Is this a good alternative? I have read many places heat can make infection worse.
Hello Krys, Following a wisdom tooth extraction, I would not apply heat externally. If you have swelling around the extraction site, do warm salt water holds in the mouth. That will help to bring down the swelling. Also, I do not disagree with the dentist prescribing antibiotics if he / she feels that infection is present. Removal of the tooth is the key to healing as it allows infection to drain through the extraction site as needed. I hope that helps. Good luck. Dr. Silberman
I just want my toothache to be gone what can help it go away faster thank you
Hi Cynthia. Sorry to hear you are going through this. You really didn’t provide me with enough description to help you. The best advice would be to get to a dentist as soon as possible to make a proper diagnosis and treatment plan for you. Feel free to write back to me if I can be of further help. Give me more information: your age, description of the problem, pain, swelling, bleeding, and how long this has been going on. Good Luck. Dr. Silberman.
Hello, I have been having progressively worsening tooth pain for weeks and now I am at the unbearable stage. My dentist scheduled me for the first available appointment next Tuesday and gave me Hydrocodone, Ibuprofen, a sedative to take the day of oral surgery, and Pen VK. I was specifically told not to take any of the medications until the day of surgery, which is 5 days away. My mouth is hurting soooo bad!!! Pain is 10/10 and on both sides of my mouth. I am literally in agony. I don’t understand why I can’t take any of the pain medication until after surgery. Does this seem right or did I misunderstand? I am literally dying of tooth pain. Please help!
Ibuprofen and Tylenol neither one provide any relief and I have an ulcer I need to be careful taking NSAID pain medication with. I’ve also tried salt water, oragel, and just plain warm water. Plea hell me!!!
Hi Michelle, Sorry to hear you are going through this. You may have misunderstood the instructions. See what is written on the prescription bottle. Most times the pain medication prescribed is designed to tide you over until the treatment can be done. You should check with the doctor, but I would think that you can take it now. Also, if you have an infection that has killed off the nerve of the tooth, the pain is coming from gasses building up in the tooth with no where to go. Heat causes gas to expand. Your body heat could be causing the gas to expand and cause the intense pain. If this is the case, holding ice water in the mouth will cause the gas to contract and stop the pain temporarily. This, in conjunction with the prescription pain medication should quiet the situation. I hope this helps. Good Luck. Dr. Silberman
I think my teeth infection caused gum disease. Can this be cured? If so how? My bottom gums look so bad but I don’t have insurance. The dentist wants 1300$ upfront What do I do? The inside of my throat is turning blue and purple. The hospital can’t do anything. And I’ve never been in so much pain.
Hello Kirsten, Sorry you are going through this. In answer to “Can this be cured”, there are very few dental problems that can’t be cured when treated in a timely manner. I can’t tell from your description what the problem is and what the treatment would be. Some suggestions as to where to go from here because of your limited finances. Check to see if there are any dental schools in your area. They usually have reduced fees and, because they are academic institutions, they would have a large cross section of instructors that could address the teeth, gums, throat and any oral treatment needed. Another option is to contact your local dental society and ask if there is any charitable organization in your community that can help you. The national dental association is the American Dental Association in Chicago. If you have any trouble locating your state or local dental society, give them a call for guidance. Also the Catholic Charities has Mission of Mercy in some areas that set up for free treatment four times per year. It’s on hold now due to Covid 19. When they do have these marathon 3 day sessions, the lines are long but there is no cost to you as it is all volunteer. In our area, we have a hundred dentists and dental hygienists meeting in the local school gym with portable dental treatment units. Also, you should contact your local health department and ask for recommendations. In my area, we also have Donated Dental Services. Local dentists volunteer to take patients in need who are referred for screening to Donated Dental Services by local clergy. Lots of avenues for you to investigate. I hope at least one of them works out for you. Good luck and stay safe. Dr. Silberman
Hi Michelle. See my other response. Best of luck to you. Dr. Silberman
I had this pain about a week ago, and it hurt whenever any hot or cold entered my mouth. I went to the dentist and they found a hole in one of my teeth, filled it and fixed the issue. The next day I woke up in excruciating pain. I got another emergency appointment, and upon xray they could find nothing wrong, only that my wisdom tooth might be impacted. He prescribed me Amoxycillin for preventing infection between my wisdom and molar (which is where most of the pain was) and Dihydrocodein for my sleepless nights. The painkillers did literally nothing, and I’ve had 3 hours sleep over these past 4 nights and it’s at the point I need cold water in my mouth 24/7 or the pain is too much. Checked my teeth today and my back molar (the one I suspected) and the molar next to it (the one he filled last week) are both now green. Is it possible they got this infected with 0 signs on an xray in 3 days? Thanks, James.
Hi James, Sorry to hear you are going through this. The application of cold stopping the pain temporarily is the clue that leads me to believe the problem is the tooth they filled, and not the wisdom tooth. A tooth can be without symptoms until it is filled, and the dormant infection that was already inside gets stirred up by the treatment. It is possible that it is a combination of the wisdom tooth plus the one that was filled, but the Amoxicillin would have quieted your wisdom tooth gum problem over the four days that you’ve been taking it. The filled tooth needs root canal treatment or extraction to fix the problem. If the root canal treatment cannot be completed today, the dentist could numb the tooth and open it to allow for the pressure inside the tooth to be released and the infection removed. Then a medicated cotton can be placed inside the tooth to help with the infection as well as keep food out of the roots. Also the height of the tooth should be reduced to stop you from biting on it and give it a rest. It will need a crown in the future anyway, so reducing the bite would be very helpful now, and necessary later to accommodate a crown. Meanwhile, continue with the application of cold to keep getting some relief until such time that the dentist can fix the problem. Good luck. Dr. Silberman
I have a chip tooth I used cold compress it went away for a moment then started back what can I do to relieve pain fa good.other then getting tooth pulled.
Hi Alex, From your description, it sounds like you have an infection in your tooth. It could have been caused by a cavity or trauma. Either way, the remedy is to see a dentist who can fix the problem. The tooth can be removed, or you can probably save the tooth if the support of the bone and gum is good, and there isn’t too much of the tooth that has been lost to decay. It would likely require a root canal treatment followed by a supporting core filling and finally a crown. Dentists call it a crown while some may call it a cap which covers the tooth completely and helps to stabilize the problem. The crown prevents the tooth from getting week and fracturing. I hope that helps. Get to a dentist ASAP. Good Luck, Dr. Silberman
What would my options be for constant daily pain after I eat on tooth 2 or 3? Doesn’t hurt when I drink cold but bothers me sometimes after I have warm food. Xrays show no cavity or infection. Would this mean I have a crack or fracture? Would root canal be needed? Would a CBCT scan show the crack? Thank you
Hello Jennifer, It sounds like it’s pretty simple to diagnose your condition. You have an abscessed tooth. If it is in the early stages, it usually doesn’t show up on a conventional 2D x-ray. The 3D CBCT could show a crack if there is one. Did the dentist test for it by having you bite on a Tooth Sleuth? It is a plastic bite stick that you can place on each cusp of each tooth to determine if there is a crack. Sometimes a crack can be seen clinically by shining a high intensity while light on one side of the tooth. It can illuminate a crack because the light doesn’t pass through it the same as on the light source side. The thermal sensitivity is the giveaway to your condition. Cold drinks can actually make it feel better while hot drinks make it worse. There are gasses trapped in the tooth from the infection that expand with heat and put pressure on the nerve endings in the bone outside the root tips which causes the pain. Cold stimuli like ice water makes the gasses contract and the tooth feels better. You can identify which tooth it is by applying a cold stimulus to each tooth individually. The one that doesn’t respond is the culprit. Place the ice at the gumline on the cheek side. As soon as you feel the cold in the tooth (not on the gum) remove it and see how long the cold lingers. All of the back teeth will respond similarly, except the bad tooth will not respond. Or it may have a delayed weaker response than the others with a slight linger. I suggest root canal therapy and a crown. If there is a crack, the crown will hold the tooth together to prevent further fracture. If the crack extends into the bone, it may not be salvageable. I hope that helps. Good luck. Dr. Silberman
I went to quick care because I was having terrible pain and my mouth come to find out I have a severe infection they gave me medication two different antibiotics and a nausea pill I’ve been taking it like I’m supposed to for the past I think it’s been 4 days I’m still having the pain what should I do
Hello Kim, You didn’t say if your infection is coming from a particular tooth or a generalized mouth infection. Usually, if it’s tooth, the question is about a tooth. I’m going to assume that your infection is gum related. If I’m wrong, write back to me. Gum infections can be quieted with antibiotics but the cure is to get a deep cleaning from a dentist / dental hygienist, to remove the buildup that is causing the problem. Meanwhile, you can get a numbing mouth rinse from any pharmacy. Ask the pharmacist for guidance. There are prescription mouth rinses that are stronger than over the counter. My favorite is Magic Mouthwash which would have to be called in to a pharmacy. It is a combination of Benedryl, Lidocaine, and Kaopectate. I hope that helps. Good luck to you. Dr. Silberman
I just experience severe tooth ache 36hrs . if i scale it from 1-10 its a 10 i cried and i feel its swelling is it possible to remove a teeth even its still swelling ? or in pain
Hello Sylvia, It is better to take a tooth out when there is no swelling present. If the pain can be controlled with antibiotics and pain medication first, that is preferred. But if the swelling is not severe, the extraction can still be done. See a dentist as soon as possible. Good luck, Dr. Silberman
Hi, I had a root canal about a year or so back and was feeling great up until recently when the tooth in question began to hurt again but 10 times worse. I can’t even take a big breathe threw my mouth as air hurts, and room temperature water shocks my tooth. What do I do?
Hello Deborah, It is highly unlikely that the root canal tooth is the culprit, assuming that the root canal treatment was completed. I’m guessing it’s another tooth in the area of the root canal tooth. A tooth that has been treated with root canal therapy over a year ago would not be able to feel a cold stimulus. I recommend you see the dentist and have them take x-rays and run some tests to see which tooth is causing the problem. Good luck, Dr. Silberman
I had a traumatic experience and I’m scared to go to the dentist
Hi Sean, I suggest you Google “Dentists in your area” and start reading reviews. The dentists with compassion will stand out by what their patients say about them. Sorry you had this bad experience, but not all dentists are the same. When you call for an appointment, a really good dentist will set the tone in his/her office and will make you feel welcome from the moment you call. Good luck. Dr. Silberman
I woke up yesterday with an abscessed tooth swelling on my left cheek. I went to the emergency room and received antibiotics and was told to see my dentist. The earliest they can get me in is October 8th which is a month and a half away.. will the antibiotics heal it for the time being how long until my face swelling goes away. My kids are freaked out and I’m freaking out and don’t want to return to work.
Hello Sylvia (or is it Malina), Be sure to avoid applying heat to your face because it dramatically increases the swelling caused by an abscessed tooth. If you have already applied heat, there isn’t much you can do to reduce the swelling except to let the antibiotics take their course. The swelling after heat application can last a week. Without heat application, the swelling will last 72 hours provided that the correct antibiotics are prescribed. The antibiotics will mask the problem temporarily but not heal the problem. I always see my patients the same day if they are in pain. It would take five minutes of my time to take an x-ray and diagnose the problem. I would prescribe the appropriate antibiotic and get you on the schedule for treatment, and most importantly place you on a short call list for openings that come up sooner. If your dentist can’t see you for a month and a half, find another dentist. Google dentists in your area and find one that has good reviews. If your problem is tooth infection, Clindamycin is the antibiotic of choice. If the problem is gum or gland related, Amoxicillin is the antibiotic of choice. I hope that helps. Good luck to you. Dr. Silberman
If I have an imbedded tooth does the dentist have to dig it out and how does he go about doing so and will it cause horrible pain?
Hello Grandma Deb, I can’t tell what technique the dentist will use nor how you will feel afterward (for removing an impacted tooth). So many varying factors. It mostly depends on what it looks like on the x-ray. If it is not causing you swelling or pain now, by the time you reach Grandma status we usually just take an x-ray every year to make sure that it is not changing (Cystic growth, etc). But my guess is that you are having swelling or pain, or both, and that is why they want to take out the tooth. Ask the dentist the same questions. They can easily answer this with the x-rays in hand. If they expect you’ll have pain afterwards, they will prescribe the appropriate medication to keep you comfortable. Most extractions are not difficult and heal quickly. Good Luck, Dr. Silberman
My gum is swollen and my tooth at the left hand side in front i.e 4th tooth in front left side hurts and has affected both up and down.what do i do?? Dentist very expensive here.. is there any other remedy??.
Hello Victoria, You will likely need to have an x-ray taken, so you need to go to a dentist. You can call ahead to different offices and ask for an estimate for both an emergency visit and an x-ray. Then they will be able to give you a diagnosis and an estimate for the necessary treatment. If there is infection present, they could prescribe an antibiotic to quiet the problem until such time that you afford the treatment. Do not apply heat to your face as this could increase the swelling. Good luck, Dr. Silberman
Hello sir, i have severe pain since last day, upper left side in one tooth, only ice and cold water giving relief. I am taking following medicines
Cap.solvocef 500mg
Tab. Flagyl 400mg
Tab.synflex550mg
But above medicine is not giving me relief except cold water or ice. Kindly guide and help me in this regard
mwahidbaloch@gmail.com
Hello Abdul. You have found the best way to get relief, temporarily. Applying ice water to the bad tooth will stop the pain. The problem is that there is an infection in your tooth. The circulation into the tooth has been damaged, so the antibiotic can not kill the bacteria inside. The bacteria thrive on being in a dark, warm, moist environment. The give off a biproduct of gas that is trapped in the tooth. The cold water causes the gas to contract and stop the pain for a while. Your body heat is enough to warm the gas and cause it to expand again, and the pain returns. The treatment is to save the tooth with root canal therapy, or have the tooth extracted. See a dentist as soon as you can, and I’m sure you will be offered those options. Good Luck, Dr. Silberman
Call your dentist and tell them that it is an emergency. Stress that you are in pain and cannot take it. Normally, they will fit you in regardless if there is a wait list. If that doesn’t work ask your dentist for a pain reliever –they may be able to prescribe something that is stronger than you are taking. Furthermore, if the tooth is impacted (which yours sounds like) they give you meds to relieve the swelling in order that they will be able to facilitate the extraction. If worst comes to worst perhaps call a different dentist. Normally, the ER cannot do anything for you.
Hello GoToothache! Thanks for the helpful tips. We agree that if you are in pain, you should call your dentist. They will either be able to fit you in for an appointment or offer advice on easing the pain.
My face is so swollen because of my toothache..I never in my life had this..not even when I’ve had some of my teeth.pulled..I’m 61 diabetic and can’t stand this pain…
If you can’t get in to see a dentist, go to an emergency room or Urgent Care Center. You need to be put on antibiotics to control the swelling. As a diabetic you know that the healing response is always more difficult. It is very important that you do not apply heat to your face as this will dramatically increase the swelling. It is OK to apply cold compresses. You can take Tylenol 500 mg (2 extra strength) along with Motrin (two 200 mg) every 8 hours. Or when you get your antibiotic prescription you might be able to get a stronger pain medication prescribed too.
Recently had a root canal performed on an upper right tooth (the one before the last molar) 3 days after being home I’m having WORSE pain than I had before going in. It’s weird because I’m getting pain obviously from the tooth they put a temp filling (I go to my reg dentist Aug 11) but I’m also feeling INTENSE pain 2 teeth up from it my “fang” it’s SEVERE like scale 1-10 it being a 15 pain. On the bottom and between.
I’m trying to get into the Endo for an emergency apt however it’s the weekend and they’re closed. I haven’t been able to eat anything not even soup bc everything is irritating my mouth. My regular dentist was unable to give me pain meds as he’s out of the country til my apt on the 11th but his nurse prescribed me the antibiotics you recommend. I’ve been on those for 2 days now. 🙁
I’ve had a lot of dental work done like my 4 front teeth are fake and I’ve had MANY root canals. This however has been the worst pain ever.
Hello Jamie, Sorry to hear you are going through this. 20% of all patients who have had root canal treatment and did not premedicate with antibiotics have pain after treatment. I always premedicate and never have postop issues. But this is where you are now. Your antibiotics have to catch up to the level of infection. It is OK to increase the dose from one Clindamycin 150mg every 6 hours to two Clindamycin 150mg every six hours. Doing the math, that is 300mg every six hours. Also, hold ice water in your mouth around the tooth. If the pain stops, it indicates that there is another canal that needs treatment, or there needs to be additional treatment on one or more of the canals that were just done. If the cold makes it worse, it would be from another tooth. My guess is that it is the tooth that you just had treated. It can cause radiating pain including to your “fang” as well as to the opposing teeth. For pain, alternate Tylenol and Motrin every four hours. Take two extra strength Tylenol to start. Four hours later take 600 mg of Motrin (Advil, Ibuprofen). Then start alternating. I hope this helps. I feel strongly that the ice water will keep you comfortable until the antibiotic kicks in. Good Luck, Dr. Silberman
Hello I woke up to ear and throat pain on my left side and I seen my doctor and they prescribed azithromycin. Later on the next day I realized it was my tooth because my face the lower part of my jaw is swollen and won’t go down to normal size. Right as the pandemic occurred I had two teeth that broke off at the gum-line on opposite sides of the bottom of my teeth (the bottom k9s) although there wasn’t any pain I was nervous to go in to the office since I have interstitial lung disease and im considered at risk. These last couple months I didn’t have pain until now but I’ve been rinsing my mouth with mouthwash, water/hydrogen peroxide mix, putting cold compress on my face 24/7. Any help please!!!! I’m allergic to penicillin and I’m currently taking predisone, iron pills, vitamin d and c pills, cellcept for my lung disease and allergy medication!
It is safe to go back to the dentist. While we were closed during the early stages of the Pandemic, we spent many hours a day on webinars to learn about the virus and how to deal with it. Most dental offices have taken the precautions necessary to be able to open safely and treat patients without great risk. My suggestion for you is to get back to the dentists ASAP to have the infected teeth extracted. You should inquire about their safety protocols first and let them know of your concerns. And by the way, you have been doing the right thing by applying cold compresses (not heat). I hope that helps and good luck to you. Dr. Silberman
Have a broke lower tooth I’m in clinda 300 mill 4 times a day and its been day 3 and the pain is still terrible on and off but mostly on …how long can this go on for?
Hello Dennis, Clindamycin is the drug of choice and sometimes takes a few days to kick in. It works faster if you have not applied heat. No hot liquids, hot compresses, hot showers, saunas etc. If the tooth is not sensitive to cold, hold ice water in your mouth around the tooth and the pain should subside without a minute. Keep ice water in the mouth as often as you need it to stop the pain. Also, apply cold compresses to your face to cool down the area. You can get eugenol liquid and apply it to the tooth. As for medication, take two extra strength Tylenol every 8 hours (2 x 500mg) and three Ibuprophen (3 x 200mg) every 8 hours. Alternate the Tylenol and Ibuprophen (Motrin, Advil) so that you are taking pain medication every 4 hours. Have your dentist render treatment as soon as possible, either via root canal therapy or extraction. I hope that helps. Good Luck.
Dr. Silberman
I just wanted to say what a GREAT dentist and person you are. Most people will not answer questions unless you are their patient, and I’ve read your responses to everyone. Absolutely kind of you to do so. I was directed here after googling a question, and you had answered my exact question. Thanks for being such a great Doctor. You are appreciated
Wow! Thank you Chris. It was very nice of you to take the time to write this comment. I appreciate it very much. You should know that this is the first actual response from any individual that I have received, and ironically it was not prompted from a response of mine to you personally. I often wonder if my advice has been heeded, much less appreciated. LOL So thank you again. Have a wonderful Thanksgiving tomorrow, and stay safe in this crazy pandemic. Follow science and wear a mask. Dr. Silberman
I wholeheartedly agree with Chris comment. This is the most caring informative dentists site I have seen while searching for toothache relief in the middle of the night.Google pulled up this site and I so wish I didn’t live half a country away . Dr Silberman would be my new dentist !! To take the time to reply so kindly and thoughtfully to all these questions must be the consuming. God bless you Dr. Silberman, your answers help more people than you can possibly know. I wish more people would acknowledge that.
Hello Jim, Thank you so much for your kind words. Whether it’s a pandemic or this crazy world in which we live, (though it’s cliche’) we are all in this together. Giving of oneself with no expectations for something in return is its own reward. I am just happy that I can share information to those who need my help. Your note of thanks just adds to my rewards. So thank you very much. And if you ever move to Waldorf, Maryland, it would be my pleasure to take care of your dental needs. Best, Dr. Silberman
Yes I have to agree with previous comment ! You are a wonderful REAL dentist who knows what he is talking about , who truly cares about others tooth pain /problems and gives the best advice FREE idk one that would do such a thing like you doc .your the first dentist to mention the cold water thing lol everyone including some dentist thought I was crazy when I would say that’s the only thing that helps my toothache ! ( bring back old school dentistry’s” lol .google brought me here and I already know my diagnosis after reading comments lol . * bad tooth pain hole in tooth excruciating pain only relieved with cold water *
Thank you Kay for taking the time to write. It is interesting that such a basic thing regarding hot and cold stimulus is not understood by some dentists. But I’m glad we have access to information through the Internet to expand knowledge. Thanks again for your kind words. Dr. Silberman
Hello Dr Silberman,
I second what Chris said. Me too i was searching a question and google directed me to you and i have been reading along your answers.
Thank you so much for the advice and support you give to the people.
Thank you Ami. I appreciate your kind words and your taking the time to express them. Have a great day. Dr. Silberman
Hello, my lower first molar had a long standing caries and i had sensitivity, there was bleeding from the tooth so the dentist started rootcanal. all went fine without antibiotics and analgesics until the last phase of obturation. Just after the obturation, i started feeling pressure pain on biting and it increased eventually then it became continous. And the intensity increases after consuming hot liquids. It relieves after antibiotics n analgesics. Later when i visted to dentist he took an xray, there was no abscess but PDL widening, and a bit short post obturation radiograph. then why is the pain aggravated after the rootcanal therapy and it increases allot when i try gargling with hot saline water.
Hello Simran. Your description was helpful for making a diagnosis. If heat is still causing pain, there is still gas trapped in the tooth that is expanding when you drink something hot. The trapped gas can either be in a canal of the tooth that still needs to be obturated (filled). Or it could be the area at the tip of the root that is unfilled “short”, which is visible by the “post obturation radiograph.” Or lastly, it could be coming from an adjacent infected tooth that also needs root canal therapy. My guess would be one of the first two options, and the treatment would be the same. Removing the obturation and refilling the tooth to the apex (to the end of the root tip) and making sure all canals are filled is the most likely remedy. Also, whenever possible, I try to reduce the height of the tooth immediately following treatment so that when you bite together, there is no contact with the opposing tooth. This provides relief during the healing period following root canal treatment. The body will respond to this adjustment over the next few weeks with “equilibration.” The tooth will gradually rise back into contact again and become fully functional on its own. I hope that helps and good luck to you. Dr. Silberman
My upper jaw hurts tremendously. It’s the top back tooth. I took 2 extra strength Tylenol. I was not even able to sleep. I stayed up all night today. The only thing that seems to subside the pain temporarily is holding water in my mouth. The Tylenol didn’t seem to make a difference. I recently went to the dentist and was cavity free. So I am confused as to why it hurts to the extent it does.
Hello Julia, Given that the tooth feels better with cold water held in your mouth, I suggest you go back to your dentist to be re-evaluated, or go to another dentist for a second opinion. Relieving pain with cold water is usually a sign that you have an infected tooth. Gasses that are trapped in the tooth caused by the infection can expand from your body heat and put pressure on the nerves in and around the tooth. The cold water cause the gasses to contract and helps to stop the pain. The source of the infection could be from tooth decay (a cavity), a history of trauma, a fracture line, etc. Do not apply heat to your fact externally because it will draw out the infection to the surface and cause swelling. Continue with the ice water holds until you can see your dentist. I hope that helps. Dr. Silberman
I was having a tooth extracted last year and it broke. The dentist did a root canal and I’ve kept the roots in my mouth. Now I’m having severe pain not relieved by cold water and barely touched by Norco and prescription strength ibuprofen. I’m waiting for my dentist to call in an antibiotic as their office is closed til Monday. I just want the pain to stop!
Hello Jennifer,
If your “tooth was being extracted and it broke”, why did they decide to try to save it by doing a root canal? It is possible that when the tooth broke, another crack formed going down the root. The crack would give sanctuary for bacterial growth and the only way to fix the problem would be extraction. An antibiotic will quiet the situation, but it sounds to me like that tooth / root should come out. I hope that helps. Good luck. Dr. Silberman
Im pretty sure i have an abscess. I went to the er cuz the dentist isnt open. They gave me amoxicillin and hydrocodone/acetam for the pain and its not helping. When they gave it to me at the hospital it worked just fine but im on day 2 and now its not. I have to keep cold water in my mouth just so im not in pain. What do I do?
Hello Brittany. Sorry to hear you are going through this. It sounds like you have an abscessed tooth. The ice water helping with the pain is the way to definitively diagnose an abscess. I am not a fan of Amoxicillin for tooth infection though it is commonly prescribed for it. Because you have already started on it, I would stick with it if the dosage was 250mg three times a day. I would suggest increasing the dose from 250mg three times a day to 500mg three times a day. If you started at 500mg, I would switch to Clindamycin 150mg four times a day. It is more effective against tooth infection than Amoxicillin, in my opinion. It is important that you have no GI issues (ulcers, colitis, IBS, Crohn’s Disease) in order to take Clindamycin, but I believe you will get relief more quickly. And of course, have the tooth treated by extraction or root canal therapy to resolve the problem. I hope this helps. Good luck. Dr. Silberman
Im pretty sure i have an abscess. I went to the er cuz the dentist isnt open. They gave me amoxicillin and hydrocodone/acetam for the pain and its not helping. When they gave it to me at the hospital it worked just fine but im on day 2 and now its not. I have to keep cold water in my mouth just so im not in pain. What do I do?
This was a duplicate and I responded already. Good luck. Dr. Silberman
I took advil or tynenol with cold water. My orthodontist suggested try rinsng your mouth with salt water. It will get better as your teeth align.
My sister pregnant her wisdom tooth have a cavity nothing is working we tried everything the dentist won’t pull it because they have to put her to sleep the tooth pain wake her up at night she can’t sleep or think
There should be a way to get this tooth numb without putting your sister to sleep. I suggest going for a second opinion. Also, the dentist could numb the tooth and remove the part that’s causing the pain. After delivery, she can go back to fix the tooth. Good luck and I hope she has a happy and healthy baby. Doc
Two teeth extracted that were infected I was on antibiotics 2 weeks before extraction…now it been 5 or more day and seems to be still draining and pain I have been on antibiotics for over two weeks now what so I do help joy
Hello Anthony, You need to go back to the dentist and have them evaluate the extraction site. It is possible that you have what is called a dry socket. When a tooth is extracted, a blood clot forms where there roots of the tooth were, filling in the void. The clot keeps the inner bone covered and keeps air from reaching the exposed bone surface. If the clot is lost, the exposed bone has nerve endings that cause pain. The dentist can pack some material in the site to cover the bone and stop the pain. More antibiotics would not help this condition because it is not an infection. Also, there may be something else going on if there is both pain and drainage. A dry socket usually has no drainage. Regardless, you should go back for a re-evaluation. I hope this helps. Good luck and stay safe during the Covid 19 Pandemic. Dr. Silberman
Hello. I have some dental problems at front teeth and others as well.
One morning i woke up with headache, nose pain. I took antibiotics and pain killers but the nose pain never went away.
After few months started feeling the pain at ears, eyes, and overall feel tired .
I went to neurology and did an M.R.I which showed nothing wrong at the head. Did a C.T. at nose which showed nothing wrong. Can these symptoms be related to teeth problems? thank you
What kind of problems are you having with your front teeth? An abscessed upper front tooth can cause “nose pain” as well as headache. I suggest you go to a dentist for evaluation. A serious complication known as cavernous sinus thrombosis can occur if an upper front tooth abscess goes untreated. Do not delay. Do not apply heat too your face and stay away from hot drinks. If you are cleared by a dentist, you do not have to avoid those things. Good luck to you. I hope this helps. Dr. Silberman
You give great advice and I need some badly!! I am very young and need all teeth pulled and a full denture. I went to a local dentist 3 days ago when I started having unbearable pain. This dentist wanted nothing to do with me since after insurance id still owe $7,500 and don’t have it. They just wanted me out of their office at that point. The next day my face blew up like a balloon and I knew I had an infection so I had to go to the hospital for antibiotics. If you can tell me in your experiences, is there anything I can do? Insurance will cover 7 teeth annually but will I find a dentist who will be willing to pull the ones causing me pain that’ll be covered? Or will everyone want to do the whole job or nothing?
Hello Nicholas, So sorry to hear you are going through this. The important thing is to get the infection under control, and it sounds like you are on the road to making that happen. The antibiotics will quiet the problem, but not cure it. It will buy you some time to get a game plan in place before moving forward with treatment. Remember to avoid applying heat to your face, being in the sun, or anywhere that’s hot, because that will bring out more swelling until such time that you get the treatment you need. Now to the game plan: Find a dentist who will work with you. If you have a credit card, charge the work and pay it out over time. If you don’t have enough credit limit, ask if they have a credit service like Care Credit. This is a medical / dental line of credit that can only be used for health purposes, and qualifying for credit is easier. Your dental insurance is there to help, but only slightly. Many policies have a limit to what they will pay annually per person. They are in business to make money and they know how to structure your policy, not to help you, but to be profitable. Ask for a treatment plan proposal from the dentist. This will break down the cost of each treatment, including each tooth extraction and any extra care required during the extraction process. It will also list the cost of the denture. Get a proposal for both an immediate denture and a permanent denture. The immediate denture would be inserted at the time of the extractions so that you will always have teeth to smile with, and it will act like a bandage covering the extraction sites. After the mouth has healed, you would go back to have a permanent denture made. The reason for the two dentures is that, during the healing process following the extractions, the gum will shrink and get healthy and tight as it pulls away from the immediate denture. That space between the gum and the denture will cause little if any suction and they will become loose. The permanent denture will match the healed gum area precisely and will hopefully prevent the need for any adhesives to hold the denture in place. Once you get the permanent, the original immediate can be sent back to the lab for a reline. That way it will fit your mouth as good as the permanent one, but it offers you a backup in case of emergency. The dog will love your denture and chew it to pieces, and when that happens, you’ll have a backup. So be warned, take your denture out at night to give your gums a chance to breathe (never leave it in overnight except for the night following your extractions) and when you do take it out, put it in a safe place out of reach of the dog. I hope that helps. Good luck to you. Dr. Silberman
Hello, your information and these questions/comments have been so helpful. I have a question I’ll try to keep short. I haven’t had insurance so haven’t been to a dentist in several years. I went to urgent care for two infected teeth at the same time. They prescribed amoxicillin 875mg 2x/day for 10days. It will be a week tomorrow and one tooth the abscess went down on my gum and is fine but the other has gotten just a LITTLE bit better pain wise during the day but when it hits about 3:30 I feel so much pressure, feels like my tooth is going to explode, hurts in my jaw, throbbing, can feel every breath I breathe inside the tooth and sometimes pain into my ear. I get a headache and I’m taking Tylenol and ibuprofen but I feel like I’m taking to much. I have an appt Monday the 22nd for X-ray/exam and extraction if they can do it same day if it doesn’t need surgery. This particular tooth use to have a filling and over a year ago the filling came off and it has a huge hole and the hole goes very deep into my tooth. I’ve tried so many home remedies and most just give a quick temporary relief I’m in so much constant pain I’m completely worn out and I have 3 kids 🙁 Do you have any recommendations? I go back to work next week and I’m praying I can figure something out for relief. Thank you!
Hello Kelly, Sorry to hear you have to cope with this AND take care of the three kiddos. That’s really challenging. It sounds like you have two different types of infections going simultaneously because the Amoxicillin was effective for one and not the other. The one that was not helped is the one with the hole. Your description of being able to feel every breath tells me that the tooth is still alive, and applying ice water would not be helpful, but would be detrimental. Often in severe toothache situations, applying ice water helps, as you’ve probably read in some of my other answers. Not in this case. I would call the dentist and explain your situation, and ask to be put on a short call list. Hopefully you can be flexible and get in to see the dentist ASAP. I have a same day emergency policy. I will see anyone in pain the same day to at least be able to make a diagnosis and recommend treatment. The best home remedy for a cavity as you’ve described is some form of cloves. Clove oil can be put on a small cotton ball and placed into the cavity for relief. Any pharmacy carries it. Or you can literally grind up cloves and add a drop or two of olive oil and place that paste into the cavity. Cloves is the key to relief, plus covering the exposed area with a clove paste will protect it from the air. Continue alternating Tylenol and Motrin every four hours. If your dentist can’t see you until the 22nd, call other dentists to find one that will take a same day emergency. Online reviews are helpful in making the right choice. I hope that helps. Good Luck, Dr. Silberman
Rinse with warm salt water, Infection in your mouth can spread quickly. Do not use alcohol as this causes inflammation to your gums making it worse.
Hi Deborah! Thanks for sharing. Warm salt water rinses are an easy and effective way of preventing the spread of infections
I have had a toothache for over a month. The dentist extracted my back tooth but I am experiencing severe pain in my lower tooth that is a root canal with a crown. The dentist did x-rays and said there is nothing wrong with my root canal. Is sending me for a 3-D image to see if there is a crack. Appointment is a month away!!! What can I do for the severe pain until then???
Hello Victoria, The 3D x-ray is the correct next step in the diagnostic process. But waiting a month would be challenging. Call your dentist and tell him/her what is going on. See if there is another dentist with the 3D technology that could get you in sooner. To get some relief while waiting for the 3D, the dentist could reduce the height of the tooth slightly so that the opposing tooth isn’t constantly impacting it. Also, a round of antibiotics (Clindamycin 150mg every six hours for 10 days) would probably help with the pain. I hope that helps. Good Luck, Dr. Silberman
If your old its all good, if not then be sure to lay of acid drinks and candy. And don’t brush your teeth right after eating these, wait at least an hour
Why does it hurt so much worse when I quit using cold water. Will it eventually stop hurting like that or will I have no choice but to try to withstand the pain when stopping the use of cold water. It hurts so bad when I stop using cold water I can barely talk. It like no pain I’ve ever had
There is an infection in your tooth. The bacteria (germs) in the infection give of a byproduct of gas. The gas can’t escape and is trapped inside the tooth. Applying cold to gas makes it contract and takes pressure off the nerve which stops the pain. A dentist can numb the tooth and open it to allow the gas to escape which will stop 80% of the pain. You can save the tooth with root canal therapy or have it extracted. I hope that answer helps.
I can’t afford to go to a dentist someone told me to go to the local feed store and buy fishbiotics cephalexin is this a suitable substitute till I can get into the dentist
Hello Worried, That’s an appropriate name for how you should feel if you are considering taking fish antibiotics. While it is true that the antibiotics used to treat fish are the same as humans and other animals, it is the only pharmaceutical group that is unregulated. You have no idea if the strength per dose is accurate, or what the purity of the product is. The cost of the fish antibiotics would probably be around $30. For a little more, you could see a dentist and get a proper diagnosis with treatment options. Call some dental offices and ask if they could see you to have an evaluation at minimal cost. If you need an antibiotic, an appropriate one can be prescribed. An alternative is to go to an emergency room or urgent care, and they should be able to prescribe for you too. Your best bet is seeing a real dentist. Call some dentists and explain your predicament. See if one will take you to diagnose the problem and take an x-ray for a set fee. Good luck. Doc
This is the problem I have, the cold water takes the pain away but 10 seconds later it comes back even worse so I have been drinking cold water constantly for the entire day, I’m worried about what happens when I have to go to sleep because I wont be able to drink water.
Ice water is an excellent means of keeping severe tooth pain under control. It doesn’t work in all situations, but when it does, it’s immediate and often total relief. When gases are trapped in a tooth, your body heat is enough to expand those gasses and it puts pressure on live nerve endings. The cold water lowers the temperature and relieves the pain. You may have a sleepless night because it might be the only thing that works until a dentist can give you some dental anesthetic to numb you. At that point, either the tooth can be removed or an opening in the tooth can be made to allow the gasses to escape. Either way, the pain should be relieved.
Hello Dr,
I’m currently in intense tooth pain. I was told by a dentist that I need two root canals and that I have an infection in one of them, the other one is cracked. I just graduated and have to travel back to my country next week, but I’m afraid that the pain in the airplane will be unbearable. Currently the only thing that keeps the pain away is taking sips of cold water every 30 secs. While traveling though, I won’t be able to do that because I need to wear fsce protection due to covid. Can you please suggest some strong medicine that will numb the pain for the entire trip? It’s just one day. Thanks in advance.
Hello Leandro. Sorry to hear that you are going through this. You have found the short quick fix to calming a tooth in an advanced state of infection: sipping ice water. An antibiotic will help to stop the pain by eliminating the bacteria that are causing the problem (gas trapped in your tooth). But it will take 48 hours. Until then, I would continue sipping the ice water. I would suggest alternating 2 Extra Strength Tylenol and 3 over the counter Motrin. Take one or the other every 4 hours. The antibiotic of choice is Clindamycin 150mg every 6 hours (if you are not allergic to it and if you have no gastrointestinal issues). You could go to an Urgent Care if you can’t get in to see a dentist. You could get a prescription from them for the Clindmycin, and possibly for a narcotic for pain. If you can avoid the narcotic, I would advise it. Bottom line is that you need to get these teeth treated, either with Root Canal Therapy or extraction. Everything else is a temporary fix. I hope that helps. Good luck. Dr. Silberman
Whenever my mouth is empty I’m in extreme pain, I’m having to keep cool water in it at all times. I’ve taken over the counter pain killers and they don’t seem to be doing anything for the pain. It hurts all over I can’t tell where it’s coming from, it hurts to eat or have anything to hot or cold. Even going just a few minutes without a liquid in my mouth about brings me to tears. I called my dentist but they are closed due to the virus.. I can’t sleep or do my job like this. They called me in amoxicillin 500mg but nothing for the pain.
Hello Kedanna, From your description, it is very hard to make a diagnosis. The fact that it hurts all over the mouth leads me to believe that it is a tissue problem not a tooth problem. An abscessed tooth is usually localized enough that you can tell which side of the mouth the pain is coming from. But a tissue problem (cheeks, gum, tongue, palate) can all be inflamed if there is something else going on. It could be a bacterial or fungal cause, and the treatment for them are different. Your dentist should have an emergency number where you can reach out to someone on call. If they don’t, call another dentist locally until you find one that will accept your call. They should be able to ask the right questions and have you take pictures with your phone to send to them so that a proper diagnosis can be made, and the appropriate prescription medication can be offered. If I am right, a prescription for Magic Mouthwash would be very helpful. It is a combination of Benedryl, Kaopectate, and Lidocaine. The Benedryl acts as an antihistimine, the Kaopectate coats the inflammed surfaces, and the Lidocaine numbs it to give temporary relief until the correct antibacterial or antifungal medication is taken. I hope that helps. Good Luck. Dr. Silberman
I’m 21 and I have tooth on my left bottom side (two teeth away from my wisdom teeth that are also coming in) an it’s hurting so bad its causing me an extreme earache as well, I tried Coconut oil pulling but it hasn’t really helped and my 500mg Ibuprofen isn’t helping either. It’s to the point I can’t even sleep I just toss and turn at night. I don’t know what to do!
Sorry that you are going through this Annabelle. It sounds like you might have an infection in your tooth and you should see a dentist who would be able to diagnose the problem. It may need an antibiotic to help stop the infection and the pain. If you can’t see a dentist, go to an Urgent Care or Emergency Room. Though they don’t have the diagnostic skills of a dentist, they would be able to put you on an antibiotic to quiet the situation until such time that you can get to see a dentist. If the tooth is infected, it might need to be extracted. Or it might be saved with root canal therapy. So get to your dentist or ER as soon as possible and stop the pain. The treatment of choice is easier to select when you aren’t hurting. Good Luck, Dr. Silberman
Is it contraindicated to have my tooth extracted if I am still having a toothache?
No. If you have no swelling or minimal swelling, having the tooth extracted should not be a problem. There may be other medical complications that would prevent the dentist from doing the extraction, but that should have been reviewed by the doctor already. If not, I’m sure they will look at your medical history to determine if it is safe to extract your tooth.
Hello Robert! Thank you for commenting. We believe everyone, regardless of age, should be aware of sugary and acidic drinks or foods.
And great tip on waiting to brush! It is proven that you should wait to brush after having acid in your mouth or else it can further damage your enamel.
Hello my lower broken tooth is causing me a severe pain to the point i hit my head and wish for death,i went to the dentist today and he gave me some antibiotics to heal the abscess before removing my tooth i went home and took the meds it stopped for only 2hours and started hurting like crazy again and it wont stop at all i dont know what to do :’) helpp
Hopefully your situation has been resolved. For pain management, we recommend alternating Tylenol (2 x 500mg tablets) with Motrin (Ibuprofen, Advil, 2 x 200mg tablets) every four hours. Do not take more than 6 Tylenol or 6 Motrin in a 24 hour period. If the tooth isn’t cold sensitive, holding ice water in your mouth can quiet the pain. I hope you are doing better now. Best, Dr. Silberman
I went to a DDS for pain in tooth #18, which was throbbing somewhat and sensitive to pressure. X-Ray showed this tooth previously had root canal treatment, so he assumed the pain was referred from tooth #19 and performed a root canal on that one. Over the next 2 days the pain worsened, still apparently emanating from #18. I went back in at which point I was referred to an endo specialist who would not be able to see me for 5 days from that point. I was given an Rx for antibiotics and told to take double the max recommended dose of Advil to manage the pain. Today the gum around the tooth is quite swollen. The pain is unbearable. I would have preferred to try to save the tooth but at this point will try to find someone to extract it in order to obtain relief. How common is it to have a previously endo treated tooth to cause issues? The root canal had been done over 10 years ago.
Hello Mika,
A tooth that has had root canal treatment can fail and eventually need extraction. My success rate on root canal treatment is 98%, provided that the patient follows up that treatment with a supporting post and core filling and a crown. Some of the causes of root canal failure include a missed canal that needs filling. Usually this will flair within a year of the original treatment, but it could take several years to become symptomatic. Of course it is best to find and treat all of the canals at the initial treatment, but if not, it can be treated successfully later. It is rare for a missed canal to flair after 10 years. The more common cause of root canal failure after 10 years is that the tooth can fracture. Bacteria can develop in the crack and there is nothing that can be done to fix the problem except to extract the tooth. There is less frequency of fracture if a post is placed in the main canal to give internal reinforcement to the tooth. I like to make the comparison that it is like rebar in cement. Not all dentists do this, but I’ve seen too many molars fracture without the help of the post. Just my opinion. Once extracted, the tooth can be replaced with an implant in most cases. There may be a bone graft placed at the time of the extraction to facilitate the placement of the implant at a later date, in 3 or 4 months. I hope that helps. Good Luck, Dr. Silberman
I have a visable abscess in my mouth and the pain is killing me. I have antibiotics, but is there anything I can do to alleviate the pain a little until I can get to the dentist Wednesday
Sorry you are going through this. The abscess tells me that there is no “feeling” in at least one root of the tooth. The pain is coming from the infection outside the tooth or from one of the other roots that still have feeling. A quick remedy is to hold Ice Water in your mouth in the area of the affected tooth. It should take away the pain for a while and can be continually reapplied as needed. Once the antibiotic kicks in, the frequency of the need for ice water should decrease. Hopefully, the other teeth are not sensitive to cold or this becomes a trade-off.
The reason ice water helps is because the bacteria inside the tooth give off a bi-product of gas. The gas is trapped and has no way to escape. When gas is heated it expands. Your body heat may be enough to cause it to expand and put pressure on the nerves causing the pain. The ice water gets the gas to contract and remove the pressure from the nerves. You may have to keep ice water on the night stand next to the bed if the pain wakes you. Take a swig and hold it around the tooth, then swallow and go back to sleep.
Where are you located?
I hope this helps. Good luck!
My molar tooth cracked and my tooth nerve was alive so the dentist put a crown on it without a root canal(DEC). He did mention that I may need one down the road. Anyways, I finally got the new crown on (end of Feb) and this month I have an abscessed next to my gum. It does not hurt unless something very hot or very cold is put on it. I am on antibiotics and have to wait a month to finish my root canal( the dentist started it) with an endodontist. Not understanding how I could have no pain but an abscessed on my tooth. It can get irritated with food, especially salty food; on the other side I have a temporary crown on a canine so I can’t eat on that side. Lastly, when the dentist went into the fake tooth a smell came out. Awful smell- is that from the bacteria? Never smelled it before. So happy he did not smell it. OMG. Does the abscess go away after my root canal is finished? Or how does it go away?
TY
Hi Maryanne, Sorry that you are going though this. Your dentist has provided you with excellent care. I agree that in your situation, I would have placed a crown on the damaged tooth in hopes that it would heal and not require root canal therapy. Each tooth has it’s only blood and nerve supply and the tooth shelters this from the bacteria that are in your mouth. But if a tooth cracks or decays, sometimes the bacteria can get into the tooth circulation. This may or not cause discomfort or temperature sensitivity. The bacteria take over inside the tooth and the blood and nerve gradually disappear. The abscess forms as the bacteria increase in number. That can result in swelling or pain or both, or sometimes a pimple forms to create a relief valve. Instead of pressure building up in the tooth and the abscess, the pimple (fistula) allows for drainage and relieves the pressure, and there is usually no pain. The root canal treatment cleans out the bacteria from the hollow spaces of the root while leaving the actual roots intact. Sometimes it smells really bad, like in the case of your tooth. Once cleaned out, rinsed and dried, the space in the roots are filled with a plastic type material that flows into position. That process eliminates the bacteria from the tooth, and the antibiotics kills the bacteria outside the tooth in the jawbone and gum. The infection goes away and everything heals within a few weeks, if all goes according to plan. I hope that answers your questions. Best, Dr. Silberman
I will tell you I am on antibiotics now for 4 days !! and I have been taking ibuprofen 800 milligrams and alternating and IT DON’T WORK! I have also took a tramidol 100 milligrams! and IT didnt work the pain was so bad that I turned my head upside down to stop the pain for just a bit of relief!!! anyone who has pain get ambensol!!! the gel kind it is magic!!!!!!!stops the pain instantly!!!
Hello Sara, If Ambesol worked, the problem is likely more gum related than tooth related. Tooth pain would be unaffected by a topical anesthetic like Ambesol. Having said that, the antibiotic of choice for gum problems is one in the “cillin” class, like Amoxicillin. You should be taking that every 8 hours (500mg). If it is a tooth problem, Clindamycin is the drug of choice, either 150 mg or 300 mg every 6 hours. The correct antibiotic should become effective after 48 hours. For gum problems, warm salt water holds in the mouth would be helpful. A teaspoon of salt in an 8 ounce glass of warm water held for a minute or two every few hours will help. I hope that helps.
Hello Dr so recently the nerve in my tooth died and it was also infected around my gums and was spreading but my dentist put me on antibiotics and I alternated between two pain medications it’s been 4 days and the swelling and infection is going away and there’s no more pain now I just have to get a root canal I was just wondering if I could take a hot shower because I know if u apply heat to an infection Thats not good and I don’t want the infection coming out so is it okay if I take a hot shower?
Hello Russell, I wouldn’t allow the heat to be in contact with the area for very long. I have seen where a sauna caused an abscessed tooth to swell the face considerably. Take your hot shower but don’t let the hot water run on that side of your face, and don’t stay in for too long. Have a cold compress ready to apply to your face when you exit the shower, just to be on the safe side. Good luck. Doc
I’m going through some hella pain with an abscessed tooth right now. It just started yesterday. My whole tooth is gone and all that remains is the root under the gums. The pain is unbearable. But I was always told that cold water was bad to use as it holds the infection in where warm water extracts it out, but ice cold water is the only thing that works for me. Glad to see a professional recommending it. Even though it only lasts a few seconds at most. I was also told not to swallow the water because then I’m just swallowing the infection and that can cause me to be sick. Is that true?
Hello Stacey, So sorry to hear that you are going through this. Yes, the cold water held in the mouth will stop severe pain in some cases, but just for a short while, as you stated. It is OK to swallow the water. That is not going to pass your tooth infection to the digestive tract. Hopefully you are going to a dentist ASAP to have that root removed today. Or at least be put on antibiotics which will stop the pain in 48 to 72 hours until such time that the root can be removed. As for the controversy between heat versus cold, the rule of thumb is to never apply heat externally to the face to soothe a tooth infection. That will draw the swelling to the outside of your face. If there is gum related swelling or following an extraction, warm salt water holds inside the mouth will help the unhealthy gum tissue to heal. Cold can be applied externally, but I’m not sure how much that will help. When cold is held in the mouth to stop the pain, the reason is because there are gasses trapped in the root with no place to escape. The gasses are formed from bacteria in the infection. Cold water causes the gas to contract and take away the pain. by removing pressure on the nerve. I hope you feel better soon. Best, Dr. Silberman
I broke off a small piece of my upper back molar a month ago. The dentist suggested I have the tooth pulled, but I pressed for other options. The dentist then put a filling in after cleaning out the decay.
Now the tooth is throbbing..I went back in yesterday, the dentist tapped on the tooth and it was not sensitive. She said the filling looked securely sealed. She told me to gargle with warm salt water. (I just put a hot press on the gum area and it feels good.)
Our options are.
1.Pull the tooth. My dentist said this would not jeopardize the integrity of my other upper teeth and would not be noticed.
2. Seek out a dentist to do a root canal.
3. Hope that the heat treatment will calm down the ache.
What do you suggest?
Hello Theresa. Did the dentist run any other tests besides the tapping test? Did the dentist take an xray to see if there was any infection visible at the root tip? Did the dentist test the tooth with cold and compare it to your other teeth? Did the dentist check your bite with carbon paper to see if the filling was high? Did the dentist apply an electrical stimulous to determine if the tooth is still alive? All of these tests are critical to make a diagnosis and to present treatment options. If warm salt water makes it feel good, it could very well be a gum issue. It is possible that something is stuck under the gum, like a piece of popcorn, and it may loosen on its own with warm salt water. Depending on the results of the tests listed above, the tooth may need root canal treatment to save it. Or it can be extracted if you decide that the cost of the root canal is too great. FYI, do not apply heat outside the mouth. No hot compresses, saunas, hot tubs, etc. If the tooth is abscessed, the external heat will cause face swelling and a lot more discomfort. Warm salt water inside the mouth is OK if it relieves the pain. I hope that helps. Good luck.
Dr. Silberman
Hi Dr 🙂
I realized last Sunday (5 days ago) something was not very well with one of my wisdom tooth (already grown). I saw a dentist on Tuesday and she confirmed that the tooth is going through an infection and needs to be pulled out. Therefore since 3 days I am getting Amoxicillin 1000 mg 3xday, and I must wait at least one week for the imflammation to disappear and have my tooth pulled out.
I don’t have an extreme pain, but the whole area (including my ear) is swollen; I find it almost impossible to open my mouth (only eating baby food). My question is: is the antibiotics my dentist prescribed enough? Or I have to take something else as well?
Info+.: we are having very hot temperatures where I live now (40 degrees) can it also have an impact ?
Thank you a lot!
Hello Patty. Sorry for the delay in getting back to you. Hopefully the problem has been resolved by now. But for anyone else reading this and having a similar problem, it does take time for the antibiotics to kick in and reduce the swelling. I would suggest warm salt water rinsing to help bring down the swelling. Also, apply cold compresses (never hot) to the outside of your face. Any external heat will increase the swelling and pain. That would include weather related, or sauna, or hot tub, or any other source of heat. Keep it cool. I hope that helps. Good Luck, Dr. Silberman
Hi Doc! How long does it take reversible pulpitis to reverse?
Hi Dana, I usually tell my patients that antibiotics will quiet a tooth within 48 hours, but it won’t fix the problem. It lessens the pain by 80%. The fix is an extraction or root canal therapy and either will stop the pain completely. I hope that helps. Doc
I am having a tooth pulled tomorrow that has had a root canal in the past. My face is super swollen and draining out of my nose. I am on antibiotics. Can I apply a warm wet wash cloth to help the abscess drain?
Do not apply heat to your face. It will draw the infection to the surface and create severe swelling. It is OK to apply cold compresses. You should not have tooth infection drainage from the nose. There should not be communication between the sinus and oral cavities. Be sure you tell the surgeon at the time of the extraction that this has been your experience. It may be necessary to apply a membrane that will separate the extraction site from the sinus to create proper healing.
I had a tooth pulled a year ago. This week I have developed an incredible throbbing pain on the gum in the tooth extraction site. What could this be?
There are a few possibilities. If part of the extracted tooth was left behind, it is possible that your body is still healing and pushing the fractured piece to the surface. Essentially, you are “teething” as the fragment pushes out through the gum. Another possibility is that a neighboring tooth is acting up and it’s very difficult to determine exactly where the pain is coming from. If you are having any sensitivity to cold, hot or pressure, the problem is likely another tooth. In any event, you should see a dentist to have the site x-rayed and evaluated. I hope that helps.
I have severe toothache, been to the dentist and nothing is visible on the xrays. The pain is unbearable, if I sip on cold water the pain subsides but only for a minute. I’m on antibiotics and painkillers but nothing is making is easier, it gets worse every day. Not even able to fall asleep, the pain is just horrific.
What should I do?
You have a tooth that is infected. It is in the early stages of infection so it does not show up on the x-ray, but that doesn’t mean the pain is any less. The bacteria causing the infection have a by-product of gas. There is no escape route for the gas to get out of the tooth so it gets trapped in the root where the nerve is located. The pressure from the gas builds up and causes the pain by pressing on the nerve. When you sip something cold, the gas in the tooth contracts and takes the pressure off the nerve, and the pain stops. But it is very temporary. It confirms the diagnosis. Also, if you take your finger and tap on that tooth, it will feel different from the other teeth. Sometimes the difference is very mild and sometimes severe. It just depends on how advanced the infection is. Bottom line is that tooth needs a root canal treatment to be saved. The alternative is to have the tooth extracted. Good luck. Doc
Thanks for the tip Dr. Silberman. It is indeed interesting to note that heat can actually cause inflammation in your tooth, since warm saline water is considered a useful home remedy to tackle infections. Rather it is the hot spicy foods which can cause gum inflammation.
Warm saline rinses are a good home remedy for minor gum swelling. An abscessed tooth is a different story. It is best not to apply heat externally as it will draw the infection to the outer surface and potentially cause severe swelling. If the abscess is draining in the mouth next to the tooth, it is again OK to use warm saline to help with the draining process. No External Heat.
dear dr silberman, my front center top tooth is very loose and there is some pain. dental appointment is in a few days time. how may I reduce the swelling or kill the bacteria that is causing the inflammation please? thank you
Until the tooth is removed, hold warm salt water in your mouth around the tooth to help bring out some of the swelling. Once the swelling is reduced, it will feel more comfortable. Once the tooth is out, it will feel even better. I hope that helps. Best, Dr. Silberman
I went to the er today and I have a decyed tooth that’s hurting me server pain and can get my medicine until 10 in the morning anything I can do to get some relief until I get my medicine
If your tooth is not sensitive to cold, the infection may have killed the nerve inside the tooth, allowing the infection to pass into the jaw. The ER should would prescribe an antibiotic to deal with the infection. But if you have no sensitivity to cold temperatures, holding ice water in your mouth around that tooth will be a quick short term fix. The ER may also give you some pain medication, but if not, you should alternate 2 x 500mg Tylenol with 3 x 200 mg Motrin (Advil, Ibuprophen). Take Tylenol, then in four hours take Motrin, then four hours later back to Tylenol. Good Luck. Dr. Silberman
I recently got a crown put on a tooth that had gotten a root canal about 7 years ago. I never had any pain in the tooth for all these years. After the crown was put on(About a month ago), it was fine as well.
Up until about 4 days ago. I had felt like there was something stuck between by teeth. I flossed, and there was a bit of blood. The next morning I woke up with pain at about a 5, from 1-10. Every day it has gotten worse, to now it being at a 10.
I went to a dentist yesterday(The only one with openings on a Friday). They did xrays, and said that , my root canal “Didn’t work”. I’ve had years of xrays and have NEVER been told that. They said I would need to have it redone, set me up an appointment for 10 days from now. And here I am today. In the worst pain of my life. Waiting for 10 days from today.
Does this sound normal? There is no swelling. Just a little redness around the gum that touches the crown. My tongue cannot even lightly touch the tooth without terrible pain.
Hi Paige. Sorry to hear you are going through this. Without an x-ray to diagnose, it is very difficult to determine the problem. It is possible that the root canal needs to be retreated. It is also possible that there is a crack in the root of the tooth just below the newly placed crown and a retreatment won’t work. The tooth may need to be extracted. In either case, you need to be put on antibiotics to get the infection under control. Warm salt water holds in the mouth around the tooth might help bring out some of the redness and prevent swelling to help quiet things. Also, a combination of 400mg Motrin (Advil, Ibuprofin) plus 1,000 grams of Tylenol (2 extra strength) should help you with the pain. These are over the counter non prescription medications that are very helpful when used together. I hope that helps and I hope you can get in to see the dentist sooner. Call them and explain the situation and let them know you can come in at any time on short notice. Good Luck. Dr. Silberman
Hello doctor,
I have recently had a root canal on my lower left side which has been successful. After 1 week i started to get a root canal on my lower right side (tooth no 7). I have never experienced pain on that tooth despite always eating on that side all my life. After the first appointment my dentist cleaned the tooth and put temporary filling. But now my tooth is throbbing with pain. I went to him and got the filling removed and he says its because of trapped gas. Im currently using Metrolag, klavox and cataflam. But i just can not bear the pain. I cant do anything and only feel like weeping.
Hello Paige. If the Metrolag and Klavox antibiotics have not been successful, I recommend Clindamycin 150mg four times a day for 10 days. I find it to be more effective than the other antibiotics in the treatment of tooth infection. You cannot take this medication if you have gastrointestinal problems like Crohn’s Disease or Irritable Bowel Syndrome. Also, check to see that, when you bite together, do your upper teeth contact this tooth. If so, ask the dentist to reduce the height of the tooth to eliminate contact with the opposing teeth. That will help to stop the tenderness. The tooth reduction will be necessary in the future to accommodate a crown so don’t worry about adjusting the tooth height. In addition to the Cataflam, you should add 2 extra strength Tylenol every 8 hours to help control the pain. I hope that helps. Good Luck, Dr. Silberman
I cant get in to my dentist till tomorrow I am hurting I have taken ibuprofen, used cold pack nothing is working. Even did the salt water still nothing, I cant use ice water as this only increases the pain
Hi Wendy. You can take two extra strength Tylenol every 8 hours and 2 Ibuprofen every four hours. Don’t apply heat to the outside of your face because it could create and draw out swelling. If the pain remains as intense, you might need to go to an emergency room for care. I hope that will tide you over until you can see your dentist. Good Luck. Dr. Silberman
Im getting my tooth pulled in 6 dAys I believe an infection is beginning to abscess its a weekend, should i go to the emergency room to get antibiotics or can i wait until Monday to ask my dentist?
Hi Jessica, I would recommend that you go to the emergency room for an antibiotic. Or call your dentist that is going to be doing the extraction. If there is an emergency number for the dentist, he / she could call in a prescription for the antibiotic and you could save the emergency room visit cost. I am assuming that you have already seen this dentist and an x-ray of this tooth has already be taken. If you cannot reach the dentist, you should go to the emergency room. The antibiotic will take 48 to 72 hours to become fully effective so be patient. For pain, you can take 2 extra strength Tylenol every 8 hours, and 2 over the counter Advil (Motrin, Ibuprofin) every 4 hours. And remember to avoid applying heat to your face. Stay in air conditioning. The heat will draw out the swelling to your face and become very uncomfortable and unsightly. Applying ice is OK. I hope that helps. Good Luck, Dr. Silberman
I was told by a dentist that they couldn’t pull my wisdom tooth because i have another wisdom tooth growing under another so now im stuck wondering how im gonna get my wisdom teeth out can you help me?
Hello Rodneica, I am not sure exactly what your condition is. It is unusual to have a second wisdom tooth below another one. It happens, and in that circumstance, it is possible that the deeper one would be left in place and x-rayed every 3 to 5 years to make sure that there is no cyst formation around it. Consider getting a second opinion from an oral surgeon. Good Luck. Dr. Silberman
I’m having the absolute worst pain in my jaw , I’m visiting my family in ny and have an appointment with my dentist when I get home to California. Went to the Er twice first time I got antibiotics and a pain blocker shot , nothing changed for the better 4 days later my face was really swollen and the pain was 100 times worse went back this time I got a cortisone shot and some pain pills nothing Is helping I feel like I want to cut the inside of my mouth the drain the infection is there a safe way to do this at home
I’ve had a toothache on my right side a a few days and went to a dentist and was prescribed antibiotics and tylenol 3 with codeine. The pain med did not do anything. I had to end up getting whiskey and putting it on my tooth. About half way through my antibiotics the other side starts to hurt. I finish the antibiotics and still hurts on the left now should I call and see if I could get another round of antibiotics?
Hello Thomas, I would call the dentist and explain what you are going through. It’s possible that a different type of antibiotic would be more effective. Also, I am having just as much, if not more success, avoiding opiods like Tylenol with Codeine. Try alternating two extra strength Tylenol with 2 200mg Motrin (Ibuprofen, Advil) every four hours. In other words, take two Tylenol, then four hours later take two Motrin. Continue to alternate as needed. If you are not having cold sensitivity, it is possible that there are gases building up in your tooth that are causing your pain. Take a glass of ice water and hold the water in your mouth until the pain subsides. If trapped gas in the tooth is the problem, it will be relieved by the cold water. It is a temporary fix, but it works great. The treatment of choice would be extraction or root canal therapy. Good Luck, Doc
Hope all is well! I’m having some very intense pain on the right side of my mouth and found out tooth #31 is infected. I’ve been on antibiotics and am on the Tylenol/Advil rotation, which is helping a little bit but not much. I am scheduled to get all 4 of my wisdom teeth pulled along with #31 pulled at the same tile by an oral surgeon. Does that make sense to get them all pulled in one sitting? I’m quite nervous the post-op pain will be unbearable due to the infection on top of the wisdom teeth getting pulled. Any advice to calm my nerves and what do you think the pain will be like? I really appreciate your help!
The extraction of wisdom varies in the degree of complication. Easy ones require Tylenol or Motrin post-operatively while impacted ones require a narcotic for pain control. Adding the extraction of #31 to the mix will have no additional impact on the type of pain you experience. Once the infected tooth is removed, the pain goes with it and the extraction site heals. Usually I recommend patients take a day or two off to rest following extractions and minimize their activity, and modify their diet to be soft foods. Don’t worry.
I had a deep cavity on one of my top molars. My dentist did a filling 4 days ago. Everything was fine until the anesthesia wore off and I got home. I have been in SEVERE pain and I am very uncomfortable. The only thing that subsided the pain is when I fill my mouth up with water and let it just sit in my mouth. Strange but it works… also I am pregnant so I’m only able to take Tylenol for pain. I have tried orajel, clove oil, etc nothing is working. I really just want this pain to stop. I think my dentist may have drilled a little too much and possible irritated my nerve. First time I went to that dentist other than a cleaning. Please help.
Sounds like this was a cavity that was so deep, it caused an infection that your body was tolerating. The tooth was like a hornets nest of bacteria instead of bees. The dentist’s work stirred up the hive and you are feeling the result. The reason that the cold water helps is because there is gas that is trapped inside the tooth. The bacteria give off a by-product of gas and there is no escape. The cold water causes the gasses to contract and take the pressure off of the nerve endings. The treatment is to get the tooth numb and have the dentist open the chewing surface to allow the gas to escape. Once the gas is out, the pain will not come back after the numbness wears off. The next step would be to fill that space where the bacteria were, and that process is called root canal therapy. The alternative is extraction, but if you can save the tooth, try to do so. Good luck and I hope you have a happy and healthy baby. Doc.
Had a root canal yesterday and the doc said I would still feel the unbearable pain I was in before for a day or two afterwards. My question is why does the ice water trick still work after it was done?
If all of the canals of the root were filled, there should be no space left in which gasses can collect, so the ice water trick should not work. There are some possibilities. If the dentist did a partial root canal treatment and did not fill the roots, there could be gas build up and the cold water would work. Or if the canals were filled and one canal was overlooked, same holds true. Also, it is hard to tell if the pain is coming from the tooth that was worked on. It is possible that the tooth next to this one also needs root canal treatment, or one that is in the opposing jaw. Sometimes the brain gets confused and can’t tell if the pain is upper or lower jaw. I hope that helps.
Doc
I have had 2root canals on my front teeth after I had crowns put on them, but my nose and front teeth still hurt! Ice water helps them . Yet the doctors are telling me it is a nerve making my nose and teeth hurt. I have been on Clindamycin 3 times. Please advise as I don’t want to take a nerve medicine all of my life. Should I just have them taken out?
Hello Sandy, Assuming that the canals of the roots of your front teeth have been completely filled leaving no trapped gas pockets in them that could expand and contract with temperature change, the next likely cause of the problem is another tooth. Sometimes with tooth pain, it is difficult to isolate the tooth that is causing the pain. If ice water takes away the pain, it must be a trapped gas pocket in a root that is causing it. Front teeth are the least complicated when it comes to root canal treatment, so I have confidence that the source of the pain is not the teeth that have already received root canal therapy. Clindamycin is the drug of choice for tooth infection. If it made the problem ease up while you were taking it and then return when you went off of it, it is likely tooth infection that is causing the problem. That would be further evidence that it is another tooth. If the Clindamycin has no effect, it could be nerve inflammation, which is what your doctor is suggesting. A neurological workup is you next step in figuring out what’s going on. I hope that helps. Let me know if you have any further questions. Dr. Silberman
Several months back, I broke a tooth pretty bad. About three months ago I developed an abscess with puss coming out of it and I was prescribed an antibiotic, it seemed to work. I made a huge mistake and didn’t have it extracted at that time. So about a month ago the abscess came to visit again. My dentist prescribed Amoxicilin and scheduled an appointment for a surgical extraction. Well, my appointment wasn’t until this up coming Friday. About 9 days ago, the abscess was there again and the pain was beyond horrific. So, my dentist called in a Rx for Clindamycin 150 mg HCL to take tid for 7 days. I called my dentist yesterday because I had already completed the antibiotic, but there is still puss coming out and the pain is so horrific. I haven’t slept, but about a total of 5 hours in the past 3 days. I feel exhausted, but this pain will not subside for me to sleep at all. So, here I am at 3:50 in the morning and my dentist is squeezing me in at 3 PM to do the surgical extraction. I am counting down the hours hoping that it will come quick. My concern is, since there is still infection and Clindamycin did not work, what happens now? Will the extraction just clear up the infection? Can I take another antibiotic at this point if no other antibiotic has helped? I know very little about teeth, but I do work in a hospital and have a fear that I will get c-diff.
Once the tooth is extracted, the infection will clear without the need for additional antibiotics. The infection will have “an exit route” though the extraction site. I hope that helps.
Doc
Thanks so much. My tooth has now been surgically removed and the clot has formed well thus far, but the amount of pain I am in is horrific. I previously had 3 wisdom teeth removed and had less pain than what I am experiencing after this removal. My dentist said that OTC Motrin should work, but it doesn’t even ease the pain. What now? Do I just wait it out? Am I supposed to have this much pain?
Without seeing the xray, it’s difficult to answer your question. Most simple extractions that require no removal of bone have minimal post op pain and are treated with Motrin or Tylenol, or a combination of the two. I usually recommend alternating them every four hours. If you start with 400mg of Motrin (Advil, Ibuprofen), then take 1,000 mg of Tylenol in four hours. Then four hours later go back to 400mg of Motrin and continue alternating every four hours until you don’t need it anymore. If there was bone removed at the time of the extraction, some narcotic medication may be necessary until initial healing has set in. An intermediate medication that is a prescription but not as strong as some medications is Tramadol. You could suggest that to your dentist. Good luck. Dr. Silberman
so i had half a root canal done back in february and that tooth hurt for like 4 hours one night and then i woke up and my cheek was swollen. my tooth hasn’t hurt but it’s been swollen for 3 days now and i went to the dentist yesterday. he gave me antibiotics and nothing will take the swelling down. i’ve applied ice packs and done everything. idk what to do
Having half a root canal done is like delivering half the baby. Not good for you or your baby, or in this case, tooth. The roots of your tooth are like straws with a thick outer shell and a thin opening that runs down the center. These canals can be treated by being cleaned out and filled to prevent bacteria from growing in them. That is a root canal treatment. If you empty the canals and don’t fill them, there is no circulation or nerve in the tooth, so it will feel OK for a while. But without circulation, there is no way for your body to clean out the bacteria that will inevitably form in that dark, warm moist space in the canals. The bacteria build up in number and pass into the bone at the tip of the roots, causing pain and swelling. So here you are. If oral antibiotics are not working, you may need to be hospitalized for intravenous (IV) antibiotics. If the swelling is not too severe, you might be able to increase the antibiotic dosage orally. Consult with your dentist. Most importantly, do not apply heat to the swelling. It will dramatically make it worse. Good luck. I hope that helps. Dr. Silberman
Hi Dr. Silberman
I felt a bump on the gum below my second to last tooth on bottom and the dentist after taking an xray said he thinks it is a fractured root in a root canal tooth and might require extraction. I had iced it and the bump went from the front of tooth to behind it actually. When I went to dentist he drained it and I am on third day of antibiotic. I don’t have pain and the swollen gland has now disappeared but I do think there is a little swelling still on that side of my mouth. Does that mean that there still may be pus or could it be that the tissue is just inflamed… Should I be using ice externally still as well as a little internally holding ice cube.. Nothing hurts and antibiotic seems to be working but since it’s Thanksgiving week and antibiotic ends Wednesday want to keep any infection/bacteria at bay…
Also is it good to continue with warm salt water rinses and is using hydrogen peroxide rinse a bad idea… I know I once used that on my knee each day and it actually didn’t heal since it kept tissue raw it seemed… Nothing hurts but there seems to still be a little more fullness on that lower side of my mouth . If I do need it extracted do you know if usually there is a waiting period to see if the area reinfects to determine this.. Thanks for a great blog.
When a tooth is diagnosed with a root fracture, the only solution is to extract the tooth. The sooner, the better. It can be replaced in the future (implant, fixed bridge, etc). Minor swelling can occur with or without pus being present. The inflammatory response of the gum tissue can create minor swelling too. Warm salt water rinses on a tooth that has been previously treated for root canal therapy is fine as is rinsing with peroxide. Applying heat to a tooth that has not had root canal treatment is a bad idea.
I have been on antibiotics for about 5 days now, clindamycin and flagyll, due to a cracked tooth that is due to have a root canal in a few days. It has been extremely swollen and painful…it’s subsiding some, but I cannot open my mouth more than about a fingers wdith without major pain, and have been pretty much “eating” soups and stuf i don’t really need to open my mouth much to consume. I do have swelling in the jaw, and do cold packs off and on all day. Is there anything I can do to help with the pain and inability to open my mouth? If I can’t open my mouth wide enough how the heck can they do a root canal? I’m worried and don’t know what to do.
You are correct that a root canal won’t be possible if you can’t open very wide. Sometimes the antibiotic takes a while to be effective, especially on a lower tooth where the circulation is poor. It might be necessary if the swelling persists to go to the ER for IV antibiotics. You will need to work closely with your dentist to make that determination. This level of swelling happens very infrequently. It is usually associated with someone applying heat to the outside of the face in an attempt to get some relief. Heat is what brings out the swelling. It is possible to get the swelling without the heat though . . . . . it happens. The antibiotics you are taking are the same as what I would have prescribed. Hopefully your swelling has subsided, but if not, consider the ER. Good luck.
The limited opening of the mouth is due to the swelling from the infection. Once the swelling and infections subside, you should be able regain the ability to open wide again. The root canal treatment might need to be postponed. Some infections take longer than others to be resolved with antibiotics. Oral antibiotics might not be strong enough to control the infection and IV antibiotics will do the trick. This is rare, but it can happen. Your dentist may want to increase the strength of the dosage of the antibiotics. And remember, do not apply heat to the swelling. It will make the swelling dramatically worse and increase the pain.
The limited opening of the mouth is due to the swelling from the infection. Once the swelling and infections subside, you should be able regain the ability to open wide again. The root canal treatment might need to be postponed. Some infections take longer than others to be resolved with antibiotics. Oral antibiotics might not be strong enough to control the infection and IV antibiotics will do the trick. This is rare, but it can happen. Your dentist may want to increase the strength of the dosage of the antibiotics. And remember, do not apply heat to the swelling. It will make the swelling dramatically worse and increase the pain.
My dentist did a freeze test on #11 after a filling a year prior…now it hurts like mad now. Does that mean I will have to get a root canal or will it calm down?
I have jaw/teeth pain on lower and part of my upper teeth we did xrays and found my wisdom tooth is on that main nerve and the tooth is trying to erupt.
Hi Amber, I’m not sure what you mean by a freeze test. If a filling is large, the tooth may eventually become sensitive to cold or hot or pressure, even though there are no symptoms immediately after placement. In your description, it has been a year since the filling was placed. To test the tooth we take an x-ray to see if there is visible infection at the tip of the root. We do a tapping test and compare it to other teeth to see if it feels different. And we do a cold test where we apply a cold stick to the tooth in question and compare it to the teeth around it or the mirror image tooth on the other side of the mouth. This could be what you mean by a freeze test. These tests help to determine if the tooth needs root canal treatment. Based on your description, it sounds like the tooth need root canal treatment. I usually put my patients on a round of antibiotics to calm the situation, and then to the root canal treatment. It’s best to remove as many bacteria as possible before doing the treatment. Take the bees out of the hive before you stick your hand in it. I hope that helps. Best, Dr. Silberman
I went to the dentist yesterday as I was in agony. She said my wisdom tooth is coming through and that’s what is causing the pain. There is some swelling and I have been given a 3 day course of antibiotics. I’ve been taking Ibuprofen and paracetamol regularly but the only thing that is helping is holding cold water over the tooth but as soon as the water is gone it starts hurting again
Hi Erin, Sorry to hear you are going through this. The source of your pain is coming from gasses that are trapped inside the decayed / infected tooth caused by bacteria. The antibiotic will decrease the bacteria present and the gas production will slow as a consequence. Your body heat is often enough to expand the gas and put pressure on the nerve causing the pain. Be sure to avoid heat (coffee, tea, saunas, direct sun, hot showers, etc) The cold water reduces the pain because it causes the gas to contract and takes the pressure off the nerve. Getting the tooth extracted will give you the relief you are looking for. The antibiotic helps gradually to relieve the frequency that you’ll need the cold water. But getting the tooth out will solve the problem. I hope that helps. Best, Dr. Silberman
Hi Dr. Silberman, Had a crown placed in Oct. From the time the temp was placed to the permanent placement, my tooth hurt. Probably should have had them check the bite on the temp but by the time i decided to, the permanent crown was ready to place. The seating of the permanent really hurt and has since. One 200 mg Ibuprofen takes the pain away quickly and thoroughly. Had 2 bite adjustments done which helped quite a bit but the throbbing was still there off and on. Sensitive to cold but pain immediately disappears when cold removed. Doesn’t hurt to brush or floss unless i get too deep. Can feel the edge of my crown with my fingernail. Feel like it hurts at the gum line. Salt water takes the pain away after several minutes. Very confusing symptoms of both reversible and irreversible pulpitis at the same time. Have an appt in 2 weeks. would appreciate any input. Thanks so much!
Confusing symptoms indeed. I’m guessing that the tooth needs root canal treatment or extraction. I am betting that this is a molar, or a two rooted bicuspid. If a tooth has multiple roots like a molar, each root has its own nerve supply. One root could be infected while another is irritated. Infection is not reversible while an irritation is. That is why you might get symptoms of both. The infection eventually will take over and the choices are still going to be root canal treatment or extraction.
Forgot to mention, my tooth was crowned because it was cracked. But had no pain before the crown prep.
Got a silver filling replaced a month ago to a white one. About 2 or 3 weeks ago it started to hurt/ throb occasionally. Flash forward to a couple of days ago..now I’m having intense pain to hot. The only thing that helps is holding cold water on it. Calling Monday!! Hoping it’s just gas trapped in the tooth and doesn’t require a root canal): Maybe a new filling??
When the ice water holds take away the pain, that usually means you have two choices. Have the tooth extracted or save the tooth with root canal therapy. A new filling isn’t going to help. When an old filling is replaced, it is usually because there is new decay present. By removing the decay and the old filling, the goal is to stabilize the problem. But if the decay has progressed into the circulation, an infection has already begun, even if you have no symptoms. The new filling can stir up the “bees in the hive” and the symptoms begin. Looks like that’s what happened in your case.
My son in law has an abscess in his mouth and he keeps having a hot bath he thinks its helping.. I’ve told him that it will make it worse. Am I right
Hello Sarah, If a tooth is abscessed, a hot bath is the worst thing you can do. Also hot compresses, heating pads, direct sunlight, saunas, and so on. The heat draws the swelling to the surface of the face and is much more difficult to control the infection. Sometimes that swelling can be great enough that it crosses the midline of the body and impairs breathing. He needs to seek treatment as soon as possible. If your diagnosis is correct, a prescription for antibiotics can help. The tooth may need to be extracted or have root canal therapy to save it. Good luck, Dr. Silberman
About 80% of my teeth have broken at gum level due to my health. Chemotherapy, systimic lupus & other things have destroyed them. The ones not broken are cracked and breaking apart. I’m in constant pain. About 3 months ago I started getting huge pockets of ( what I’m assuming isinfection due to it being yellow) in my cheek, jaw & we’ll my entire mouth. Then the swelling & pain dropped off. My doc (not a dentist)said they drained into my neck glands & sinus. Well now my entire right side of my face, neck ECT has swelled up huge & the pain is unreal. What can I do to handle the pain. I have no money to go to a dentist let alone have them all pulled. Plz any ideas would be so helpful. It’s so bad!
Sorry to hear you are going through all of this. Each State has its own system for handling cases like yours. In the State of Maryland where I am located, I work with two different organizations. The first is known as Donated Dental Services (abbreviated as DDS). Many churches refer their needy parishioners to DDS which screens the prospective patient for their specific dental needs, and then refers them to a volunteer dentist, such as myself. I render treatment to these patients at no charge. In return, the State offers me Continuing Education credits which will go towards my re-licensure. The other organization is called Mission of Mercy. It is either a function of, or hugely supported by, Catholic Charities. Each quarter annually, they take over a high school or college gymnasium in different parts of the State and set up 100’s of dental chairs for treatment of the indigent. Dentists, hygienists, assistants, administrators, etc, all volunteer for 3 days to take care of as many dental patients as possible. I suggest you check with your State Dental Association and find out what they have that is available to you for either free dental care or at a dramatically reduced cost.
week cycle of amoxicillin be effective in suppressing a toothache/infection – about 1 month?
(Started it 4 weeks ago. Would’ve had likely root canal by now but delayed by Covid-19 crisis)
Thanks
Tony, Amoxicillin can help treat a tooth related infection. It will quiet the problem but not resolve it. I prefer Clindamycin over Amoxicillin, but only if you have no history of GI problems. It is common for your symptoms to return a month after taking the antibiotics for a week. I would try to get the tooth treated. If your dentist is not open, call around to find an endodontist (root canal specialist) who is open during the Pandemic. Many endodontists are staying open to help relieve hospital emergency rooms from non-Covid19 related emergencies. Good Luck. Dr. Silberman
First I would like to say you clearly don’t know everything. Putting cold on a hurt tooth makes it much more painful. Putting HOT TEA ON A HURTING TOOTH DOES IN FACT HELP IT. it’s a natural remedy.
Hi Krystal, There are degrees of infection when it comes to decayed teeth. During the early stages, the nerve of the tooth is alive and irritated by the decay. The first stage of infection is sensitivity to cold and applying cold would make it worse. As the infection advances, the bacteria destroy the circulation and the nerve of the tooth. In the advanced stages of infection, the tooth can no longer feel the cold, but the heat will cause the gas to expand inside the tooth and cause pain. Holding ice water in the mouth at that point will relieve the pressure from the gas and stop the pain. I advise that you have the tooth treated as soon as possible before it advances to the later stages of infection. Also, please remember not to apply heat EXTERNALLY to your face as this will draw out the infection and cause swelling. I hope that helps. Dr. Silberman
Dr. Silberman , I had both my lower wisdom tooth’s removed 4 days ago, the right side hurts a lot . And my lower front teeth started having dull pain. Why does it hurt? And Which painkiller would work best?
Hello Reeba, Whenever a tooth is extracted, the body goes through a natural healing process where the extraction site fills with blood and it coagulates (meaning that a clot forms), and the bleeding stops. The clot acts like a plug that keeps the root area bone from being exposed to air. If the clot is lost, the pain from the exposed air can be very painful. I suggest you go back to the dentist who did the extraction and have the site packed with a gel that will soothe the exposed bone. The packing is not uncomfortable at all, and the relief is 90% and is immediate. If the dentist cannot take care of it, you can do it yourself. Buy some sterile gauze, a plastic syringe for rinsing the extraction site, and a bottle of Oil of Clove. Rinse the extraction site with the squirting of the syringe using water or peroxide. Take a small piece of gauze approximatlely 1/4 inch by 1 inch, dip it in the Oil of Clove with some sterile tweezers and put the gauze in the extraction site. Leave it for a day. Change it on day two, and every day as needed until the pain has stopped. If you do nothing, it will heal on its own in a week, but it won’t be comfortable left untreated. Good Luck. I hope that helps. Dr. Silberman
Thank you Dr Silberman, I’ve booked an appointment for tomorrow. I shal let you know how it went . Thank you so much.
Going Through very tuff situation. Cant contact with my dentist just bcoz of virus. My root canel teeth is paining too much. I got hole in another tooth also.. But still cant understand why my root canel tooth is paining like hell. Can i apply cold water in root canel teeth… Becoz i felt like warm water increase my pain.. So i m avoiding warm water… Help me pls.. And i m 14weeks pregnant also..
Sorry to hear you are having this problem. Holding ice water in your mouth in this situation should help you. But it is a short term fix. It sounds to me like there is an additional root in your root canal tooth that needs to be cleaned out and filled. This can happen sometimes. You should do the ice water trick until such time that you can get an antibiotic prescribed by the dentist, and one that your OB/GYN approves of. You should be OK in that department as you are out of your first trimester. Once the infection is quieted, the dentist should look for the additional root to fix the problem. The alternative is to extract the tooth. I hope that helps. And I hope your pregnancy has an easier go of it than your tooth. Best, Dr. Silberman
Hi~my tooth has been aching since April and I don’t really have a good night sleep.. since we are in quarantine due to the pandemic I cannot visit the doctor for a while what should I do?
I would keep the pain in check by alternating Tylenel and Motrin (Advil, Ibupofen). Take two extra strength Tylenol. Then four hours later take two Motrin. Then four hours later go back to 2 Tylenol. Continue alternating every 4 hours to keep it quiet. Also, hold some cold water in your mouth and see if the tooth is sensitive. If so, avoid cold drinks. If not, holding ice water in your mouth may help a lot, and avoid hot drinks. It depends on the status of your tooth and the level of infection to determine whether it is cold or hot sensitive. Test it on your own and you decide what’s best for you. I hope that helps. Good Luck. Dr. Silberman
Hi- One week ago, had a root canal on tooth #30. This is a tooth that has been cracked for many years and recently developed decay. My jaw underneath the site still feels a bit swollen and “pinches” at times, and I sometimes feel the pinching towards my chin. I don’t feel pain, it’s just uncomfortable and I’m very aware of the feeling. Prior, to my root canal, I was on Amoxicillin for one week and the endodontist said he didn’t see any infection during the procedure. I also wear a night guard an have terrible TMJ. Could I still be healing? Maybe it takes longer for me because of the TMJ? Thank you in advance.
Hello LB, It is common for there to be some discomfort after root canal treatment. I recommend alternating Tylenol 500 mg x 2 every 8 hours, and Ibuprofen (Motrin, Advil) 200 mg x 3 every 8 hours. Alternate the medications so that you are taking Tylenol, then Motrin 4 hours later, then Tylenol 4 hours after that. . . .and so on. If there is swelling, there is infection. I would recommend going back on the antibiotic, and my drug of choice would be Clindamycin 150mg every 6 hours. It should not be taken if you have GI issues (Crohn’s Disease, IBS, etc). Once the infection clears, you’ll feel better.I hope that helps. Dr. Silberman
Hello Dr.Silberman
So i have a seizure disorder. I was eating when i went into a seizure and the folk broke tooth 30 right side bottom row. I’m in trouble pain and i been taking 8oo mg ibuprofen and 300 mg Clindamycin and salt water rinse and cold ice water in my mouth. It’s hard to find a dentist to remove this tooth asap. They not taking patients with Medicaid. So i have to play cash. And i don’t have the money. What can i do. And is there anywhere i can get it removed faster. Then Next thrusday. Because the dentist that did my x-ray wanted me to call around for another dentist to remove it and it’s hard to find one….tips please
Hello Shaneka, Contact your local dental association or State dental association. Every State is different. In Maryland we have Donated Dental Services which can offer guidance. Some areas depend on local churches to refer patients who need care. Catholic Charities also have their Mission of Mercy program which may be able to help. The underserved community gets free dental care four times a year in Maryland through Catholic Charities. Clindamycin and ice water holds should help, but might take a few days. You should alternate the Ibuprofen with Tylenol. Alternate them every four hours. In other words, 4 hours after the Ibuprofen, take two extra strength Tylenol. Then four hours later, take the Ibuprofen. Hang in there. Hope this helps. Dr. Silberman
I have been in severe pain for over a week now and nothing is working for the pain. I was told it was infected and was given amoxicillin, which hasn’t helped at all and Ibuprofen 800mg, of course not helping. I was already taking Norco for a chronic health issue and that isn’t helping, even though my pain doctor said take 2 at a time. I want the tooth out but was told it can not be pulled while infected. Is that true? No matter in 4 days it’s scheduled to be pulled.
Hello Lisa, Depending on the circumstances of the infection, extracting a tooth while it is still infected can be problematic. But if you have been taking an antibiotic and it is in your system at the time of the extraction, it should be fine. Norco is a combination of a narcotic pain medication and Tylenol. You could also take 600mg of Ibuprofen (Motrin, Advil) every 8 hours. It would help with the pain as it is an anti-inflammatory. Do not take any additional Tylenol. Also, if the infection has created a trapped gas pocket in the tooth, you might get immediate relief with “ice water holds”. Take a swig of ice water and hold it around the tooth. If it’s a gas pocket, the cold water will cause the gas to contract and take the pressure off of the nerve ending, which would stop the pain. Any discomfort that would be created by the cold water would be short lived so hang in there. The severe pain should subside within a minute. You may have to do that regularly until the antibiotic kicks in. If you have been on the Amoxicillin for several days, you may want to switch to Clindamycin 150 mg four times a day. There may be bacteria that the Amoxicillin isn’t hitting, but the Clindamycin would. And remember, do not apply heat to your face or inside the mouth. Good luck and I hope that helps. Dr. Silberman
I had molar 18 extracted 5 days ago. The extraction site does not hurt as much as my bottom front teeth hurt. There are no sutures and I was not prescribed any medication. The only thing that relieves the pain is keeping ice in my mouth, I’ve tried 600 mg ibuprofen and nothing, as well as with Tylenol. Is there anything else I I can do. I recently had a cleaning as well and my front teeth were not an issue. The dentist also mentioned TMJ but i was never diagnosed. Is there anything I can do to help with the pain? Or is this something that will go away as the extraction site heals.
Hi Maria, Sorry to hear you are going through this. There are two issues to discuss with you. First, it is not uncommon to have a “dry socket”5 days after an extraction. This happens when the healing clot that is in the extraction site is dislodged. Air hits the exposed bone and causes pain. The dentist can apply a medication into the site, without numbing and without difficulty, that can make it feel better. If you are unable to get back to the dentist, go to any pharmacy and buy some oil of cloves. Also get a plastic syringe that you can use to flush out the site with warm salt water. Take an eye dropper and put a drop or two of the clove liquid into the site after flushing with the salt water, and gently bite on some gauze. Having said that, I don’t think you have a dry socket because holding cold water in your mouth would not help it. Now let’s talk about the second issue. I think you have another tooth problem. You need to have the other teeth checked to see if there is an abscess. The cold water would make an abscessed tooth with gasses trapped in it feel better. Go back to the dentist and get checked for a dry socket and for another bad tooth. I hope that helps. Good Luck, Dr. Silberman
Pretty nice of a dentist to help with questions. I myself have what I’m guessing is a trapped pocket of gas because cold water really helps until I swallow it. I’m really scared to get a root canal as I’ve had extractions before and he ever shot me up with 2 things in my mouth before and it still hurt. Do you have to be awake for a root canal? do you think dentist would be able to sedate you if your terrified of a root canal and the pain? I also have government insurance right now so I don’t know if it would even cover it.
Hello Stephen, I was an instructor in the Department of Oral Diagnosis at the University of Maryland Dental School for years. My private practice got too busy for me to continue working at the school. I miss teaching, so the internet affords me the opportunity to answer dental questions. Glad I can help you. To answer your questions: The cold test would indication that there is an abscessed tooth that needs root canal therapy. If you are very apprehensive, you could ask for something to relax you prior to your visit. There are always risks with “being put to sleep” so for something that is as relatively easy as a root canal treatment, I would not recommend that. Root canal treatments get a lot of bad press. My experience is that most of my patients doze off during the procedure because they are long and boring and NOT uncomfortable. I am in the minority of dentists, but I routinely put my patients on Clindamycin 150mg (an antibiotic) prior to treatment (unless there are medical reasons not to do so like a history of GI illness or allergy to the Clindamycin). It reduces the infection making it easier to get the tooth numb, and my patient’s post operative discomfort is almost none (no swelling, no pain). Most dentists who don’t prescribe antibiotics preventively, wind up putting one in five of their patients on antibiotics AFTER doing the root canal because of swelling and pain. If it was one in five thousand, or even one in five hundred, I might consider doing it that way. But 20% of patients suffering makes no sense to me. I can’t help you with your insurance questions. The dentist’s staff should be able to help with that. I hope this was helpful. Good luck. Dr. Silberman
Hi doc, mighty nice of you to give free advice like that. Is it normal for an abscess to keep growing after 3 days of antibiotics? I went to the dentist with a chipped filling but no symptoms, did a root canal, sealed the tooth, face swelled up, dentist prescribed Augmentin (I’m in Europe), went in as adviced to get the temporary filling removed as it was best for the tooth to remain open until the infection was in check. After 3 days of Augmentin I feel like this thing might burst in my mouth. I alternate Nurofen and Panadol, not unbearable pain anymore but increasing in swelling. I’m probably going back in Monday, just wanted to get a second opinion. Thanks!
I am not a fan of Augmentin for tooth infection. I prefer Clindamycin if you have no GI problems. If you have applied heat to the area, you are causing more problems because the bacteria proliferate in the presence of heat. Avoid heat. Apply cold to reduce the pain and the swelling. IF the root canal was competed, meaning that the roots were filled so there is no place for bacteria to grow, the tooth infection should slow. There is no reason to leave the tooth open if the root canal has been completed and the roots filled. I suspect that the treatment is not completed and that they are leaving the tooth open to drain. This could take a long time and might not work. I think it is better to be sure the root canal treatment is complete, the roots are filled, and the breeding ground for the bacteria has been eliminated. Once that is done, the swelling should go down. See if you can get Clindamycin. The normal does is 150mg every six hours, but you might need to bump it up to 300mg every 6 hours. Good Luck, Dr. Silberman
Jello I’ve been having severe gum and tooth pain as across my entire gum and tooth line from rear teeth to the front teeth the pain always begins in the gums and moves out to the teeth the pain lasts a few days then receded to non existence I have been to three different dentists and none of them can find anything wrong in should note that ate the time the pain starts I have not eaten anything in hours and I I rarely drink soda so km not sure what’s causing this any advice
Hello Barrett, Because you have been to three different dentists and none of them can see the reason for your pain, I would see a neurologist. Your symptoms could be from an inflammation of one of the nerves, such as trigeminal neuralgia. Once the inflammation is removed by either steroid injection or oral medication, you will get some relief. Good luck. Dr. Silberman
Hi Dr Silberman,
I had a filling on Wednesday. It’s now Sunday and the pain seems to be getting worse.
I have a good dental history.
However a cavity was discovered between my teeth on the 2nd tooth from the back on my upper left.
The cavity was deeper than expected and the dentist remarked that we were lucky to have found the cavity for repair when we did.
I experienced pain on the afternoon of the filling.
The next day I had no pain.
That evening I wore my set of retainers (they keep my teeth in place following straightening).
I woke up in pain. Since then, the pain has been getting worse.
I went to the dentist on Saturday and he said the area looked fine and performed well for all the sensitivity tests.
The issue I’m concerned with, I previously had a benign tumour removed from the sinus cavity directly above the tooth.
The tumour was huge, it was causing the bone to expand. All the lining was removed at the time of surgery. The surgery was 2.5 years ago so the lining should have grown back.
I’ve taken Amoxycillin for 24 hours.
Do you have any advice about what to do?
How many days should I wait to go for another opinion?
Should I go to an ENT of a dentist?
Thank you,
Jo
It sounds to me like your retainer may need to be adjusted to fit the new filling. I would try that first. If the problem persists, the tooth may be infected and require root canal therapy. The testing of that tooth over time will determine what treatment is necessary. If infected, the tooth will become gradually more symptomatic, indicating the need for treatment. I do not believe that your symptoms are related to the treatment you received 2 1/2 years ago. Good luck. Dr. Silberman
seeing the advice of a cold liquid or ICE directly on the infected tooth would literally send me shooting to the moon like a rocket in pain with what i am currently dealing with. i know it works for others but holy hell absolutely off limits for me.
Applying cold directly to an infected tooth takes away the pain when the infection is advanced. In the early stages of infection, the tooth is hyper-sensitive to cold. You know best when it comes to your own particular situation. Listen to your body. If you aren’t sure, try it . . . . . even if it is one time. You may be surprised that it could help. In all cases, applying heat externally is a bad idea because it can draw the infection to the surface and cause severe facial swelling. It sounds like you need to see your dentist ASAP to fix the problem. Best of luck to you. Dr. Silberman
My dentist of 27 years retired. I had not gone to a dentist for four years. I am 68 years old. The reason I am sending this question to you is I need your advice about the new dentist who recently crowned my molar. One of my molar crowns I had for 11 years came off when I flossed. I went to a local dentist and his staff temporarily used adhesive to put it on. I was told it would most likely come off again by the dentist. I explained I was having financial problems. He was cold and dismissive and said that I would probably need to have the tooth pulled in that case. I understand at the time that he gave me the only option available in my financial situation. I scheduled an appointment with them to have my teeth cleaned. They scheduled the appt. in three months. I babied that crown. I would not have my tooth pulled. I am a religious flosser. I cancelled my appt. with the office because of his attitude towards me. The crown lasted me another year. I flossed it off again. I finally got into see another, close by, dentist after three days. They had just reopened dental offices in my state. I knew nothing about this dentist except 3 Yelp reviews. He was young and nice and he had his staff put the crown on. He looked at my tooth. The crown was more a cap and did not cover the tooth. I asked him if it had decayed he told me no. I told him about my job, Covid 19 related, I was not working at the moment. So there was only so much I could afford. He told me I had two options he could cement it back on or I could have it crowned. He and I never mentioned pulling it. I made up my mind to get my teeth cleaned. They also did full mouth xrays. Well after the xrays he said my upper back molar had cracks it also had a big filling. He showed me a color photo. The cracks looked hairline to me. But he said he felt this needed a crown more then the tooth that they had put temporarily adhesive on. Well my crown fell off again during flossing.. I had not scheduled an appointment to have my upper back molar crowned. Well again I went in and one of the ladies who was part of his office staff ground down the adhesive so she could get the cap to fit on my tooth. The dentist was not there that day. She told me not to count on the crown staying on and that it could come off anytime. I was not to floss it. They scheduled in two weeks to have a new crown made in office to replace the unstable crown. Since the crown would be made by the dentist the procedure would take 2 and a half hours. I was happy to finally get this tooth taken care of. Well he had a heck of a time getting my old cap to come off. It apparently wasn’t as urgent and unstable as his staff assistant told me. When he was grinding my tooth he flooded my mouth and I choked pretty bad. Then when he was putting on the permanent adhesive he tried to floss the crown off and he struggled and struggled it finally popped off. He did more adjusting of the crown and again he did the same thing flossing it so hard it flew to the back of my throat and I almost swallowed it. I bent over not swallowing and thank God it fell into my hand. He also was not acting very confident, which had me concerned. He finally adjusted the crown to be able to easily floss it. He asked me about the bite and I told him it seemed a little high. He ground it down and it was hard to tell but seemed alright. I was very grateful to get my crown done it was a much larger one. With my wonderful retired dentist who had done my other molar crowns it was so easy when he did them and no problems. This time when I tried eating it seemed to catch on upper teeth and was painful to chew. It wasn’t so sensitive the first few days. Now I am experiencing great sensitivity. My crowned tooth aches with warm and cool water. I have been taking aleve. When I wake up my tooth aches slightly. I have not been eating on that side for fear I might add more trauma to the tooth. It has almost been two weeks. It wasn’t so sensitive at first but it seems to be getting more sensitive as time goes on. It is so sensitive, if I stroke the crown It hurts very slightly. I am afraid. I have never had a root canal. I don’t want to lose this tooth. I just need to have your advice Should I go to another dentist and get advice. I don’t understand why he wanted to crown the other molar first. Then all of a sudden this one became the priority. Is this normal practice or should I be on my guard? I have been under a lot of stress getting Covid at the end of February and now having to deal with what they call Post Covid Fatigue. I got tested a few days before my crown came off and I was negative for Covid 19. I would greatly appreciate your response. I feel so helpless.
Hello Madalyn, Sounds like you have had quite the dental journey, and had to deal with getting Covid 19 too. I hope your Post Covid Fatigue passes so that we only have to deal with your tooth. I would go back to the dentist who placed the crown and have him check your bite. From your description, your “excursive movements” may be off. By that I mean that when you chew from side to side, the opposing tooth is being blocked in some way by the new crown. This would cause hot and cold sensitivity in the new crown. The dentist will have you chew on some carbon paper. I usually suggest to the patient to “bite, chew, grind and slide” on the carbon paper. That covers all of the directions of chewing and will leave a mark on the crown to be adjusted off. The dentist will adjust and repeat until the bite is right. Hot and cold sensitivity is more common in teeth that have just received treatment, and especially those with an improper bite. Once the bite is adjusted, I would suggest using a desensitizing toothpaste (Sensodyne, Crest for Sensitive Teeth, Colgate for Sensitive Teeth, etc.). Between the adjusted bite and the desensitizing toothpaste, the sensitivity will go away if the problem is an irritation. If the problem is an infection, the sensitivity will get worse in spite of the bite adjustment and desensitizing toothpaste. Time will tell and you need to be patient for a couple of weeks. If the tooth starts to ache by itself or is sensitive to temperature with a lingering discomfort of a minute or so, it will probably need root canal therapy. The other issue is whether you should stay with this dentist. I would stay put for now, but you might call around to see if there is a dentist who will offer you a free consultation / second opinion. I have always provided that service to the public. If a patient has been diagnosed properly, I refer them back to their dentist for treatment. Getting confirmation on diagnosis and treatment plan gives us the peace of mind we all need at times. I hope that helps. Good luck to you. Dr. Silberman
I ate a chip 4 days ago and it triggered pain on my tooth and the pain has been killing me since then. I take 600mg of ibuprofen at night to help me sleep and it helped lower the pain level for the past two days, which was good because I don’t take it during the day to avoid taking it too often. Today, I woke up with a bad ache again, and I can’t even drink cold water because it hurts so much at contact. Should I try a warm salt water rinse? I Tried rinsing with peroxide and it doesn’t work. Engenol drops helps but wears off within a few hours. I don’t know what to do at this point. I’ve never experienced this much pain before. I’m researching dentists in my area, but some of the reviews scare me even more. I don’t know what else to try for temporary relief while I find a good dentist.
Hi Dean, It sounds like you have cracked a tooth. It is like a crack in a windshield of your car, if you can relate to that. A crack suddenly appears and stays until you hit a bump in the road, and the crack extends further. In a tooth, the crack can go vertically towards the nerve or away from it towards the gum. It sounds like yours is towards the nerve. If the crack is through the tooth to the root at the bone level or below, it may need to be extracted. If it is to the nerve but not to the bone level, it could be saved with root canal therapy and a crown. As to how to treat it until you see a dentist, I would do your best to avoid biting on it. And avoid cold. Do not apply heat as it will help create an infection. Pain medication can help. I would recommend two extra strength Tylenol (2x500mg) every eight hours. And 600mg Motrin every eight hours. Take them alternating every four hours for continuous relief. Use the eugenol drops as often as you need to keep it quiet. Bottom line: get to the dentist for a diagnosis and treatment plan. I hope that helps. Good Luck, Dr. Silberman
So I’m having to keep ice water in my mouth to take away the pain which is bad enough to make a person pass out. I read you said something about gasses trapped inside the tooth. Dentist is not an option. Is there a way to get ride or release those gasses. I can’t keep this ice water much longer.
Hello Phillip. Somehow your question was duplicated, and I already answered and posted once. Please see my prior response or reach out to me again. Good Luck. Dr. Silberman
So I’m having to keep ice water in my mouth to take away the pain which is bad enough to make a person pass out. I read you said something about gasses trapped inside the tooth. Dentist is not an option. Is there a way to get ride or release those gasses. I can’t keep this ice water much longer.
Hello Phillip. Sorry to hear you are experiencing this toothache. The ice water trick works, but is a short term fix, as you’ve come to learn. Unfortunately, there is no way to resolve this other than seeing a dentist to numb the tooth and make an opening in the chewing surface to release the trapped gas. That would be the first step in the root canal treatment necessary to save the tooth. The alternative treatment would be to see a dentist, or oral surgeon, to extract the tooth. Probably not the answer you wanted to hear, but those are your two choices. Good luck. Dr. Silberman
I am currently experiencing an extreme swollen face from an abscess tooth and I am confused on what I should do to help the swelling go down should I take a hot compress or a cold compress I have not had my teeth polled or had any kind of dental work in the last eight years I’m currently waiting to get all of my teeth polled to get a full set of dentures
Hi Christy. My answer to your question is simple. Never apply heat to your face when dealing with tooth infection. It dramatically increases the swelling and makes the infection much worse. If you have already done so, you can start applying cold compresses. But you will also likely need to get some antibiotics. If the swelling is severe, you may need to go to an emergency room where antibiotics can be administered intravenously, directly into your bloodstream. Severe swelling can be lethal and nothing to play around with. If the swelling is under your jaw and crosses the midline of your face, it can impact your breathing. If the swelling is in the upper jaw in the front of the mouth, the infection can flow up to the brain (Cavernous Sinus Thrombosis) and can be lethal too. So go for treatment immediately, and good luck. Dr. Silberman
I had a broken tooth for quite some time that eventually lead to an abscess. On a Friday it was hurting bad and by Saturday, I noticed a hard bump on my jaw near where the broken tooth was at. Got in Monday to a dentist and they removed the tooth, saying the abscess had moved to my jaw because it had nowhere else to go.. but they did not provide any antibiotics. The infection is still there, the bump is present. Do I just wait for it to drain on its own? Pain is controllable with ibuprofen .
Hello Mandy, The infection will gradually drain through the extraction site. There is no need for antibiotics at this point. I recommend very warm salt water holds in your mouth in the area of the extraction. No swishing. Just hold it in the area of the extraction to draw the infection to the surface. It will either drain or gradually dissipate on its own. Give it a few days. I hope that helps. Good luck. Dr. Silberman
Hello Dr Silberman. First, thanks. You clearly care.
Here is my question. I had a root canal in June (#3) and another one in October (#31). I started having pain in #3 about three weeks ago but the last week became unbearable. I feel like it radiates now to the whole right side of my mouth!
I’ve been taking Ibuprofen, which helps but wears off quickly. I usually don’t take any pain meds so when I do (once a year or so), Ibuprofen works like a charm. Not right now. The only thing that helps is to hold cold/room temperature water in my mouth (I have really sensitivity so trying to avoid ice water).
I called my dentist and my endo. My endo gave me an appointment for next week and prescribed amoxicillin. My dentist looked at a CT/x-ray they took when I went for the post second root canal filling and didn’t see anything. My dentist even suggested not to take the antibiotic and demand the endo saw me right away. I tried but couldn’t get an appointment. My endo just prescribed stronger pain killers, which I may try to avoid for now (if I can).
This is the worst pain I’ve felt (and I live with chronic pain). I’m very confused about what could be happening since I already had a root canal 🙁
Please help! Thanks so much!
Cristina
Hi Cristina, Sorry to hear you are going through this. There are a few possibilities regarding the source of your pain. #3 may have an additional root that needs to be filled. It is not uncommon for a root to fill up with gas, a bi-product of bacteria trapped inside. The gas expands with heat and puts pressure on the nerves outside the tooth in the bone, or any remnant of nerve in the root. Your body heat could be enough to cause the expansion. That is why the cool water makes it feel better. It could also be that #3 is not the problem and that the roots have all been filled. It could be coming from #2 or #4. It is very hard to identify which tooth is the culprit. Other factors could be causing you pain, like a vertical fracture of the tooth. But if the CT scan did not show it, and if both #3 and #31 are crowned, it’s not likely. Plus the fact that cold makes it feel better is pretty conclusive that it is gas trapped in a root somewhere. I would definitely not wait on the antibiotic. Amoxicillin is popular but Clindamycin works better for this type of pain. You can’t take it if you have any GI issues (irritable bowel syndrome, Crohn’s disease, ulcerative colitis, etc.) Taking antibiotics is controversial in dentistry and, in my opinion, it shouldn’t be. If you have a hornets nest, don’t stick you hand in the nest without making sure the bees are gone. Clindamycin does a good job of reducing the bacteria (the bees) which are the source of your pain. It’s not a cure, but it should make it feel 80% better. Meanwhile, use the cold water to keep it quiet and start taking the antibiotics ASAP. Good luck and I hope that helps. Dr. Silberman
Hi, Dr. Silberman, I’m hoping you can help! I had a root canal on top premolar three weeks ago. Afterwards, I felt pain on any pressure on the temp crown. I went to get the bite adjusted. It hurt a bit less. Went in again for a root canal evaluation on the other side and the dentist (not the same one), hit all my teeth with the little percussion instrument and slammed it into the temp crown. I almost passed out it hurt so bad.
So now the tooth still hurts a lot on any pressure. My first dentist checked xrays and scans for infections or accessory canals and saw nothing. The two back cusps of the tooth hurt terribly on any pressure (even light tooth brushing). Dentist tried to numb me back up to see if tooth was cracked under the temp crown, but he could not numb me up. He tried in 8 different places with several different anesthesias.
So now he can’t get the temp crown off and he can’t numb me up. I took dexamethasone for 2 1/2 days and am feeling a little better after a week. The dentist wants to put me under sedation and extract the tooth. I would rather not have an extraction if I can avoid it.
Plot twist in that I got a premolar root canal last year on the other side last year and due to COVID, never ended up getting it crowned. The back two cusps on that tooth are also still sensitive to pressure.
I am worried it might be a neural problem and that an extraction would make things worse. I have not been able to chew since before Thanksgiving.
Thanks for any ideas you can provide. My dentist has had over 10,000 patients and cannot figure out why I cannot be numbed up anymore when I was for the root canal.
Hello Muriel, Sorry that you are going through this. It is very unusual to not be able to numb an upper premolar. If an infiltration injection (numbing on the cheek side of the tooth) is not sufficient to numb the tooth, then certainly a palatal injection on the roof of the mouth behind the tooth would numb it. Also, though it is controversial among dentists, I always prescribe antibiotics for root canal treatment. My go to is Clindamycin 150mg 4 times a day for 10 days. You did not mention if antibiotics have been tried yet. After a round of antibiotics with the tooth out of occlusion (shortened to be out of contact from the opposing tooth), I would re-evaluate. At that time I would check the tenderness to tapping on the tooth and possibly take another x-ray to see if there are any new changes. If there are new changes, it’s likely that there is a crack in the tooth and it would have to be extracted. My gut tells me it’s not neural, but you can’t rule it out. Try other treatment first and see how it goes. Good luck. Dr. Silberman
You are simply wonderful! I stumbled on your site looking for some help and read A LOT of comments and your replies. What a great dentist you are to provide all this advice to anyone! You are a kind and simply stellar guy, I applaud you!
Thank you Kristin. You are a real mensch for saying so ….. LOL Warm Regards, Paul B. Silberman, D.D.S., MOT
I had to go to the dentist this week because of severe pain in a molar (#30). The tooth had a deep filling that the dentist had replaced this past July because the original filling had fallen out. The x-ray this time showed an abscess at the root and I was referred for a root canal and given a prescription for Penicillin. I have been on the Penicillin for 4 days and the pain is not easing up at all-in fact it is getting worse. The pain is radiating to my other teeth and across my entire jaw. I am taking ibuprofen and acetaminophen every 6 hours but it barely touches the pain. The endodontist cannot get me in for treatment until the 19th-which is ten more days. I am unsure if I can continue like this for that much time. Should I consider just having the tooth pulled now or do I have other options?
Hi Mike, Sorry that you are having to go through this. To stop the pain immediately you can hold ice water in your mouth next to the tooth. You may have read my thoughts on this in other posts, but if not, it’s worth repeating. Your tooth is on a classic trajectory. When the tooth was refilled, it was probably already damaged by decay, even though it was asymptomatic. Now that the bacteria from the decay has taken over the tooth, they have created a by-product of gas that is trapped inside. Ice water will get the gas to contract and take the pressure off the nerve endings and stop the pain. Your body heat is enough to get the gas to expand and cause the pain. You can’t keep ice water in your mouth until the 19th, so I would recommend asking your dentist to see you tomorrow on an emergency basis. He can drill open the top of the tooth to release the gas and stop the pain. It is not a difficult nor painful process. Releasing the gas will give you relief until you can get to the endodontist (root canal specialist) on the 19th. As long as the dentist has numbed the tooth to open it and relieve the gas, I would ask that the height of the tooth be reduced so that you can bite together more comfortably. The tooth will need to have a crown placed on it anyway, so doing this will help you now, and less tooth reduction can be done later when you get the crown. I am not a fan of Penicillin for tooth infection. Clindamycin 150mg every 4 hours is better against the type of bacteria found in a tooth abscess. If you have any GI issues, I would stick with the Penicillin. You might suggest switching to your dentist and get his / her opinion. It’s just my opinion having done this type of work for decades. And a reminder, avoid applying heat to your face and stay away from hot food and drink until you have resolved this problem. I hope that helps. Good Luck. Dr. Silberman
First of all, I’d like to say thank you in advance for helping me, and so many others, with our dental issues! It truly is amazing that you care so much!
So, a while ago my first molar on the right side of my lower jaw (#30 I believe) broke off, roughly 1/3 of the tooth is gone. I had went to my usual dentist and they said there was no infection and would wait until there was pain to treat the tooth. 6 days ago the tooth began hurting tremendously and I called and only 1 dentist could get me in on such short notice. They performed an x-ray and determined there was quite a bit of infection so they put me on amoxicillin and I was on it for 3 days but it didn’t help and the pain and swelling got worse. I called yesterday and they switched me to clindamycin and it seems to be helping. I am waiting to call and set up an appointment with a specialist to do a root canal because the dentist I went to can’t do it because based on the x-ray it may have complications.
I have stayed in excruciating pain since this began and haven’t been able to sleep more than 1 hour each night due to the pain, I have been told I can only take Tylenol because I am 14 weeks pregnant. I can’t bear cold water touching the tooth due to it being broken and salt water hasn’t been helping. I was wondering if you knew of anything that could take even a little pain away.
Thank you for your time and understanding!
Hi Brittany, Sorry to hear you are going through this, and thank you for your kind words. It sounds like this tooth is in a multi stage of deterioration. Because this tooth has several roots, at least one of them is resisting the infection and holding on to being able to feel a cold stimulus. When there is infection visible on the x-ray (a dark area in the bone outside the tip of the root of the tooth), that indicates that the infection is fairly advanced. With at least one root in early stage and at least one in late stage of infection, you get the worst of both worlds. In late stage, applying ice water provides immediate relief. But in your situation, the early stage root says NO! Here are your options. You can call your dentist or endodontist and ask if they would do a pulpectomy. This is stage one of root canal treatment wherein the nerve of the tooth is removed and a temporary filling (or just cotton) is placed until such time that the root canal treatment can be completed. That would stop the pain. Another option is to continue on the Clindamycin and give it a few days to kick in. It is a much better antibiotic than Amoxicillin for tooth infection. If it isn’t better in a few days, ask if a higher dose would make sense. Typically, 150mg four times a day is normal, but in stubborn cases, going to 300mg four times per day is an option. This is more true for lower teeth than upper teeth due to the comparatively less volume of circulation in the lower jaw. Also, you should talk to your OB/GYN about using Tramadol short term until you can get out of pain. I would not use it in the first trimester, but because you are past that, it may be okay to use it. It is stronger than Tylenol and is not considered a true narcotic, which I would not use during pregnancy. And because you won’t be on it for long, the chances of addiction for you or the baby are remote. Those are your choices as I see them. Good luck to you and your baby. Dr. Silberman
Why my tootache still getting worst I take IBUPROFEN
Hi Angie, You really didn’t give me much information for me to help you. Your best bet would be to see a dentist as soon as possible. You can take up to 600mg of Ibuprofen (Also known as Motrin or Advil) every 8 hours. You can also take two Tylenol 500mg each every 8 hours. Don’t take them together. Alternate the every four hours. If the problem is caused by decay, the cavity would have to be quite large for there to be any pain, and it is likely you will need either an extraction, or if you want to save the tooth, a root canal treatment. But again, see a dentist to resolve the problem, or write to me with more details. I’d be happy to help. Dr. Silberman
I have had a filling done on the 31st of January due to having a cracked tooth, it’s my very back one on the top left side of my mouth, they numbed my mouth a few hours later I was experiencing bad pain, the next day so today 1.02.21 I have severe pain all in the left side of my mouth but I’m pregnant what do I do it’s hurting to the point where I’m crying, they said to either have a root canal done or a tooth extraction but they don’t know what’s wrong with my tooth but it’s causing me a lot of pain
Hi Courtney, Sorry to hear you are going through this tooth problem, especially while pregnant. It sounds like you have an infection in your tooth. If the infection has been there for a while, it won’t be sensitive to cold water. Take some ice water and hold it in your mouth next to the tooth. It will either make it worse for a minute, or it will stop the pain completely. The advice you were given is correct: you need either a root canal treatment to save the tooth, followed by a crown to preserve it, or you will need to have the tooth extracted. I hope the ice water trick works for you. If you are going to save the tooth, antibiotics will help to quiet it. Clindamycin is my antibiotic of choice, but you will have to get that prescription from the dentist. Amoxicillin is not a very good option because it takes longer to work, if at all. Remember to avoid applying heat to your face or drinking hot liquids until the problem is fixed. Heat can cause severe swelling to your face. Good luck and I hope you have a happy healthy baby. Dr. Silberman
I had a root canal, back upper molar, 5 days ago – given 800mg ibuprofen when I left the office with instructions to repeat that dosage every 6 hours. The first 2 days I had some pain and swelling but nothing that wasn’t handled with the prescribed treatment. Then yowzer! My pain has really increased. The meds wear off after about 4 hours and by the time I can take it again it takes an hour or so for the meds to kick in. The pain doesn’t seem to be in my tooth but in my cheek area. I called my endo and was told this is normal and that because my mouth is so small there was a lot of manipulation done to be able to get to the molar. My endo added 2 Extra Strength Tylenol and I am alternating between the 2 meds every 3 hours. It still does not seem to cut the pain. Does this sound normal to you?
Hi Cindy, If your mouth is sore, there may be some damage to the soft tissue, as suggested by the endodontist. For now, let’s rule out the tooth as the source of the problem and that the root canal treatment looks good on x-ray. Let’s treat the soft tissue injury. I recommend Chlorhexidine mouth rinse twice a day to help with the healing. It is a prescription rinse and the endodontist could prescribe it for you. Swish for 30 seconds twice daily and don’t eat or drink afterwards for an hour. At other times during the day, I recommend warm salt water holds where the tissue has been damaged to help keep down the swelling. You could also buy some over the counter numbing gel and apply it with a cotton swab (Q-tip) to the damaged tissue. I agree with alternating the Ibuprofen and Tylenol, but these other treatments will get the site comfortable and heal more quickly. Good Luck. Dr. Silberman
Thank you so much! I will get with my Endo about the rinse. I had never been to this Endo before and as much as I like her and feel comfortable with what she says I’ve never had many dental issues so am a little unsure as what to expect. It helps to have a “2nd opinion”. I so appreciate the fact that you are willing to talk with someone who isn’t your patient. It’s nice to be on the receiving end of kindness and maybe some day I can “pay it forward” in some way.
Hi. I have a dentist appointment in the morning but I have a toothache that is causing me agony. It is a molar at the back where a large filling us, and if I touch the top and bottom tooth together and bite gently its pure agony. I’ve tried heat (mistake apparently) and pressing a bag of iced peas to my face but I don’t know what else to try to get through the night. I’m also taking ibuprofen and paracetamol whenever I can and rubbing anbesol on my gums.
Is there anything else I can do just to get through the night relatively pain free?
Hello Brad, It is difficult to definitively diagnose the problem, but it sounds like you have an abscessed tooth. The infection at the tip of the root is trapped and expanding, and pushing the tooth up. That’s what is making the tooth feel taller. When you bite on the taller tooth, it is being forced down into the infection, and you know the result. Take ice water and hold it in your mouth over the tooth. The trapped gasses in the infection will contract and stop the pain temporarily. It’s the best thing to do until you can get in to see the dentist. Do not apply heat to your face because it draws out the infection towards the heat and causes your face to swell. I hope that helps. Where in the world are you? Your time stamp says 9pm and it’s 4pm here US East Coast? Are you in Europe? Good Luck. Dr. Silberman
I had my large molar break off down to the gum line. It had a crown but no root canals. It has infection at the root. I was prescribed clindamycin. I take 2 capsules 3 times a day. I started yesterday at noon and it is 38 hours that I have taken them and I have no relief no matter what pain medication I have taken. I have taken ibuprofen, Tylenol, anaconda and was prescribed Norco this a.m. with still no relief.
Is the antibiotic not working? I can still feel swelling in my jaw and it causes ear pain along with the severe toothache.
Hello Mary Lou, Sorry to hear you are going through this. The Clindamycin works, but sometimes it takes longer for some people. It is still the go to antibiotic for tooth infection. I assume that the capsules are 150mg each. You are taking 300mg every 8 hours. You could bump it up to 300mg every six hours. Check with your dentist. The infection in your tooth is caused by bacteria that have a bi-product of gas. Assuming there is no sensitivity to cold in the tooth because the infection is advanced, take some ice water and hold it in your mouth. This will give you relief as the cold makes the gasses contract and takes pressure of the nerve endings. You could also apply ice packs to your face, 20 minutes on and 10 minutes off, to help cool down the area for the same reason. Do not apply heat to your face as that will make the swelling worse and draw the swelling into your face dramatically. The cool down will help with the pain medication because with a lower intensity of pain, the medication works better. If there is not a lot of natural tooth structure left, it sounds like your best bet would be to have the tooth extracted. If circumstances are favorable, an implant to replace the tooth after it is removed would be ideal. Good luck to you. Dr. Silberman
Hello! It is advisable of removing of an impacted teeth while its swelling? I hope you will notice my comment. It helps me to decide of what to do or don’t. Thank you!
Extraction of the wisdom tooth in the presence of swelling is usually fine. You haven’t described the degree of swelling. I might not recommend it if the swelling is great enough to compromise your airway. Otherwise, go for it. Once extracted, the swelling will subside.
Good Luck. Dr. Silberman
My tooth has cracked significantly and hurts when I am sitting down numbing stuff does not work anymore and neither does over the counter pain medication, I’m pregnant and no dentist are open right now. Should I go to the hospital. The pain on a scale from 1 to 10 is a 8 when it starts hurting. Makes my jaw hurt and that whole side of my face.
Hello Marieca, Your email just popped into my inbox, but the time stamp is from three days ago. I hope I can still be of help. Your question was time sensitive, so I hope that you have resolved the situation by now. The answer to your question is “yes”, if the pain is severe, go to the hospital and let them address it. By now, hopefully you have seen a dentist to resolve the problem. Sorry I didn’t get to you sooner. Crazy internet stuff. Good Luck.
Dr. Silberman
Hello, I have a bump on my gum and it stings a ton when I try to eat with the tooth. I’m thinking this is a tooth abscess but I did some research and don’t think I have the finances to have it properly treated due to the Pandemic. What can i do?
Hello Lee, A proper diagnosis is critical in determining the cost of treatment. The diagnostic process should be simple: an emergency examination (limited examination) and an x-ray. If you don’t have a dentist, search the internet for where you live and select one that has good reviews. Call and explain your situation and ask what the cost will be to get a diagnosis. The dentist will present you with treatment options. Once you are armed with this information, you can make the decision which is right for you. I hope that helps. Good Luck. Dr. Silberman
I have an upcoming root canal on my bottom left k9 tooth in the front of my mouth and it is killing me
Even the air hurts it
What can I do to help with the pain until the appointment? I love ice water and sucking on ice that usually helps but the cold is hurting the tooth along with air and food and just everything
What are some home remedies I could use to help the pain until the root canal finally gets done ?
Also just a ps I have been having many many dental procedures getting my whole mouth fixed (this is the last issue that needs fixed before I can get fitted for partial back molars i also had all my molars pulled and every front tooth on the top root canaled and capped ) but this is killing me what can I do?
Hello Kaysy, Good name. I have never seen the name Kaysy before. As for your tooth, ask the dentist if they can see you ASAP. That would be the first thing to do. It is likely that the tooth needs root canal therapy to save it. If you can’t get to the dentist, and if there is an open cavity, you can apply either clove oil (from a pharmacy) or make your own clove paste. Mash up some cloves and a a couple drops of olive oil and put the paste into the cavity. If you have to wait awhile to see the dentist, ask to be put on an antibiotic to quiet the problem. Clindamycin 150mg four times per day is my antibiotic of choice. You can’t take it if you have any GI issues. Good luck. Dr. Silberman
Severe pain in teeth hole what can I do to get rid of the pains
Becky, you aren’t giving me much information. First, I recommend seeing a dentist. Second, you can put some clove oil on some cotton and place it in the hole for some temporary relief. Or take some cloves and mash them up, and add a couple drops of olive oil to make a paste, and place that in the hole. But seeing a dentist ASAP is the best course of action. Good Luck, Dr. Silberman
Hi there! Please help… I got 6 veneers in my top teeth about 2 years ago. Over the past few weeks my front tooth has been sensitive to cold temperatures and over the past few days there has been nerve pain. The pain is manageable and not extremely painful but it’s definitely uncomfortable. It comes and goes so I can manage with it but I’m wondering is this the start of a bigger issue? Any insights on what I might have to do or what could be causing this? Do you think it’ll go away? Thank you so much!!!
Hi Niall, It sounds like there is an infection in the tooth. You should see the veneer dentist to confirm the diagnosis. Assuming that to be the case, it will need root canal treatment. The access to the infection would be through the back of the tooth so there would be no change to the veneer. Once confirmed and while you are waiting to have the root canal treatment done, I recommend Clindamycin 150mg three times a day to quiet the problem. It is the antibiotic of choice, in my opinion, for tooth infection. You can’t take it if you have any GI issues (Crohn’s Disease, Irritable Bowel Syndrome, etc.) The taking of antibiotics prior to treatment is controversial, but I feel strongly that you put out the fire before going in. Or take the bees out of the hive before putting your hand in. This prevents any post treatment discomfort. Good Luck, Dr. Silberman
I’ve been to two different dentists in the last three days and they have stated that I have an infection in my gums. My issue is I don’t have pain in my gums but in two specific teeth. Both dentists x rayed my teeth and said they looked fine. I’ve been prescribed amoxicillin for the infection and dihydrocodeinne for the pain. How long should it be until I start to see the benefits of taking the amoxicillin? I’ve taking them for two days now.
Hello Stuart, If it is a gum issue, usually 48 to 72 hours is the amount of time necessary for the Amoxicillin to kick in. But that is systemic, and you should also be doing something locally. In addition to the antibiotic, I would prescribe Chlorhexidine Rinse, a very effective mouthwash against oral infections. Warm salt water would be helpful until hour get the Rinse. Good Luck, Dr. Silberman
I have a deep pocket between two teeth.my dentist said he couldn’t pull it because of the deepness.He is sendings me to oral surgeon.in the meantime he gave me penicillin and Tylenol 2with code.I still have pain.what else can I do
Hello Lana, You can take 600mg Motrin (Ibuprofen, Advil) alternating with the Tylenol 2 every four hours. That way you are taking pain medication every four hours but switching from Tylenol to Motrin and back to Tylenol. Also, you can take two Tylenol 2 at a time, which equals one Tylenol 3. Also, note that two Tylenol 3 equals a Tylenol 4. Depending on your weight, one Tylenol 4 every 8 hours should help a lot more with the pain than a Tylenol 2. Good luck and feel better.
Dr. Silberman
Hi I’ve had tooth ache for 2 weeks now I went to the dentist last Tuesday and was told I had a infection and to take amoxicillin 1 3 times a day , It got significantly worse but started to get better about 2 days ago. My antibiotics ran out yesterday (Monday night ) promised a call from dentist today but no call and pain is coming back quick I guess I need more tablets ?
Hello Holly, It sounds like you not only need more antibiotics, you have to have the underlying condition that is causing the infection treated. If it is a gum problem, you probably need a deep cleaning to get rid of the calcium buildup. If it is a tooth problem, you probably need either an extraction or a root canal treatment to save the tooth. I hope these basic guidelines are helpful. Good luck. Let me know if you have any more questions. Dr. Silberman
Is it okay to eat hot soup if I’m having root canal pain? I would try not to let the soup touch my tooth.
Hi Lauren, The answer to your question is “sometimes”. It depends on the level of infection in the tooth. It really is on a case by case basis. If you know that heat triggers the pain, I would advise against soup. If you are not sure, I would hold some warm water in your mouth to test the tooth and if it bothers you, take some cool water to stop the pain, and skip the soup. If it doesn’t bother you, go for it. Only in very advanced infections is when I recommend ice water to stop the pain and avoid heat. Good Luck. Dr. Silberman
Dr. Silberman:
I am experiencing intense pain from my lower right mandibular incisor. I need it to be extracted but I’m having to wait to see the dentist until Monday and it is Thursday! I can’t make it through the weekend like this. I’ve tried all the home remedies to no avail. I’ve been taking amoxicillin and before that I took cefdinir. I’m also taking ibuprofen as often as I’m allowed and it isn’t even touching the pain. I can feel a deep bruised feeling down into the pointed tip of my chin. It’s making my 2 bottom center right teeth both hurt and feel loose. I’ve read several places that say to NOT lay down flat. However, laying flat on my stomach with my hurt side of my face down on the pillow is the only way I can get any relief at all. I take beta blockers for my heart and nuvigil for narcolepsy. Just so that you have all the info. I’ve been dealing with this for 3 days straight and the antibiotics aren’t making the pain go away like they have before with an abscess. Do you think I have something else besides an abscess? I’m not sure what else would cause such horrific pain that radiates into my ear and jawline besides an abscess. But surely the antibiotics would have fixed that by now. Right? Any suggestions or advice you can offer is appreciated.
Hi Amanda, Sorry to hear you are going through this, and that you are losing your teeth. It sounds like you are in an advanced stage of infection and that holding ice water in your mouth will give you relief. There are gasses trapped in your tooth that are expanding and putting pressure on the nerves in your jaw, and that is why it is radiating to the ear. But that’s another story. Try the ice water holds. Also, alternate Tylenol with the Motrin. You should be taking one in alternation every four hours. Two extra strength Tylenol, then four hours later 600 mg Motrin, then four hours later back to the Tylenol. The antibiotic takes longer for lower front teeth because the circulation in that area of the jaw is very weak. Remember to avoid heat. No hot liquids or hot food. Do not apply heat to your face. Try applying cold packs. Good Luck. Dr. Silberman
I have really bad pain in the back of my mouth. Both top and bottom are swollen. It is causing the same side of my face to swell. I had the same pain a few days ago, I swished some salt water around for a few seconds and it went away instantly. Now around a week or so later, the same pain is back, but worse!
Hello Andrew, I am guessing that you are in your late teens or twenties. Just a guess, but it sounds like your wisdom teeth (third molars) are erupting. They come in in spurts. The push the gum up causing it to swell, and when you bite together, you bite on the gums and it makes it worse. Warm salt water takes away the swelling and the situation returns to normal . . . . for a while. In a week or a month the process starts all over again. You should consult with a dentist who can determine if there is room for the teeth. I may be necessary to have them extracted. Good Luck. Dr. Silberman
Hello! Last Wednesday I started noticing pain in my upper back right teeth. On Friday, it was unbearable so I went to a dentist who did a cold test on it, and it was excruciating. Based off x-rays, they recommended a root canal because the decay on one tooth was getting close to the nerve. They told me they could not do anything for me that day and would not see me until I had my regular cleaning. The pain did not subside all weekend even with Tylenol, Motrin, and Orajel. I also used salt water and hydrogen peroxide rinses. It was hurting throughout my mouth, jaw, and ear. I went for a second opinion on Monday. They noted three cavities on all the upper back right teeth. Also, I had a previous filling that was loose. They filled all three teeth. Tuesday I went back in because I was in so much pain, but they said all of my x-rays and new fillings looked fine and did not show any more decay. Since then, the pain has slowly started to dull. However, it still has moments where it is excruciating. It is not keeping me up, but does wake me up (I can take meds and fall back asleep). Tylenol and Motrin have started to help to reduce the pain. It is more of a persistent dull ache at this point. Heat has also seemed very helpful, but I saw where your post said not to do that. My gums on that side of my mouth are swollen, and the tooth that had the deep cavity is sensitive to touch. Cold temperatures cause excruciating pain, so I am avoiding that. I also am not chewing on that side. Are these normal signs of a healing filling? Or do you think a root canal was/is needed? Could there be an infection that is not visible on x-rays? Any advice is greatly appreciated. Thank you!
Hello Mallory, So many good questions and so many different problems going on simultaneously giving multiple symptoms. Unbearable pain in the presence of tooth decay usually indicates an infected tooth that requires root canal therapy (or extraction). The dentist doing the cold test was able to identify the culprit. Cudos to that dentist for diagnosing properly. Prioritizing your regular cleaning over treating this infection warrants two demerits for that dentist. The second dentist did not do the cold test and missed the correct diagnosis. The new fillings that were placed can often cause sensitivity to cold drinks while, simultaneously, the infection continues to grow in strength. If you are using a whitening toothpaste, stop using it and substitute a desensitising toothpaste for awhile. Whitening agents make new fillings sensitive to cold. And they distract from the real issue which is the infected tooth that needs root canal therapy. X-rays do not show infection until advanced stages, so if they are trying to diagnose infection from an x-ray, find another dentist. Cold test, hot test, tapping test, palpation test, x-ray test, are all tools to use to get to the correct diagnosis. Two of them need to be positive to identify the tooth. You said you had a positive reaction to the cold test, and it is sensitive to touch. Bingo. Those are your two positive tests. I suggest you find an Endodontist (root canal specialist) who will see you and make the right diagnosis, and treat the right tooth. Then ask the endodontist for a referral to a general dentist. And look at online reviews to help you make a good choice. Good luck and I hope this helps. Dr. Silberman
My jaw started hurting real bad but I can’t tell which tooth is hurting and it it like throbbing and it just drive you crazy.I put ice and try salt water to ease the pain and it worked but the pain came back.i told my mom about it and I told her this could be an affection bu5 she don’t take seriously,and I’m scared that it developed more and loose my teeth I’m only 14.
Hi Gabriella, At age 14, there are two possibilities for the pain you are experiencing. Look in your mouth and see if you can find a very large cavity in your teeth that could be the source of the pain. Your first molars erupted into your mouth and age 6 and could have had enough time to decay into the nerve to create this pain. The ice would have made it feel better for a short time. If none of your teeth have a large hole like this, at age 14, your second permanent molar could be erupting. As it is coming in and gradually breaking through the gum, the gum can swell and be painful. The ice and saltwater would help take down the pain and swelling, but just for a while. I would continue with the ice and salt water, and I would take some Tylenol (2 extra strength) and 4 hours later 3 Motrin (also known as Ibuprofen or Advil) They are 200mg each so you would take 600mg every 8 hours, alternating with the Tylenol. At age 14, do not take any medication without your mom’s permission. In this case, you would be teething, and it will pass. Or ask mom to get some teething gel at the pharmacy to numb the area. If it is a cavity, you need to see a dentist ASAP. Mom might need to look at your upper teeth in the back because it is hard to see them in the mirror. If there is no cavity, you are teething and there is no need to see a dentist. Good Luck, Dr. Silberman
I went to a dentist to have my tooth extracted but even with the anesthesia I still felt pain he wasn’t being patient with me being my first time he was trying to isolate the teeth when the pain occured so he said he cannot work on me I had to leave now my cheek is swollen even with the pain from the tooth and injection site what do u advise I do
Hello Tonia, Sounds to me like you need to find another dentist. Try Googling a dentist in your area and find one with lots of 5 star reviews. Look for those that indicate they actually care about their patients. If you can’t get into see one quickly, go to your regular doctor or Urgent Care or Emergency Room and see if they might provide you with an antibiotic and pain medication if they determine there is an infection. Good Luck, Dr. Silberman
The area from my lip to my eye is swollen and painful could this be a tooth infection?
Hello Clay, Yes this could be a tooth infection. This area of the face can pose a serious threat to your health. One possibility is called cavernous sinus thrombosis which has severe complications potentially. Do not apply heat to your face. And see a dentist as soon as possible, or get to an emergency room or urgent care for an antibiotic prescription. Good Luck, Dr. Silberman
Hi Doc. About two months ago, I went to the dentist for a small case of gingivitis. As a result, I received a deep cleaning. Granted its been a while since I have had a proper cleaning, I think this has affected my gum’s recovery.
After about two weeks of the cleaning, I began to experience mild gum irritation, around the sites which had been inflamed prior to my cleaning. I went back to the dentist, and was recommended a salt water rinse. Doing that for two weeks, nothing changed. Due to this, I went back, where the dentist had now said that the recovery has been slow because of my poor oral health. I was recommended to buy an electric toothbrush, which I did, as well as to use a chlorohexidine rinse twice a day.
Nevertheless, I still have not seen positive progress. My teeth are a lot more sensitive, and I often feel numbness around some areas and constant pulsing from my teeth in other areas as well. The gum irritation itself is more annoying and uncomfortable some days over others. Its quite defeating to see no progress as a whole, and I just don’t know what else to do or try so that my teeth can feel normal again.
Do you have any recommendations? I’d appreciate it.
Hello Korintia, There are a lot of different issues that you have addressed. Based on the information you’ve given to me, here are my thoughts. If you only had a “small case of gingivitis”, a deep cleaning wasn’t necessary. We do deep cleanings where there are calcium deposits (calculus) present that need to be removed while you are numb. It may be that your situation was more advanced than you thought. The chlorhexidine rinse is something we give routinely after deep cleaning, and that usually works well. Is it possible that you need better home care? Regular flossing? If you are leaving a film of food debris on your teeth, you can get chronic inflammation. Meticulous flossing and brushing may correct the problem. It is also possible that there is a low-grade infection that needs to be corrected, and once controlled, your regular home care may be sufficient. To knock out the infection, I usually recommend a round of Amoxicillin 500mg every 8 hours for 10 days (for patients with no penicillin allergy). It is also possible that there is a fungal infection that needs a different type of medication. These are decisions that can be made clinically. As for the sensitive teeth, this is common following deep scaling because, as the tissue gets more healthy, it shrinks. With shrinkage there is more tooth exposure at the root level. The easiest way to correct that issue is with a desensitizing toothpaste. The over the counter brands like Sensodyne work well, but they take 4 to 6 weeks, so be patient. I hope that helps. Best, Dr. Silberman
Thank you for the reply! I really appreciate it. I am planning to go back to the dentist again next week to get my gums checked out again. What would you recommend I tell the doctor? I was just going to mention the symptoms I have, as well as the stuff I have already tried that haven’t worked.
The last time I went, the doctor had mentioned that the next step would probably be to get routine cleanings each month. I would say, because of my gum’s very slow recovery, that that would be a bad idea, since it could potentially damage my gums more, backtrack the recovery process, and never let me feel fully 100%. Any advice on that too?
Thanks again.
Hello Korintia, You should tell the dentist everything that has been going on with the gums. Ask the dentist for an honest evaluation of your home care and to revisit proper home care instruction. If they are recommending a monthly visit, it may be that they don’t have confidence in your ability to keep the buildup off your teeth. You should get some Sensodyne Tartar Control toothpaste that would help with both the sensitivity as well as the calcium buildup. Good Luck, Dr. Silberman
Hi.. I am having tooth ache in one of my pre molar of upper jaw since yesterday.. now it’s causing ache in my left side as in whole side.. it relives pain for a short while when applied cold stuff but starts again.. this pre molar has grown bit outer side of my jaw line.. sometimes foul smell stuff comes out of it when pressed but not always…please help..
Hello Nidhi, The relief you are getting from cold, though temporary, is a sign that there is an infection in the tooth. The bacteria are creating the foul smell as well as gas that is trapped in the tooth. Cold helps the gas to contract, which takes the pressure off the nerve endings. That is why the pain goes away. But your body heat is enough to make the gas expand again and cause the pain to return. Keep ice water handy to hold in your mouth. Do not apply heat to your face or eat anything hot. See a dentist as soon as possible. The tooth may need to be extracted, or it might be saved with a root canal treatment. Good luck. Dr. Silberman
Hello,
I am having an issue with my lower back second molar. My symptoms:
– burning itching ache around where the tooth meets the gums
– itchy burning discomfort into gums and jaw
– my tooth enamel is stripped on the side and exposed Dentin/roots
– I am recently pregnant and have acid reflux during all my pregnancies (3)
– this filling has always felt problematic since done 2 yrs ago, but no issues in xrays then or now
My dentist applied a desensitizer on the tooth 5 days ago and prescribed peridex mouthwash a couple weeks ago. He said he is trying to be conservative and hopes this helps without drilling.
It seems the discomfort happens in the middle of the night/ when I am stressed. I do have TMJ on that side and a mouth guard at night.
My dentist may do bonding, redo the existing filling or crown. My fear is that it is inflamed and is irreversible at this point.
Thank you for your opinion. It always helps to get sound advice rather then the google rabbit hole!
Hello Kristen, Congratulations on the three kiddos. Lots of ground to cover here. Let’s start with your “fear that it is inflamed and is irreversible at this point.” You said the x-ray is normal. If the dentist has probed the gum and found that the gum pocketing around the tooth is normal, then I would not worry about the problem being irreversible. If you wear your nightguard regularly, is it on the upper or lower jaw? If it is on the lower jaw, it might be that the guard is pressing on either the gum tissue or the two-year-old filling, and the guard can be adjusted by the dentist. Is the tooth testing normal to percussion and cold stimulus? In other words, does this tooth feel the same as the other teeth when you tap on it and when you drink either hot or cold liquids. If not, the tooth may require root canal treatment. The dentist should be able to test the tooth and if a positive result is received on two of those tests, a root canal is indicated. A positive result to tapping or cold would be that the tooth feels “different” from the other teeth. With cold, the difference could be either that it doesn’t respond or has a lingering response to cold, while the other teeth respond within 20 seconds but linger for less than 10 seconds. If none of your teeth respond to cold, the dentist has a tool that is an electrical stimulator to determine if this tooth is equally healthy compared to the other teeth. If the dentist thinks that desensitizing is the answer, do not use a toothpaste that has a whitening agent. It prolongs the problem. Use a toothpaste that is for desensitizing without whitening (Sensodyne, Crest for Sensitive Teeth, Colgate for Sensitive Teeth, etc.) If it is a sensitivity issue, it will take six weeks to go away using the desensitizing toothpaste. The last piece of advice I can suggest is to have the dentist check for a balancing side interference. The dentist would have you chew on carbon paper to leave a mark on your lower teeth created by the pressure from your upper teeth when chewing. Draw an imaginary line down the center of the tooth from the front of the mouth to the back. If there are any marks on the tongue side of that line, the dentist can remove them easily with the drill without numbing. This would correct the bite which could be the source of the problem. In summary, gum pocketing, desensitizing / or root canal, nightguard adjusting, or bite adjusting are the possibilities to correct your situation. I hope that helps and that I didn’t bombard you with too much information. Enjoy the kiddos. It goes by fast. Good luck. Dr. Silberman
i went to the dentist for tooth pain at a 10 at any given time and they did nothing they said i need a root canal i told them to just pule out the teeth and they are making me wait a whole month and i have no antibiotics or pain med they just sent me out with noting this is the worst mouth pain i have ever been in
Hello Lisa, sorry to hear you are going through this. Call the dentist back and explain that you are in pain and ask for antibiotics. Clindamycin 150mg is my antibiotic of choice for your condition, providing that you have no GI issues (irritable bowel, Crohn’s, colitis). If the dentist refuses, try another dentist for a sooner extraction. Or try another dentist or an urgent care or emergency room for the antibiotic prescription. For pain, try alternating Tylenol and Advil (Ibuprofen, Motrin). You can take two extra-strength Tylenol, and follow that four hours later with three over-the-counter Advil (200mg each). Alternate them every four hours as needed for pain. Good luck and I hope you feel better. Dr. Silberman
How to soothe jaw pain and not being able to open mouth cause of a tooth infection
Hello Jackie, You haven’t provided me much information to go on. You are having difficulty opening your mouth that you believe is associated with a tooth infection. I assume that the limited opening is due to swelling of the face. Do not apply heat to your face because that will make the swelling much worse. When the infection is advanced like this, holding ice water in your mouth could be very helpful to take away the pain temporarily. Also cold compresses applied to the swelling could help with the pain. I would take two extra-strength Tylenol followed four hours later by three Advil (Motrin, Ibuprofen) and alternate them every 4 hours. Most importantly, get to a dentist as soon as possible. You will likely need a prescription for antibiotics to quiet the situation. And then you will need either an extraction, or to save the tooth, a root canal treatment might be necessary. Good luck. Dr. Silberman
I have a broken tooth that needs to be extracted. My dental surgeon didn’t not give me any antibiotics or pain medication and my pain is at a 10. I do ibuprofen and Tylenol every 8 hours. Is there anything else that can help while I get the extraction?
Hello Jay, It depends on the state of infection that is present in your tooth. If advanced, the canal of the root could be filled with gas and infection. You should try holding ice water in your mouth around the tooth and see if it gives you relief. The gas would contract in the presence of the cold and help stop the pain. If the tooth is in an earlier stage of deterioration, the could might make it worse for a few seconds. But if it works, it’s a terrific way of getting rid of the pain short term. If it is going to be more than a day or two until the extraction, I would call the oral surgeon back and ask for an antibiotic and pain medication. The antibiotic of choice would be Clindamycin 150 mg four times per day. You cannot take it if you have GI complications, like Chron’s Disease, IBS, or ulcerative colitis. The antibiotic would definitely quiet things down at least 75%. Good luck. Dr. Silberman
My tooth is killing me my top back wisdom. Im not sure if its an infection or exposed nerve. Its been broken for years. Cold or warm dont really help nor does oral gel tylenol. Im not sure if the antibiotics are working if it is an infection. The pain mainly comes and night. Especially when i lay in bed. Only appears at night it seems
Hello Johnie, Very few people have room for wisdom teeth and it is not uncommon to have them extracted. If they are able to erupt into the mouth, it is often very difficult to keep them clean. They often develop either decay problems, or gum problems, or both. The obvious solution is to have the tooth extracted. Alternating Tylenol (2 x 500mg) with Advil (Ibuprofen, Motrin, 3 x 200mg) every four hours can help, as can the numbing agent like Ora gel. But getting that tooth out is the problem solver. Good luck. Dr. Silberman
Hello! For the past two day the upper right wisdom tooth has been bugging me. It feels like it’s scraping against my cheeks and my lower gums. I don’t know if it will get worse if I extract the tooth in six months when my insurance renews or if it should be dealt with urgently. There is constant discomfort when talking, eating and just sitting. It isn’t sensitive to the cold or heat. And on a scale of one to ten, I would rate the pain a 6.5
Hello Ramal, Sometimes an upper wisdom tooth erupts on an angle that causes problems as you have described. Wisdom teeth come in spurts, growing a little bit at a time, usually associated with some swelling. Warm salt water will help take down the swelling and should make it feel better. You could wait six months to get it out if it isn’t bothering you once the saltwater rinsing takes away the swelling. You’ll know in a few days. If it remains annoying, you’ll have to get it out sooner than later. Good luck. Dr. Silberman
I have just had a back tooth extraction. I am taking Omeprazole for my Crohnes flare and paracetamol. The dentist gave me penicillin and I was nearly vomiting. I am hardly eating, just water.
Hello Ayleen, Sorry about your tooth and your Crohn’s. Check with the dentist about stopping the antibiotic which can trigger the Crohn’s. See if you could use a Chlorhexidine rinse to stimulate the healing of the extraction site. Go on a white diet for a day or two (white rice, white potatoes, etc) Good luck. I hope that helps. Dr. Silberman.
I got really bad pain in my lower tooth on my left side so went to the dentist, had an x-ray and got told that I have an abscessed tooth. I got given some antibiotics for 7 days which I have no completed; I have to wait for 3 weeks for a tooth removal and maybe a root canal afterwards, I am scared that the infection will come back before the 3 weeks though( I’m not in pain anymore but what if it comes back). 🙁 thanks
Hello Kelly, If the pain returns, call the dentist to let them know. They will either get you in sooner or prescribe another round of antibiotics. Meanwhile, be careful to stay away from hot food, or applying heat to your face as this can draw out the infection and create swelling. By the way, a root canal treatment may be done to save the tooth. But once the tooth is extracted, the root canal treatment is no longer an option. Good luck, Dr. Silberman
How to remove a tooth cause it really hurt and I can’t take it anymore
Hello Regnault, Don’t try this on your own. Find a good dentist and let the professional do it. Good Luck, Dr. Silberman.
I’m swelled up so bad on the right side I feel like I’m going to pop what do I do ppp
Hello Rocky, Do not apply heat to your face. If you have done so already, that is the likely cause of the swelling. Apply cold compresses to your face and that may help. Get to a dentist as soon as you can. If one isn’t available, see an urgent care or emergency room for an antibiotic to help with the swelling. Clindamycin is the best at combatting tooth infection, providing you have no GI issues or allergy to it. Some non-dentists believe that Amoxicillin will work. It does, but not as effective as Clindamycin against tooth infection, and often physicians don’t know this. The swelling could be non-tooth related, such as a blocked salivary gland. In that case, Amoxicillin is the antibiotic of choice. I hope that helps. Good Luck. Dr. Silberman
I am in excruciating pain right now I have to keep taking a sip of cold water and soon as it warms up the lsmallest but I am screaming I mean literally screaming its 1130 on a Saturday what do I do !!!
Hello Shannon, Unfortunately, there isn’t much more that you can do. There are gasses that are trapped in the tooth that expand due to your body heat, and the cold causes the gasses to contract and take the pressure off the nerve to stop the pain. You could take a combination of Tylenol and Motrin. Alternating them every 4 hours should help, but the ice water is the key. Also, cold compresses on your cheek will help to lower the temperature in the area and help with the gas pressure. The tooth needs to be extracted, or if possible saved via root canal therapy. See if there are dentists with emergency hours tomorrow. If they don’t do root canal treatment, they can numb the tooth and drill open a hole to release the gas. That would stop the pain and prevent it from returning. They would then place cotton in the tooth to allow any new gas buildup to escape while keeping food out of the canals. I hope that helps. Good luck. Dr. Silberman
I have had pain for 2 days from the middle to the left side of my mouth. Not sure if it’s gum infection or tooth infection. I take tylenol every 6 hours but it does NOT last even a hour. It feels like throbbing pain and I have to keep ice/cold water in my mouth but it barely helps. Please help ASAP
Hello Jenna, You should alternate Tylenol and Advil (Motrin, Ibuprofen). Take 2 Extra Strength Tylenol (which you have already done). Then 3 x 600mg Advil and alternate them every 4 hours. That should give some relief. If it is a tooth problem, the ice water holds in the mouth could help. If it’s a gum problem, you could get an over-the-counter numbing gel to help with the pain. In either situation, you need to get to a dentist to diagnose the problem and get the right treatment. Good luck. Dr. Silberman
Hello,
I bit down on a hard candy a few days ago. I’ve checked my tooth all over for a crack, or any kind of break and there is none. But my tooth is in a lot of pain. It hurts to bite down on food. The only thing that seems to help the pain is taking a hot bath to relax and get my mind off of it. But as soon as I get out of the tub I start thinking about the tooth and the pain comes back. My gum does have discoloration like a bruise. I can’t tell which tooth hurts exactly it’s just a throbbing pain on my left, top teeth around the bruised area. Is this normal? Can I bruise a gum? Or does this require medical attention?
Hello Elizabeth, It is possible to cause trauma to a tooth that lasts a few days. You could consider it a bruise that needs time to heal. It is also possible to crack a tooth and not be able to see it, whether with the naked eye or an x-ray. We identify the problem tooth with a bite stick. You could use the back end of your toothbrush. Place it on one cusp at a time and grind your teeth. If one gives you a sharp response, it could be a crack. The treatment would be to have your dentist place a crown on the tooth. This would prevent the crack from advancing and causing the need for root canal treatment. If you have ever seen a crack in a windshield, you can visualize how this works. The windshield crack stays as is until you hit a bump in the road, and it spreads another inch or two. Then it stays the same for weeks or months until you hit it just right. With a tooth, the crack could be advancing towards the circulation in the center of your tooth. Once the bacteria in the crack hits that circulation, it is contaminated and will need root canal treatment. So I suggest you get it checked out sooner than later. Good Luck. Dr. Silberman
About a year and a half ago I went to a new dentist office and they insides I have a deep cleaning done, about 2 weeks later all my teeth started chipping away from the gum line.. now 3 teeth are all but gone and the rest, most front teeth the outer hard layer of teeth are chipped severally and nearly gone all inner part still there, other are not as bad but still bad and seem to just break even though they looked fine just before, also getting abscess regularly and I’m horrified to go to a dental office again.. My question is would it be worth trying to save what I have left or should I just have them all pulled and have dentures at 35??
Hello Megan, You need to Google dentists in your area and read the reviews to find one who will give you an unbiased opinion of your current dental situation. At 35, you should not be losing your teeth, but it’s possible. I deep cleaning is not the cause of the type of problem you are describing. The enamel on your teeth can be genetically predisposed to decay. If your parents had dentures, that would be consistent with your condition. But there are likely other contributing factors such as a high sugar intake or even using drugs like methamphetamine. Sugar that stays in your mouth for a long time is often the cause of rapid enamel deterioration. Soda sipping, sucking hard candy, dark chocolate, are some of the most common culprits. It’s not the quantity of sugar as much as the frequency of exposure (how long sugar stays in contact with the teeth) that causes rapid decay. See if you can schedule a consultation with a dentist who will provide a comprehensive workup. They should be able to take x-rays and present options to you for treatment. Their job is to inform and yours is to decide what is best for you. You have to decide based on financial, physical, and emotional considerations. Approach this as academically as you can and do what you feel is best for you. I hope that helps. Good Luck, Dr. Silberman
I rinsed with warm salt water and it caused me to feel like I struck a nerve. It gave me severe pain shooting in my gum
Hello Tanya, You gave me little information to go on, so I’ll share my thoughts on the most likely cause and solution. Heat is not your friend if you are having a toothache. As you’ve just learned, in your condition, warm salt water will cause pain. If it were a gum problem, it would make it feel better. So avoid that and avoid applying heat to your face. It sounds like you have an abscessed tooth. The infection in the tooth creates a byproduct of gas that is trapped. Heat makes gas expand and cold makes gas contract. The warm salt water caused the trapped gas to expand and put pressure on the nerves in and around the tooth causing the pain. I suggest holding ice water in your mouth and the gasses will contract and take pressure off the nerves and stop the pain. I suggest you see a dentist as soon as possible for either an extraction or root canal therapy. If you can’t wait, go to an Urgent Care or Emergency Room and get an antibiotic prescription, preferably Clindamycin (not to be used if you have any GI issues like IBD, Crohn’s, UC). I hope that helps. Good Luck, Dr. Silberman
I have pain and swelling, should I rinse with warm salt water or use a cold towel?
Hi Susie, It sounds like the swelling is of your face and not a gum swelling. Both warm saltwater and a cold towel COULD be helpful. It just depends on the cause of the problem. If it is an abscessed tooth, any heat could make it worse. If it is a gum problem, warm saltwater could be helpful. In either case, a cold towel is a good thing to help with the swelling. A bag of frozen vegetables like peas works well too. 20 minutes on and 10 minutes off. For the pain, if it is an abscessed tooth, holding ice water in your mouth will help. Try it. If it makes it worse, the infection in the tooth hasn’t advanced enough for the ice water trick to work, so skip it. Alternate 2 x 500mg Extra Strength Tylenol with 3 x 200mg of Motrin (Advil, Ibuprofen) four hours apart. That will give pain relief. Tylenol, then four hours later Motrin, then four hours later, Tylenol, and so on. Get to see a dentist as soon as possible, or an Urgent Care or Emergency Room. The sooner you get on antibiotics, the better. Good Luck. I hope that helps. Dr. Silberman
Hi, i recently went to the dentist on the 17th and they did a filling on a tooth as i was experiencing insane pain. It had decay but when i applied cold air or water it stopped hurting. but now even after the filling it still hurts a lot! they gave me some antibiotics and hydrocodeine tablets. Will these eventually stop the pain or will i need to get the tooth removed?
Hello Joshua, The symptoms you describe indicate that your tooth is necrotic. This means that the circulation and nerve supply that is usually in the tooth has stopped and an infection has taken over inside the tooth. The pain is coming from the nerves outside the tooth in the jawbone. An antibiotic may keep it quiet temporarily, but it won’t treat the infection inside the tooth where there is no circulation. Your chices are to save the tooth with root canal therapy, or you could opt to have it extracted. Talk to your dentist for further details. Good luck and don’t postpone treatment. Dr. Silberman
I went to the Dentist today for a root canal and he said everything went fine and there would be some moderate pain and inflammation. I already had an infection flair up the last 2 days, but the pain is excruciating if i don’t keep cold water in my mouth. will this go away in a day or two or should is this a more serious issue?
Hello Will, If the root canal treatment on this tooth was completed, cold water would have no effect on it. The fact that cold water makes it better tells me two things. Either the tooth has another canal that was accidentally unfilled, or there is another tooth in the area that is the culprit. If the root canal treatment was not completed, the temporary filling in the tooth can be opened to let the gasses out that are causing the pain. The temporary filling is soft and can be gently scratched out in an emergency situation. I recommend you go back to the dentist for further investigation and diagnosis. Good Luck, Dr. Silberman
Hi. I started having a very minor tooth ache back in December of 2020 but my dentist told me it was probably from grinding my teeth (I think that’s what he said). Anyway, I had gum surgery in an unrelated area and now my tooth ache from December is killing me (it is now April). When I went back for my post op gum surgery (that all went great), I gave the dentist an update on the pain that hasn’t gone away. It hurts SO bad with hot or cold food or drinks and the major pain lasts for like 30 seconds with further sensation for up to 20 minutes. My dentists thought it was tooth #31 so he shaved it down to see it was related to the grinding. Told me it couldn’t be #30 since there’s a crown there so I thought maybe it was #29. I still think it’s #30 but can’t exactly tell. What could the problem be and could it be #30 even though I have a crown there? Going back to the dentist of course but wanted to get your thoughts.
Hello IV, If #30 has a crown, that won’t prevent it from being a candidate for the cause of your pain, unless it has been previously treated with root canal therapy. Because there is sensitivity to cold, it should be fairly easy to diagnose which is the problem tooth. You could even do this at home. Break up some ice and take a small piece with some tweezers. Rest it on #29 until you can feel the cold in the tooth (not on the gum). Remove it immediately. Write down how long it took to feel it and how long the sensation lingered. Avoid applying the cold stimulus at the gum line which could be very sensitive everywhere after gum surgery. Once the tooth has warmed up, apply another piece of ice to #30 and write down the same measurments. And again to #31. The problem tooth should stand out in a crowd. That would indicate an infection is brewing in the tooth and it will need root canal therapy. If it is tooth #30, an opening can be made in the crown through the chewing surface and the root canal can be done. No need to replace the crown. A post can be placed in the root if the tooth requires shoring up at a later date and a filling in the chewing surface. If the culprit turns out to be #29 or #31, a root canal treatment AND a crown (and post and core filling) will be necessary. Severe pain as you are describing is almost always nerve pain from inside the tooth and root canal treatment will fix it. I hope that helps. Good Luck, Dr. Silberman
I have severe toothache pain. My dentist took x-rays and didn’t see a problem. When my upper teeth touch down on my tooth it is esscruciating pain. He prescribed clindamycin and ibuprofen 800… please tell me what may be wrong
Resa, please see my response to the other part of your question. Good luck. Dr. Silberman
Cold water with my tooth pain gives me a fit. I cannot lay on the side with the pain nor brush my teeth…. heat does give me a tiny bit of relief. My dentist told me that I am grinding my teeth in my sleep without knowing.
Hello Resa, If cold causes the pain, it is unlikely that you have an abscessed tooth. It is possible that there is a crack in the tooth. Often, a crack is not visible on an x-ray. It can be diagnosed by biting on one cusp of a tooth at a time. Test all the teeth to identify the culprit. This situation is even more common in patients who grind their teeth in their sleep. I would go back to the dentist and do the bite test to see if a crack can be identified. Meanwhile, continue with the Clindamycin and Ibuprofen. The Clindamycin is taken every 6 hours. The Ibuprofen is taken every 8 hours. I would also take two extra-strength Tylenol every 8 hours. Alternate the Ibuprofen and Tylenol every four hours. That way you can be taking something for the pain every 4 hours. Recent findings show that this technique is as effective as codeine at relieving pain. If there is a vertical crack in the tooth, and the crack does not extend past the bone support, the tooth can be saved with root canal treatment. If the crack extends below the bone level, it will have to be extracted. Good luck. I hope that gives you a bit more information to go on. Dr. Silberman
I had a toothache growing more and more painfull and so i went to the dentist to get whatever needed to be done over with and move on with life. They couldnt find an issue but did see an inflamed area. So they gave me an antibiotic and a hydrocodon pain killer. Have been on the antibiotic about 29 hours now and the pain is absolutely unbearable. I am debating going to the emergency room, but my dentist told me if i did that they couldnt really do anything. Holding cold water in my mouth the past 3 hours and it is seeming to be less and less effective at reducing pain. I dont know if i should start calling dental surgeons and offering them 500 dollars to come in late at night until i find one who bites or if going to the emergency room will get me anywhere. Any tips? I am already taking the hudrocodon and 800 mg of ibuprofen.
Hello Robby,
Sorry to hear you are going through this The ice water relief, even temporarily, confirms that there is an infection in the tooth. It will either need to be extracted or treated with root canal therapy. It should be easier for the dentist to diagnose now. Your symptoms needed to advance enough to be able to identify the source of the pain. The dentist can use a cold stimulus and rest it on one tooth at a time to stop the pain and identify the tooth. Or the dentist should have an Electric Pulp Tester to also identify the culprit. Your healthy teeth will respond to it at a low number on a scale from 1 – 10. The unhealthy tooth will either not respond, or respond at a much higher number. The medication you are taking is for pain. You need to be taking an antibiotic. The medication of choice is Clindamycin 150mg every six hours, assuming you are not allergic to it and have no GI issues like IBS or UC or Crohn’s disease. If the tooth is strong, it is worth saving. An urgent care can help with the antibiotics if you can’t get to a dentist. Good Luck, Dr. Silberman
Hi,
Dangers of applying heat while using Orajel?
Number 29. My dentist has extracted the infection and applied medicine so I can heal prior to a root canal. I’m asking the following question for a second opinion. Days before having the work I made the mistake of using Orajel and a heating pad at the same time. My lip and cheek in the affected area HAS BEEN NUMB ever since. I was thinking that the numbness was due to the infection and it would go away after having the area treated. My appointment was yesterday and my lip is still numb. My dentist brushed off my concerns. Do you have any advice? Maybe visit my PCP?
Hello Rachelle, I would doubt that your physician would be of help. If the problem persists, continue to pursue it with your dentist and, if necessary, get a referral to an oral surgeon for a second opinion. I don’t think that the Orajel would have this much impact, even in the presence of a heat source like a heating pad. The Orajel would not have that type of lasting effect. My guess is that the heating pad expanded the infection and swelling in the tissues which created the numbness. An oral antibiotic will take longer to clear out the infection and generate healing because of the heat application, but I think that is the treatment of choice. You did not mention if you were taking an oral antibiotic. If you are not taking one, I suggest Clindamycin 150mg taken every six hours for 10 days (assuming that you do not have and GI issues like IBD, UC or Crohn’s). I believe that will help with the numbness. I hope that helps. Good Luck, Dr. Silberman
Can I use cinnamon oil for a toothache?
Hello Carrie, You can use cinnamon oil for a toothache! You can also use Clove Oil, which is a better toothache remedy. You can purchase either of these items at local stores or on Amazon. Or you can make your own. Google it!
I hope that helps. Good luck. Dr. Silberman
It hurts so bad where the cavities are on my wisdom teeth and I can’t get to the dentist till Monday. Being pregnant I’m limited to what I can take. But oragel and Tylenol do nothing for it. Help!!
Hello Destiny, Sorry to hear you are going through this. The best home remedy for cavities/tooth decay and sensitivity to cold drinks is clove oil. You can buy it at any pharmacy and apply it directly into the decayed areas. Or you can Google it and find how to make it from cloves if you happen to have some in the kitchen. This works well if there is still feeling in the teeth. If the decay has advanced and has created an infection and tooth abscess, there is no sensitivity to cold drinks. The best thing to do in this scenario is to hold ice water in your mouth. The infection from the cavities can give off a gas that is trapped in the tooth and your body heat is enough to expand the gas and cause pain. Holding ice water in your mouth lowers the temperature and causes the gas to contract and stop the pain. The solution to your specific problem is determined by which problem you have. The cavity could be old. But if the infection is early, the first fix above will help. If the infection is old, the second fix above will help. Good luck. Dr. Silberman
I have no idea if I have toothache or not. My one side neck is paining very badly from last 1week , with that pain full face , ear starts paining. Why it pains, with painkillers tablet I will better. . full day goes well, only at night it get worse. Please help me with any medicine due to area lockdown ,I can’t go out
Hello Jocelyn, You need to go to Urgent Care or Emergency Room for a proper diagnosis and treatment. As for over-the-counter pain medication, I suggest that you alternate Tylenol and Motrin every four hours. Motrin is also known as Advil or Ibuprofen. Start with 600mg Advil (three 200mg pills), and four hours later take two Extra Strenght Tylenol (two 500mg pills). Alternate them every four hours for pain relief. Good Luck. Dr. Silberman
Until I can get to a dentist how to calm a chavity wisdom tooth plain
Hello Nay, Sorry to hear you are going through this. The best home remedy for a cavity is clove oil. You can buy it at any pharmacy and apply it directly into the decayed area. Or you can Google it and find how to make it from cloves if you happen to have some in the kitchen. This works well if there is still feeling in the tooth. If the decay has advanced and has created an infection and tooth abscess, the best thing to do in this scenario is to hold ice water in your mouth. The infection from the cavity can give off a gas that is trapped in the tooth and your body heat is enough to expand the gas and cause pain. Holding ice water in your mouth lowers the temperature and causes the gas to contract and stop the pain. The solution to your specific problem is determined by which problem you have. The cavity could be old. But if the infection is early, the first fix above will help. If the infection is old, the second fix above will help. Good luck. Try the one the works best for you. Dr. Silberman.
I’ve been experiencing very bad dental pain for the past 3/4years and have proceeded to not go to the dentist because I’m scared I’m going to get judged as my teeth arnt pleasant at all… when I was younger my dental hygiene was very very bad and I’ve now come out with 3/4 very badly decayed teeth one being a wisdom tooth which I’m pretty sure is still coming through so this is vet painful for me it gets so bad that I’m waking up 4/5 times every night and each toothache that I get lasts for 2/3weeks at a time constant. I just wanted an honest answer and someone to tell me the dentist is not going to judge me for my past dental hygiene because I really want this sorted it’s literally unbearable my whole face is locked in place for weeks on end
Hi Tony, I am so sorry to hear your story and that you are currently going through this. Most dentists would be sensitive to your situation and would have the attitude that it doesn’t matter how you arrived at this point, but you’re here now and we are going to bring your smile back. I suggest that you look up Google reviews and find a compassionate dentist in your area. I don’t recommend YELP reviews because they are the modern-day Mafia. I have 14 YELP reviews that are easily viewable, but you have to click on the Non-Recommended Reviews section to see all of my reviews. I have 45 reviews that could be entitled “Additional Reviews” instead of Non-Recommended. The number of stars is based on the viewable reviews in YELP instead of ALL of the reviews. My 45 “Non-Recommended” reviews are five stars. YELP want’s $1,000 per month to help with this “problem”. But back to your situation, look for reviews and find a dentist who cares. They are definitely out there. Good Luck, Dr. Silberman
If I stop using cold water the pain is terrible.
How can I sleep if I need constant ice water
Hello Mark, Keep the ice water on the nightstand. You’ve going to need it. But you can expect the ice water to control the pain for varying periods of time, hopefully giving you some breaks long enough to get some sleep. If you arent’ taking any pain medication, alternate Tylenol (2 x 500mg) with Motrin (3 x 600mg) every four hours, back and forth between the two of them. Stay away from any hot food or beverages. Get to the dentist ASAP to have the tooth extracted or to get root canal therapy to save it. An antibiotic like Clindamycin will help but it takes a few days to get the infection under control enough to give relief. Good Luck, Dr. Silberman
I recently had a deep cleaning done after many years of not going to the dentist. About a month later i developed an abscess. Could that have resulted from the deep, invasive cleaning?
Hello Keith, It is unlikely that a tooth abscess can be caused by a deep cleaning. But if your bone support around your teeth has deteriorated, you could develop a “perio-endo” problem. This means that the gum problem precipitated the bone loss, and the newly exposed root surface from the deep cleaning could have allowed bacteria to enter the circulation of the tooth through “Lateral Canals”. These are communications from the nerve in the center of the root to the exterior of the tooth. The bottom line: though unlikely, it is possible. In any event, it would not be the fault of either the dentist or hygienist. It sounds like you are back on track to getting your dental health back in order. Stay the course and good luck, Dr. Silberman
So I have and Infected upper left wisdom tooth it is cracked and broken bad I have been in clindamycin or however it spelled lol and been talking 800 mg of ibuprofen I go on the 24th to have it removed but nothing is working for the pain I just started the antibiotic today and thing other than ibuprofen that would be good for the pain it is a 10
Hello Amber, The degree of infection determines how to control the pain. If the infection is advanced, the decay could have killed off the tooth’s ability to feel pain from a cold stimulus. The Clindamycin needs a few days to kick in. The best home remedy, in that case, is ice water. Hold ice water in your mouth and it will make the pain stop. If the infection is in the early stages, the cold will make it worse. In that case, you could apply clove oil to the tooth and it could give you some relief. I would also add Tylenol to your pain management rotation. Alternate 2 extra strength 500mg tablets of Tylenol with the Ibuprofen. They should be taken alternating every 4 hours. Remember to avoid heat. No hot food or beverages and no external heat to the face. Good luck. I hope that helps. Dr. Silberman
How long should I keep ice water in my mouth
Hello Tj, The ice water trick works on relieving pain in teeth that have lost the ability to feel the cold due to infection in the tooth. The gasses trapped in the tooth contract at lower temperatures and that takes the pressure off other nerves to stop the pain. It could take a minute or two to work. But the duration of pain relief varies from person to person and tooth to tooth. It can’t hurt to leave the ice water in your mouth indefinitely to control the pain. The problem is sleep. At some point, you’ll need some. Antibiotics will help the cold to work for longer periods of time so that you can get some rest. Of course, this cold trick will just tide you over until a dentist can treat the cause of the problem. Good Luck, Dr. Silberman
I messed up and put heat compress on my face for toothache. Went on vacation and went to dentist and found out I had broken tooth. I’ve already done the damage with the heat compresses. I’m on antibiotics and steroids and pain meds until i get home. Should I use cold to help swelling now?
Hi Shawna, Sorry to hear you are going through this. Once heat is applied, it encourages the spread of the infection and can cause serious swelling. Then antibiotics and steroids will help. Application of cold at this point will help somewhat, but won’t have the same effect as before the swelling began. Sound like you’re getting good care. The antibiotic of choice is Clindamycin. Good luck , Dr, Silberman
What can I do to treat a toothache at home/what are the best over the counter medicines that I can purchase as soon as possible? Also, where is a good dentists office I can go to asap near me (south tacoma, washington)?
Hello Rebekah, The answer to your question about the best over-the-counter medicine for a toothache is, “It depends”. If the toothache is in the early stages and sensitive to cold, you can buy some Clove Oil or Clove Paste from any pharmacy. Place it into the cavity as directed on the packaging. If the cavity is more advanced and is past the phase of being sensitive to cold, the best thing to do is hold ice water in your mouth and it should stop the pain. Both are temporary but should tide you over until you can get to a dentist. Alternate Tylenol and Motrin every four hours. Take two Extra Strength Tylenol, and then four hours later three 200mg Motrin (Advil, Ibuprofen), and alternate them every four hours. As for finding a dentist, Google Best Dentist in your city and start reading reviews. Go to websites and see if they take the time to make them easy to read. Pick a dentist that is compatible with who you are. I lean towards a non-corporate entity but there are fewer and fewer solo practitioners around. Good luck on the hunt and I hope you feel better. Dr. Silberman
What is the meaning of “gasses trapped inside the tooth? Which kind of gasse may be present there?”
Hello Saptarshi, When bacteria decompose tissue, gasses are released. When you see a can on the grocery shelf and it is swollen and puffed out, the bacterial contamination within it has generated gas and the pressure expands the container. The same holds true inside of a tooth. When bacteria from tooth decay contact the circulation and nerve of the tooth, it deteriorates the tissue and the gasses are trapped. The expanding gas puts pressure on the nerves in the tooth and jaw causing pain. That is why ice water held in the mouth can bring some relief from advanced tooth pain. Cold makes gas contract and relieves built-up pressure. I hope that answers your question. Dr. Silberman
Good evening. Last month i had a tooth filling when the dentis put the braces on. She said next month on my first adjustment she will extract an impacted tooth on my left lower side days before i had my adjustment i feel pain in my impacted tooth and later on the pain also felt on the side of the tooth that the dentist had the filling now the tooth swell and the swelling spread to my jaw and i feel pain on my neck and ear too she recommended me an amoxicillin but it doest heal the swelling after that she recommended me again a co-amoxiclav augmentin but it seems not working too. The swelling is still here and ahe said she cant extract my teeth if there is still a swelling in it.
Hello Hera, I agree with the antibiotic approach as well as the choices of antibiotics selected. Hold warm salt water in the mouth several times a day to help reduce the swelling. If the swelling is still present when you see the dentist, the tooth can still be extracted, in my opinion. You already have antibiotics in your system to prevent the further spread of infection following the extraction. The dentist might need to place a drain at the extraction site to help with the potential of more swelling. Remember to avoid applying heat to your face which would dramatically increase the swelling. Good luck. Dr. Silberman
And my jaw also hurts if i try to open my mouth wide. Can i still have my tooth extracted if i have this pain in the jaw?
Hi there I’m having Troubling pain in a tooth of mine I was hoping u could tell me what the case might be it’s a non stop thing and I have to have ice cold water on it 24/7 witch is a struggle when im a stay at home mom it brings me to tears that I can keep up with my child because of this but I push through but at night I can’t sleep can u please tell me what this is ?¿
Hello Macey, You have an infected tooth. The likely cause is either a large cavity that allowed bacteria to enter the middle of the tooth where the nerve and circulation are, or it could have been from some earlier trauma where the tooth was hit. Coldwater relief is a classic way to diagnose the problem. The fix is to see a dentist ASAP. The tooth will either need to be extracted or saved with root canal treatment followed by a permanent crown. Meanwhile, continue with ice water holds to get relief. Also, a prescription for Clindamycin 150mg would help to quiet the tooth. And also alternating 2 extra strength Tylenol with three 200 mg Advil (Motrin, Ibuprofen) every four hours will help with the pain. Don’t take them together. Alternate them four hours apart. If you can’t reach a dentist, you can get the prescription for Clindamycin from an emergency room or urgent care. Good Luck, Dr. Silberman
I had a fill in a few years back and it came out I didn’t have the time to go to the dentist and wasent having any pain so I left it alone now more recently I’m experiencing lock jaw and radiating pain coming from the tooth it even gives me headaches
Hello Joseph, Lockjaw is not usually something that you would get from a tooth with a missing filling. If that tooth has an infection and there is significant swelling, it may cause a limitation to opening wide. The term Lockjaw would indicate to me that you are having pain in front of your ear at the point where your lower jaw meets the skull, resulting in having difficulty opening. We refer to this as a TMJ problem. Whether the problem is TMJ or a tooth infection, you need to see a dentist to make the right diagnosis and treatment plan. It couldn’t hurt to take 600mg of Ibuprofen (Advil, Motrin) every 8 hours to reduce the pain and inflammation. Avoid excessive chewing, like chewing gum. A prescription for a muscle relaxer could be very helpful and you can get that from either a dentist or an emergency room / urgent care. I hope that helps. Good Luck, Dr. Silberman
Hello,
I continuously try to keep good dental hygiene yet it seems to no avail. I have two wisdom teeth (left back and right back) that have gaping cavities right down the middle. They seem to cause the least of my problems. Often I am in pain throughout my lower jaw (my gums are pale pink to the bottom but a deep dusty red around my teeth) I noticed my gums around my bottom front four teeth have started to slightly separate but after noticing I started cleaning into there. I also bought gum detoxifying tooth paste and gum strengthening mouthwash as I thought this was early stage perodonditis. (My gums in certain teeth bleed when brushing). The pain is throughout my day but worse at night or upon waking up. But the worse pain is when I get a tightness all through my mouth (in my teeth, through the roof, and in my jaw) this tightness often hinders my ability to eat, talk, or relax my jaw without pain. This has pain affects not only my mouth and jaw but pokes in my temple, a deep feeling in my ear, and occasionally in my sinus and what feels like my throat. This pain is the worse to deal with. On good days I take up to 600mg ibuprofen if I can muster though but the bad days I’ll take 1200mg plus. When avaliable I will use ice/heat (I know ice is usually 100% recommended but at times I feel like its makes it a 100% times worse). I have an extreme fear of going to the dentist but feel that it is now only inevitable.
Hello Purplepixie, Sorry to hear you are going through this. Some people are genetically predisposed to dental problems. If your parents had problems with their teeth, it is likely you inherited them. I know you are afraid of the dentist, but you must go. Google dentists in your area and read reviews. There are many other people who share your fear and will have written reviews about dentists who empathize with your situation. Pick a dentist that will be patient with you and understanding. It sounds like you are prone to building up calcium deposits around your teeth below the gumline. No matter how hard you try, you won’t be able to get it out. That is something that the dentist (or dental hygienist) can do for you after getting you numb. You won’t feel anything during the procedure and you will feel much better once the treatment is completed. Then you will need to go routinely to prevent the build-up from happening again. The best reviews are Google or Healthgrades. Stay away from YELP reviews because they don’t show the whole picture and are more of a scam. Good luck, Dr. Silberman
Will freezing take effect when tooth is inflamed.
Hello Lenn, I’m not sure what you are asking. If you are asking if the application of cold to an inflamed tooth will help, the answer is “maybe”. If there is inflammation but no infection, the tooth can be sensitive to cold but usually, the pain does not linger. Application of cold would not be advised in this situation. If the tooth is inflamed and infection is present, application of cold could produce lingering pain and is also not advised. But if the inflammation has triggered an infection that is more advanced, application of cold may stop the pain. In no case is actual “freezing” a treatment. I hope that helps. Good Luck, Dr. Silberman
My mom have severe pain in tooth bcoz of gas…she have a gastric issue bcoz of gas her tooth ache badly what medcine is good for that plz suggest me i will b greatfull to you
Hello Sana, Toothache is not usually associated with gastric issues. If stomach acid is reaching the mouth (reflux) it can damage the teeth. But it doesn’t sound like that is what is happening with your mom. She should see a dentist as soon as possible. With Gastric Issues, she should not take Advil (Motrin, Ibuprofen). She should take Tylenol Extra Strength every 8 hours (two 500 mg pills). She could also try holding ice water in her mouth to lower the temperature of the bad tooth to see if that stops the pain. Good luck. Dr. Silberman
Hi, I think I have a tooth infection bc I got tooth decay. I took anti-biotic 3x a day for a week bc I believe that it can reduce the swelling, after that the swelling is gone and I thought I was fine. After a week of being fine my tooth starts to ache again, swelling again. So, I did the same procedure, anti-biotic 3x a day for a week yes, it did reduce the swelling but on the 5th day of taking anti-biotic it began to swell again. Is it possible that the bacteria develop resistance to my anti-biotic or I just need to change the brand or the dosage?
Hello Adriana, Usually dental swelling and pain are reduced with antibiotics. If taken repeatedly, the bacteria develop a tolerance to that particular antibiotic. For the same reason, we do not prescribe antibiotics for the common cold. Overuse of antibiotics has led to resistant strains that are far more difficult to treat. Antibiotic treatment for dental swelling helps with the symptoms (pain and swelling) but not with the underlying problem. The circulation inside the tooth has been damaged by tooth decay. The antibiotic can’t make its way into the tooth to kill off the bacteria because of this damaged circulation. The inside of the tooth is dark, warm, and moist, and perfect for bacteria to breed. The first time you took the antibiotics, the swelling went down. The bacteria learned from the experience and developed a tolerance, and the bacteria that were unaffected inside the tooth continue to grow in strength and numbers. You need to have this tooth treated as soon as possible with either an extraction or a root canal treatment. A different antibiotic may help in the short run, but putting off treatment and exposing yourself to more antibiotics is not the cure and it’s more detrimental to your overall health in the long run. I hope that helps. Good luck, Dr. Silberman
Ice water relieves my excruciating tooth pain. The pain comes back 15 seconds after I swallow. Should I go to the ER
Hello Justin, You should go to a dentist. The ER will prescribe an antibiotic and narcotics, but that would be masking the symptoms, not treating the problem. You have an infected tooth that needs to be treated with either root canal therapy or an extraction. Don’t waste your time in the ER. Keep applying the ice water as needed to keep the tooth quiet for now. If the dentist doesn’t have time to do the root canal or extraction, they could numb the tooth and open it up to allow the gas that is causing the pain to escape. That would prevent the need for constantly using the ice water. Good Luck, Dr. Silberman
Both the top, bottom and jaw on my left side have an awful ache and nothing is helping I can’t visit the dentist any time too soon and OTC pain meds aren’t working I don’t know what to do
Hello Alicia, I can’t tell from your description if this is a tooth, muscle or joint issue. Try cold compresses on the area, and alternate two Extra Strength Tylenol with three 200mg Motrin (Advil, Ibuprofen) every four hours. Apply the cold compress 20 minutes on and 10 minutes off. By alternating the pain medication, you are taking something every four hours. If you can’t get to a dentist, go to an ER or urgent care. Good luck, Dr. Silberman
My tooth ack is a burning
Hello Beverly, You really don’t provide me with much information to help you. Try holding ice water in your mouth to stop the pain. Of course, if your teeth are sensitive to cold, this won’t work. Alternate taking Tylenol and Motrin four hours apart. Take two extra-strength Tylenol, then four hours later take three 200 mg Motrin, and alternate them every four hours. And most importantly, see a dentist as soon as you can. Good Luck, Dr. Silberman
I was at the dentist 2 weeks ago. Everything checked out. Now my back teeth are killing me. My dentist put me on an antibiotic yesterday to see if there is a hidden infection.
But, everytime I take a drink of ice tea and swoosh it on the side it instantly goes away. But as soon as I swallow or the liquid gets warm it hurts really bad.
What is going on?
Hello Nikki, It sounds like you have an infection in one of your teeth. It may have had no symptoms two weeks ago and now is symptomatic. It happens. The bacterial infection in the tooth gives off a gas that is trapped inside. When you drink something cold, the gas contracts and takes the pressure off of the nerve which then stops the pain. Your body heat is enough to expand the gas and start the pain back up again. Your dentist can take a cold stimulus and apply it to one tooth at a time to identify the culprit. Then you have to decide if you want to have the tooth extracted, or save it with a root canal treatment and crown. I am sure the dentist will go over your options, and you have to decide which is best for you. For now you need to keep ice water handy, call the dentist for an appointment, and avoid any heat (no hot compresses, heating pads, direct sunlight, no hot food or drink). Good Luck, Dr. Silberman
Hello. I got my wisdom tooth removed 3 days ago, but my cheek is swollen on the inside and pressing against my teeth. It hurts so much that I can’t sleep or eat. What can i do to reduce the swelling?
Hello Maria, Hold warm salt water in your mouth to reduce the swelling. Don’t swish. Just hold. Also, apply cold packs on the outside of your mouth on your face in the area where you have swelling. This should help but it may be necessary for the doctor to call in a prescription for antibiotics if he/she hasn’t already done so. I hope that helps. Good Luck, Dr. Silberman
Hello, I’ve had Pretty moderate tooth pain for the past day and a half now I’ve applied ice but I’m not sure it’s helping. I’ve been taking Tylenol but haven’t tried ibuprofen (I take lexapro and wellbutrin and wasn’t sure if it’s okay to mix it) I’ve applied ice, and nothing seems to be helping. Should I call my dentist? Do you think it could be a tooth abscess? I have pain in my jaw as well as ear. I also have tmj that hasn’t been treated. So to say the least I’m in a lot of pain and would love what your opinion is.
Hello Abigail, Yes, I think it best to call your dentist. Sometimes it is difficult to identify where the pain is coming from. In your case, it could be either tooth pain or TMJ. Once a diagnosis is made, the treatment will become obvious to the dentist. In either case, it is OK to alternate Tylenol and Motrin (Advil, Ibuprofen, Motrin are all the same drug under different names). Take two extra-strength Tylenol. Four hours later take three 200mg Ibuprofen (600mg total), and alternate the Tylenol with Ibuprofen every four hours. I hope that helps. Good Luck, Dr. Silberman
All my teeth are rotting and I tried getting them out and they said I had to have a dentist say they need to come out but if you look it’s very clear they all have to go.i cant find a dentist that exempts new patients. All my teeth are down to gum on top and almost all on bottom are down to gums. I live pay check to pay check so I don’t have money. But the pain is killing me and my whole head is constantly throbbing . It’s been like this for 15 years and I cant take the pain anymore. I need help. If you know of any orthorsurgans or something . Any help would be appreciated.
Hello Meranda, Each state and locality may or may not have charitable services available to you. The resources vary tremendously. Hopefully, you are in an area that has a “dental safety net.” You’ll have to do some investigating on your own. I can make some suggestions. Contact these places and explain your situation to them and see if they can help, but expect some quirkiness in the rules. For example, if you are living in the state of Maryland and you are pregnant, your dental needs are covered by Medicaid at 100%. The day you deliver your child, your dental benefits end if you are over age 18. Anyway, check with your representative in your state government and see what your state provides in the way of dental coverage for those in need. There are charitable organizations that may be able to help like Catholic Charities. Also, look into Mission of Mercy in your area. In my area, we have Donated Dental Services which screen the patient’s needs and then asks local dentists to volunteer their services. Also, see if there are any dental schools in your state that have a sliding scale based on need. Dentists in training are closely supervised and the patients get excellent care at a reduced fee. Another option is to ask clergy for help. Go to your church or synagogue and see if they have a system in place to handle this type of need. Unfortunately, there is no universal answer. It just depends on where you live. Good luck, Dr. Silberman
I’m 29weeks pregnant and I’m having unbearable throbbing pain from my tooth to my head causing me to jump and cry what do I do
Hello Melissa, So sorry to hear you are going through this. If you have the late stages of a tooth infection, holding ice water in your mouth will help stop the pain. If it is in the early stages of infection, it won’t help. But it is worth a try. Getting to a dentist to be diagnosed and treated is most important. It is OK to have x-rays taken now that you are no longer in your first trimester. Stay away from heat . . . . no hot foods or hot drinks, no hot compresses, no direct sunlight and stay cool inside. Check with your OB but alternating Tylenol and Motrin every four hours to help with the pain. Good luck and have an easy delivery. Dr. Silberman
Why does holding water in my mouth help my toothache?
Please explain my problem I can’t understand.is it sensibity problem?
Hello Neha, The likelihood is that you have an infected tooth. The infection could have been caused by a cavity or trauma, allowing bacteria to get inside the inner workings of the tooth. The bacteria are increasing in number and they give off a by-product of gas. The gas is trapped in the tooth with no way to escape. The gas expands in heat and contracts in cold. Your body heat is enough to cause the gas to expand and put pressure on the nerves in your tooth and/or jaw. This causes the pain you are experiencing. The cold water reduces the temperature causing the gas to contract and take the pressure off of the nerve, stopping the pain. You need to see a dentist to either have the tooth extracted or save the tooth with root canal therapy. Meanwhile, keep ice water handy to keep the tooth quiet. I hope that helps. Good Luck, Dr. Silberman
I have a toothache and its throbbing here and there.
Hello Larissa, You aren’t providing me with much description of your problem to enable me to offer any advice. But you should see a dentist as soon as possible for a proper diagnosis and treatment plan. Good luck, Dr. Silberman
If I have an appointment to have the two infected teeth pulled, but my pain has went from 5 to a 10 within two days of seeing my dentist. Can you call them and get them to pull them sooner.
Hello Candace, You should definitely call your dentist and explain what is happening. Knowing your needs, they may be able to prescribe medication to quiet the teeth until such time that they can get you in for treatment, or they may be able to get you in sooner. Good luck, Dr. Silberman
Hi I’m located in Columbia Pennsylvania so I have 2 tooth decayed into my nerves missing half tooth from both teeth the one tooth was medicated filling put in but that’s no longer holding back the pain anymore I visited dentist this week subscribed me ib profen referred me to have 2 teeth extracted but obviously takes time get in these appointments as the week went on at first I was okay but now past 2 days have been unbearable taken every ib profen aleve and Advil known to man tried arm and hammer toothpaste baking soda peroxide combo no relief tried salt water no relief now I’m at point my gums are bleeding from where the two teeth are that need be extracted I guess my question is what should be my next move I won’t make it till this appointment with this kind of pain I’m at a loss what to do I can’t sleep 3 days straight it’s just getting worse and I just need relief to hold the pain over till I can get it extracted please give me some guidance I cannot take this I don’t know what to do I’m literally begging for help at this point
Hello Joshua, Sorry to hear you are going through this. Depending on the infection in the tooth, it could be in the early stages or the late stages. I am going to assume you have late-stage infection. Try holding ice water in your mouth. It will stop the pain if you have late-stage infection. If not, it will hurt for a moment and go back to the same level of pain. It is definitely worth trying. As for the pain medication, alternate extra-strength Tylenol with the Ibuprofen. Take 2 Tylenol, then four hours later take 600 mg of Ibuprofin (3 over-the-counter 200mg tablets). Switch back and forth between them every 4 hours as needed for pain. Good luck. I hope that helps. Dr. Silberman
hi i have my back tooth chipped and i had it filled with sliver fillings years ago, my tooth started to hurt so i took a 500g paracetamol and then after an hour the pain got seemingly worse.. i brushed my teeth and around the painful area and used mouthwash too and it felt better but then just ultimately got worse the pain was almost unbearable even after being cleaned. every time i lay my head it done it starts to hurt even more and then i took another paracetamol and i’m not sure if it’s even working i also took one amoxicillin
Hello Husna, It is difficult to make a diagnosis that is absolute, but it sounds like you have an infected tooth. Because the filling is many years old, it is likely a late-stage infection. For immediate relief, hold ice water in your mouth. That should stop the pain. It sounds like the tooth is going to need to be extracted, or treated with root canal therapy. Also, alternate taking the paracetamol with Motrin (also called Advil or Ibuprofen). Take them four hours apart. That would also help with the pain. But the ice water should do the trick. Remember to avoid applying heat to your face and stay out of the heat outside. I hope that helps. Good luck, Dr. Silberman
The right side of my mouth hurts and I don’t know what to do.
Kailyn, I need more specific information in order to offer advice. If you are in your late teens or early twenties, you could be teething – your wisdom teeth may be trying to erupt through your gums. Hold warm salt water in your mouth. If you have a large old cavity, holding ice water in your mouth could help. I need more clues to help me help you. Dr. Silberman
I have pain in different theeth in different time
Hello Avani, Sounds like you need to see a dentist. You didn’t really ask a question, but feel free to do so. Good Luck, Dr. Silberman
I have severe back molar pain I thought it was abscessed and went to dentist. Xray shows no infection. Seeing endodontist tomorrow Bruxism may be factor but pain is off the charts!
Jan, Bruxism can cause a vertical fracture in a tooth, allowing bacteria from the mouth to enter the isolated circulation inside the tooth. That would be the likely source of your pain. The endodontist should be able to determine the extent of the fracture. If advanced, the tooth may need to be extracted. If you were my patient, I would put you on Clinamycin 150mg (antibiotic) every 6 hours. Because the infection has not advanced to the abscess stage that would show up on an x-ray does not mean that an antibiotic is not warranted. The antibiotic would help to get the infection under control. Also, I would shorten the height of the tooth so that when you bite together, you would not cause more pain, and ultimately you would get some relief. If the tooth can be saved, it will need to have a crown placed on it. Shortening the tooth now will make it feel better and would need to be done at the time of the crown preparation anyway. If the tooth is not sensitive to cold, hold ice water in your mouth for instant relief. Good Luck, Dr. Silberman
Hi Dr. need advice.. I’ve had. numerous procedures (extraction, root canal, apicoectomy and generally had normal symptoms and healing after. (except for re infection on Apico tooth) But recently had a deep mercury filling removed, Tooth #14 and had weeks of intense pain and throbbing. gum swollen, not face. then a root canal and still shooting pains. throbbing is basically gone. this is not a normal reaction for me or anyone . i realize if we were close to the nerve a root canal may have been necessary. but still with shooting pains intermittently. was asked to see an oral facial specialist who basically said ‘could be nerve or muscles TMJ) do you have any thoughts on this? thank you. temporary filling in there now
Hello Janet, To summarize, #14 had the filling replaced followed by symptoms of intense pain and throbbing, swollen gum. If I am reading you correctly, this was followed by root canal treatment of #14. But your sharp shooting pain persisted intermittently. It is possible that there is a fourth canal that needs to be filled. It is possible that there is just a stubborn infection that is in the bone outside the tooth that needs another round of antibiotics. My go-to is Clindamycin 150 mg dispense 40 taken every six hours for 10 days. I would make sure that the tooth is out of occlusion. By that I mean the height of the tooth is reduced so that when you bite together, there is no contact with the opposing tooth. This will aid in the healing process and the tooth will gradually come back down into contact with the opposing tooth naturally. It is possible that there is a neurological component, but it is low on my list of possibilities. I wouldn’t rule it out, but it is not as common. I would look for these other clues first. I would also double-check the other teeth to make sure they aren’t showing symptoms of needing root canal treatment, either adjacent to this tooth or opposing it. Upon ruling out the other teeth as the source of the problem, and taking a round of antibiotics, a Medrol Dosepak would address nerve inflammation that could be the source of the pain. That is where the neurologist would come into play. I hope this isn’t too much information, and I hope that one of these suggestions fixes the problem. Good Luck, Dr. Silberman
Hi Doc! First of all I want to say YOU ROCK! Never have I come across such a thread where each response is replied to.
I have a current infection/abscess next to my front top tooth. Extreme throbbing pain (I’ve given birth twice but this is next level). I have a dentist appt tomorrow morning (I’m in Australia) and your cold ice water tip is really helpful. I’ve also started the ibuprofen and paracetamol every 4 hours, as you recommended and that seems to be helping! Hopefully I can get some sleep tonight. I’m just wondering, when I see the dentist tomorrow will he start me on abx , and get me to come back when infection is cleared ….or can it just be extracted tomorrow? I have awful luck with my teeth, it runs in the family, and I actually am going to enquire about full upper and lower dentures while I am there (34yo) – hopefully they don’t refuse it ? Anyway, have a great day and thanks again 🙂
Hello Stacey, Thank you for your kind words, and hope you are having a good winter down under. Sorry to hear about your tooth problems. So young to be wanting a complete denture. If that is the case, they should be able to take the tooth out. Any residual infection would drain through the extraction site. There is a big difference between a complete upper denture and a complete lower denture. Hold on to any lower teeth that are healthy enough to keep. They can be an anchor for a lower partial denture rather than a complete lower denture. The upper denture acts like a suction cup on the roof of the mouth and is very stable. The lower denture has the tongue in the middle and is horseshoe-shaped. With nothing to hold onto, it just flops around all the time. Better to have some teeth to anchor it. Have the denture made of acrylic and wrought wire. If another tooth goes bad, you don’t have to start over. You can just add a tooth to the acrylic and wrought wire partial denture. Some partial dentures (flexible resin) do not allow your to easily add a tooth. And the acrylic and wrought wire partial is less expensive. Good luck to you. Keep that ice water handy until you can get that tooth out. Dr. Silberman
I broke my tooth and no pain killer have been helping but cold water. Do you have any other alternatives? My dentist appointment is tomorrow need to get through today thank you for your time.
Hello Ali, Ice water is the key to stopping the pain in your situation. Keep a glass of ice water handy. You can also alternate taking two Extra-Strength Tylenol with three 200mg Ibuprofen (or 3 Motrin or 3 Advil). Alternate the Tylenol and Motrin every four hours. That will also help with the pain. And remember not to put heat (hot compresses) on your face. It may feel soothing to do so, but it can draw out the infection and swelling to your face. I’m sure your visit to the dentist can’t come soon enough. Good luck. I hope this helps. Dr. Silberman
Hello doc. I had my Top right molar tooth extracted exactly 14 days ago today. But I’m feeling pain around the extraction site. Not unbearable pain but strong discomfort in the gums around that area. It’s so tender and hurts if I simply put my tongue there. And I’m also getting like 3 different absess, over my wisdom tooth one at my front tooth and over the extraction site seems swolen. Help! How long should the swelling last after extraction. What should I do.
My dentist says no salt water just ice water. Is it true?
Hello Debbie, The sore gums around the extraction site are probably due to the bone being too sharp under the gum. This is not uncommon and it usually rounds out on its own during the healing process. Sometimes the dentist has to numb the area and go back and smooth the bone to get it to heal right. Because it isn’t bothering you too much, I would take a “wait and see” approach. For your dentist to fix the problem, it is not difficult to do nor uncomfortable for the patient, but it does require getting numb one more time. As long as the bone stays sharp, you will have some swelling. The other areas that are abscessed are separate issues that should all be addressed by the dentist. I do not know why your dentist advises against saltwater holds. That is a pretty standard way to reduce gum swelling. I don’t want to go against the advice of your dentist, so you should call and confirm that they do not recommend saltwater holds, and find out why. Good Luck, Dr. Silberman
My tooth is cracked into half I’ve been only taking paracetamol. I’ve tried oral gel, cold compresses nothing seems to work.
Hello Sharon, Sounds like you need to see a dentist ASAP. For non-prescription pain relief, try alternating Tylenol and Motrin every four hours. Take two extra-strength Tylenol, then four hours later take 3 over-the-counter 200mg Motrins (same as Advil or Ibuprofen). Alternate these medications every four hours as needed for pain. Also, you can go to your local pharmacy and purchase some clove oil and apply it to the broken tooth. I hope that helps. Good luck, Dr. Silberman
Hello, I had tooth ache last Monday, seen a dentist Tuesday and I’ve had a cracked tooth. He did a filling and gave me codiene and antibiotics, however it’s still hurting 5 days later
The pain is on and off. When it’s painful it’s severly painful. Holding water in my mouth reliefs the pain a little. What else can I do?
Hello Tom, The tooth is in the later stages of infection based on your description. Continue taking the antibiotics as directed. If you were prescribed Amoxicillin, it will take a little longer to get the infection under control. Clindamycin is the antibiotic of choice in this situation, but Amoxicillin is the most commonly prescribed and recommended. The tooth needs to either be extracted or treated with root canal therapy to save it. The ice water holds in the mouth will be a lifesaver. Along with the prescribed medication, take 600mg of Motrin (Advil, Ibuprofen) every 8 hours to help with the inflammatory nature of the problem and help with the pain. Good luck, Dr. Silberman
Recently had a root canal performed on an upper right tooth (the one before the last molar) 3 days after being home I’m having WORSE pain than I had before going in. It’s weird because I’m getting pain obviously from the tooth they put a temp filling (I go to my reg dentist Aug 11) but I’m also feeling INTENSE pain 2 teeth up from it my “fang” it’s SEVERE like scale 1-10 it being a 15 pain. On the bottom and between.
I’m trying to get into the Endo for an emergency apt however it’s the weekend and they’re closed. I haven’t been able to eat anything not even soup bc everything is irritating my mouth. My regular dentist was unable to give me pain meds as he’s out of the country til my apt on the 11th but his nurse prescribed me the antibiotics you recommend. I’ve been on those for 2 days now. 🙁
I’ve had a lot of dental work done like my 4 front teeth are fake and I’ve had MANY root canals. This however has been the worst pain ever.
You really are a life saver responding to all of these questions esp for us who can’t be seen by a dr until a certain apt!
Hi Jamie, Thanks for your kind words. I hope everything works out for you. Dr. Silberman
Toothache is a terrible experience. Thank you for the information you shared on this article.
Thank you, Michelle. Have a great day.
Dr. Silberman
I recently started taking cephalexin for and infection in my arm and since then, I have mild to severe pain in my teeth, sometimes just the bottom, sometimes the top as well. Is this related to the antibiotics, congestion, or potentially something else?
Hello Jessi, I do not believe there is a correlation between Cephalexin causing tooth pain. Actually, Cephalexin is one of the antibiotics that is used to treat tooth infection and stop related tooth pain. The source of your pain could be either sinus-related or tooth-related. You should see a dentist for a differential diagnosis to determine the source of the problem. I hope that answers your question. Good luck, Dr. Silberman
Anything around the house to ease the pain coming from a big hole in my second molar! It has swollen my throat and it’s very hard to eat
Hello Ryan, The swelling extending to your throat is not something to take lightly. You need to go to an emergency room for possible intravenous antibiotics. If the swelling crosses the midline, you could develop difficulty breathing. The throat swelling needs to be addressed first. Then you have to see a dentist to fix the tooth. For home remedies I suggest the following: If the tooth is not sensitive to cold, you should hold ice water in your mouth around that tooth. If it is sensitive to cold, you can apply clove oil to the “big hole” in the tooth. Grind up a fresh clove and place it in the hole to get some relief. The ice water trick works for late-stage infections. The clove works in early-stage infections. I can’t determine which you have so you’ll need to experiment and decide. For pain, you can alternate taking Tylenol and Motrin every four hours. Take two extra-strength Tylenol followed by three 200mg Motrin, and switch them every four hours. I hope this helps. Good luck. Dr. Silberman
I’m in the UK I have to have three teeth extracted and I am in constant pain with them. I’m waiting to be referred to a different clinic to have them removed because I take warfarin (anticoagulants) and my dentist doesn’t want to risk removing the teeth. Two of the teeth have holes in them and I am in constant agony how can I manage this pain until I am referred (btw standard referral to this particular place is a year)
Hello Amanda, You can’t wait a year for these extractions! That’s awful. Having said that, let me answer your questions. What can you do for the pain while you are waiting? Your dentist should prescribe an antibiotic like Clindamycin 150mg every six hours for 10 days. That will quiet the problem, but I don’t know for how long. It’s not good to go off and on antibiotics regularly because you would build up a tolerance. But you need to put out the fire now and see how long it takes for the fire to return. You should also test the teeth with ice water. If the infection is advanced, the ice water will take away the pain. If the ice water doesn’t do anything or makes it worse, you are in an earlier stage of infection. You can get some clove oil at the pharmacy and place it in the holes to get some relief. Or you can make your own by grinding up cloves and placing it in the holes. You can also alternate Tylenol and Motrin. I would take two extra-strength Tylenol and four hours later take 600 mg of Motrin (Advil, Ibuprofen). Switch back and forth every four hours between the two medications. Do this while the antibiotics are kicking in. I hope this helps. Good Luck, Dr. Silberman
I have been waking up in the middle of the night to bad tooth aim from a broken top tooth. I can see black in the rotten tooth,I brush my there and let mouth wash sit on the tooth for while and then put oriole on the tooth. This has been going on for 3 nights now.
Hello Chuck, You need to see a dentist ASAP to either fix the problem or extract the tooth. If the tooth is in the early stages of infection, you can put some clove oil in the hole to get some relief. If it is in the last stages of infection, holding ice water in your mouth will help with the pain. You can also try alternating two extra-strength Tylenol with 600mg of Motrin (Advil, Ibuprofen) every four hours. Switch back and forth between them to get some relief, but go see a dentist. If you can’t get in to see a dentist, you could go to an Urgent Care or Emergency Room because you might need an antibiotic, which either could provide you with. I hope that helps.
Good Luck, Dr. Silberman
Hello, I had a root canal treatment on my tooth and a crown a year ago. Last week I got intense pain in the same tooth. I went to my dentist, we did an X-ray, and it all seems well. We checked the neighboring tooth and they are all good. I got antibiotics and other medication for now, and we are going to try to open the tooth and see inside next week. My question, however, is it necessary to remove the tooth in this case or it is still possible to re-do root canal filling?
Hello Paulinka, Such a pretty name. A retreatment of the root canal can correct the problem but the chances of success are around 50%. Some dentists have 3D x-ray technology and , before reopening the tooth, they could take this x-ray to determine if there is an extra hidden root and canal that did not get treated. If so, and if they can find and fill that canal, the success rate jumps to over 90%. Either way, I think it is worth trying the retreatment. If the retreatment fails, an extraction and implant are your best option. I hope that helps. Good luck, Dr. Silberman
Hi. I wish I could find a dentist as practical as you sound. Finally got some insurance and went to dentist because of general mouth pain and bleeding gums. Was told periodontist — rather than scheduling appointment for deep scaling and root planning insisted I see a gum specialist which insurance doesn’t cover. 1st available appointment 2 months out. Now one month later I have severe toothache. Only ever had one cavity my whole life previously and always maintained good tooth hygiene—now at 57 this is very stressful.
Questioning whether to trust this dentist and call about toothache or seek another dentist. No loose teeth. Don’t understand why the dentist didn’t proceed with deep scaling and root planning that is paid for by insurance if done in dentist office but a specialist is not covered. Scary—I want to keep my teeth but can’t afford extra procedures not covered by insurance.
You sound like the practical and effective dentists that worked with my husband years ago. I live in another state now.
Hello AM, Thank you for your kind words. It is not uncommon to see minimal decay in the presence of gum disease. The bacteria that cause decay are different from the bacteria that cause gum problems. They don’t like each other and fight for dominance, and your gum disease bacteria have taken control. Right now, it sounds like a round of antibiotics would get your gums comfortable until you can see the periodontist. But you should go back to the general dentist to evaluate if this toothache is gum-related, or if it needs treatment now. I like the fact that the general dentist knew his/her limitations and referred you to a gum specialist rather than trying to treat you himself. Regarding your insurance, you should speak to someone at Customer Service with your insurance company. I have never seen a policy that covers scaling and root planing but restricts who can render treatment. If it is covered by a general dentist, it should also be covered by a periodontist. Good luck, and I hope this helps. Dr. Silberman
I had several teeth pulled I have not been able to open my mouth fully haven’t been able to eat in the last six days can get a spoon into my mouth what should I do
Hello Wayne, There are two main reasons that could prevent you from opening. I assume that the extractions were from the lower jaw. The injections to get those teeth numb can cause swelling in the jaw muscles at the injection site. This would prevent opening. You can take 600mg Ibuprofen (or Motrin, or Advil) every 8 hours to help reduce the inflammation in the muscle. This would help to get your ability to open back to normal. It is also possible that there is swelling of the face in that area that is contributing to the minimal opening. Continue to apply cold compresses on and off to reduce the swelling. Rinse with warm salt water holds in the mouth to bring down any swelling. Do not apply heat externally. After a few days, if you have not gotten relief, you may have to have a prescription for prednisone. You can ask your dentist to prescribe it, but try these other options first. Good Luck. I hope this helps. Dr. Silberman
In the lower jaw I get tooth ache on the right side … should I do tooth cleaning cause I have not visited the dentist
Hello Sherwin, You should definitely see a dentist for an emergency evaluation. The dentist can figure out if the problem is a tooth issue or a gum issue and then fix the problem. Good Luck, Dr. Silberman
I have a wisdom tooth that has a bad infection. The dentist has scheduled an extraction after three days and put me on antibiotics.
The pain suddenly increased yesterday and my whole left jaw hurts. The pain is spreading to my whole left head.
I’ve taken one aceclofenac tablet, one aceclofenac+paracetamol tablets, two Trypsin+Bromelain+Rutoside+Diclofenac tablets, and have even gotten a diclofenac injection in a span of 15hours. The meds either don’t work at all or can work for only an hour or two.
I’m in constant pain and I’ve tried both clove oil and ice packs but even those two aren’t helping much anymore.
I don’t know what I should do anymore.
Hello Scarlet, Sorry to hear you are going through this. The first thing I would try is holding ice water in your mouth rather than just administering ice externally. If there are gasses built up inside the tooth from infection, the cold water will lower the temperature of the gas. The gas will contract and take the pressure off the nerve in the tooth to give you relief. Typically the antibiotic chosen is Amoxicillin. In your case, it wouldn’t do squat. I would suggest switching to Clindamycin 300mg every six hours. Once that kicks in you should get some relief, but until then, keep the ice water handy. Good luck. I hope that helps. Dr. Silberman
I have terrible teeth and am now experiencing severe pain only relieved by ice water.
I have a sick child with many medical bills and their is no way I can afford dental care. I have never experienced pain like this. Please tell me there is something I can do to stop the pain. I’ve tried clove oil and ibuprofen. Please help
Hello Kate, When teeth are infected they can cause this level of pain. Sorry that you are going through this. If the pain is coming from an advanced infection, holding ice water in your mouth will take away the pain temporarily. You may have to keep a glass of ice water with you and administer it every few minutes, but at least it will give you some relief. Alternate Tylenol and Ibuprofen every four hours. Take 600mg Ibuprofen, then four hours later two Extra-Strength Tylenol, then four hours later back to the Ibuprofen, and so on. An antibiotic like Clindamycin 150mg every 6 hours will quiet the infection for a while, but ultimately you need dental care. There should be some charitable way of getting care. Call your local dental society, your congressperson, Catholic Charities, county social services, etc. Hopefully, there is some organization that will be able to help you. Good luck with your dental needs and your sick child. Dr. Silberman
Dr. Silberman, I had my dental bridge (4 units, from canine to molar) fixed 3 weeks ago. After a week(1st week) I felt a pain on the molar area (crowned). When I consulted my dentist she cant see any problem and told me that its probably has contact and fixed the contact, and prescribed me a Mefenamic Acid 500mg once a day as necessary. I’m on my 3rd week from restoration, still has the same problem. The pain is 10/10 every night. At forst the Mefenamic is helping but right now it is not at all. I find that it is relieved by holding a water into my mouth but I cant sleep with a water in my mouth. I dont know what to do. I contacted my dentist and will have a consulation again but shes not available until next week. Im having sleepless nights. Please help me.
Hello Miko, The problem is an abscessed tooth. It sounds like it is the molar end of the bridge. The diagnosis is straightforward. When ice water held in the mouth relieves the pain, it indicates an abscess. An infection has developed in the tooth and the bacteria have a by-product of gas. Your body heat is enough to expand the gas and cause pain on the remaining nerves in the area. The ice water causes the gas to contract and stops the pain immediately. The treatment is to do a root canal on the infected tooth. If the bridge was placed with temporary cement, it can be removed to treat the tooth. If not, an opening can be made in the chewing surface to access the infection to treat the problem. A filling can then be placed in the bridge to restore chewing function, preventing the bridge from needing to be remade. Mefenamic Acid is a good NSAID (non-steroidal anti-inflammatory drug), but it won’t touch the infection. The best antibiotic for tooth infection is Clindamycin 150mg taken every six hours. Between the ice water holds in the mouth and the Clindamycin, you should be fine until such time that a root canal treatment can be done. The sooner the better. Good luck,
Dr. Silberman
This is very helpful! You are a blessing ???? I’ve taken it this morning and until now I dont have pain. Still praying that the pain wont appear anytime soon.
Glad I could help Miko. Good Luck, Dr. Silberman
Help
Hello Irene, How can I help you? Dr. Silberman
Hello, I had an old filling that came off but I didn’t refill, cos I thought I could manage it. After a long while of managing, it started to hurt. I went to get the tooth refilled and 3days after the refill, I started experiencing unbearable pain, the tooth throbs and when I try to use a salt water solution, the tooth ache almost drives me crazy. I can’t seem to bite down when the tooth hurts and I’ve been on antibiotics for the past 3days. Pls help.
Hello Comfort, When a tooth has been left open for a long time, an infection can develop inside. There often are no symptoms, but when the filling is placed, it’s like stirring up the bees in the hive. It sounds like the infection is in the late stages in the tooth. There are gasses trapped in the tooth that expand with heat causing pain. Warm salt water will do that. That is why I recommend ice water. Hold that in your mouth and the pain will stop. The infection at the tip of the root is pushing the tooth up so that when you bite, it hits that tooth first. That is making it worse. An antibiotic like Clindamycin 150mg every 6 hours will help with the infection and stop the tooth from being taller than the others. Most times, Amoxicillin is the antibiotic prescribed for this and it often doesn’t work. That is why I like Clindamycin. The tooth will either need root canal therapy or it will need to be extracted. In addition to the ice water holds, you can alternate Tylenol and Motrin every 4 hours. Good Luck, Dr. Silberman
I have severe tooth ache lower inner teeth expecially in night.i am a postnatal women 2 weeks .can you give any remedies.
Try holding ice water in your mouth for relief. Also, take two extra-strength Tylenol. Then four hours later take 400mg Motrin. Then four hours later go back to the Tylenol. Continue to alternate the two medications every four hours as needed for pain. Most importantly, see a dentist for the proper diagnosis and treatment as soon as you can. Good luck and love that baby, Dr. Silberman
I’m in alot of tooth pain my filling came out I put temporarily tooth filling in and it still kills me I can’t eat anything hot or nothing it’s bothering me wicked I’ve taken several tylenol and ibuprofen to get rid of the pain and it don’t help me at all either
Hello Felicia, Toothaches are like mysteries and you solve them by the clues from the patient. In your case, the clue that breaks this case is the sensitivity to hot. That tells me you have an abscessed tooth. To stop the pain, you have to hold ice water in your mouth around the problem tooth. There are gasses trapped in the tooth that need to be cooled to take away the pain. This is a short-term fix. You need to see a dentist who can determine if the tooth can be saved. You might need an extraction or a root canal treatment. The dentist can also prescribe antibiotics if they believe it would help. Good luck. Dr. Silberman
Hi, I have a large composite filling in two upper molars. I started getting slight searing pain when I sucked in. Teeth weren’t sore when I tapped them or to hot or cold just a certain way I would talk or suck in when speaking. Dentist did X-ray and confirmed that there was decay. She’s drilled decay out and was more than expected. She’s put a temp filling in but tooth now seems even more ‘sensitive / searing pain ‘ when again i sook in when talking. She says I may need root treatment but I don’t have next app till Dec when she plans on putting new comp filling in. Do I need to experience severe pain before she decides if she needs to do root treatment? Thank you.
Hello Vikki, Sorry to hear you are going through this. There are many clues that I look for to determine if a tooth needs root canal treatment. It is important to find out from the patient if they have a low, average, or high tolerance to pain. The symptoms are then interpreted accordingly. If decay was removed from the tooth and a sedative filling placed, that should have quieted your tooth. But it sounds like it didn’t and is even more sensitive. That is a sign that the tooth needs root canal treatment. I need a second positive test to confirm the diagnosis. Does the pain come on spontaneously, or prevent you from falling asleep, or wake you in the night? Any of these would add to the evidence. It is too early to see any changes on an x-ray, but it could be a clue if you were to wait longer (which I don’t recommend). The symptoms will worsen if the tooth needs a root canal, so that is also another clue. The dentist should test all the teeth near the tooth in question with firm tapping to see if there is a difference in the problem tooth . . . . not necessarily pain . . . but just feels different to the tapping. Also, a cold stimulus can be applied to the teeth in the area to compare the responses. How long does it take to feel the cold in the tooth and how long does the sensation linger. If this tooth is different from the other teeth, that is another clue. The dentist also has an Electric Pulp Tester to measure the level of vitality of the tooth. On a scale of 1 to 10, if the other teeth respond at 2 and this tooth at 6 or higher, it is further evidence that the tooth needs a root canal treatment. Once the diagnosis is made, it is best to get the root canal treatment as soon as possible. To quiet the tooth in the short term, antibiotics like Clindamycin 150mg taken every six hours might tide you over until the treatment can be done. I wouldn’t do more than a ten-day regimen. I hope that helps. Good Luck, Dr. Silberman
I have what I think is an abscess and I need to get it treated, I just want to know how serious it is if it doesn’t get treated soon and what are some dos and donts when you have a tooth abscess. Will wearing my bite guard make it worse?
Hello Amber, When there is a tooth abscess, the spread of infection varies greatly with each occurrence. Some infections are slow-growing while others are rapid. The degree of swelling can be minimal or great. If your infection is slow, you can probably continue to wear your bite guard. The tooth will let you know. If you are comfortable wearing it, do so. The tooth can move due to the infection and the bite guard might no longer fit. If the tooth is extracted, the bite guard will fit. If the tooth is saved with root canal therapy, the bite guard might need to be adjusted. It can be very serious to let an abscessed tooth go untreated. You need to have it evaluated by a dentist. Some infections on the upper front teeth can be life-threatening with the infection passing up to the brain. Have it checked and treated. Do not apply heat to your face. No warm compresses or hot water or direct sunlight. These things can bring the swelling from infection to the outside of your face. Alternate Tylenol and Motrin every four hours for pain if needed. Good luck, Dr. Silberman
Hi I’m 27 years older haven’t been to the dentist in over 10 years scared to go and have a very bad tooth ache my one tooth is half missing and a bad cavity that is black and grey nothing is helping and I’m allergic to antibiotics which is all penicillin I’m so afraid to go to the dentist now bc I’m scared but also scare to be judge so bad
Hi Kellie, So sorry to hear you are going through this and, on top of that, have this fear of dentistry. Dental treatment has really improved a lot and is much easier than it used to be. I have families that come to my office and the children fight to be taken first. It’s a lot more fun than it used to be. But right now what you are going through isn’t fun. It is important to get treatment as soon as possible. There are other antibiotics than penicillin. Actually, for tooth infection, that is not my first choice of antibiotics. Clindamycin is my tooth infection go-to medication. You need to find a compassionate dentist that is sensitive to both your dental needs and your emotional ones. Google “dentists” in your area and read the reviews. That will help you find someone who will take care of “you”, not just your teeth. Good Luck, Dr. Silberman
I’ve not had the money or insurance to be seen by a dentist and I’ve got a bad cavity that I’ve been using over the counter toothache pain reliever something like oragel. I’ve been dealing with acid reflux for some years now and have been on prescription medication for the reflux, but I’ve noticed since I started using the oragel it seems it’s caused me to have severe heartburn,well I think it could be from using the oragel but not sure. So that’s my question can oral tooth pain reliever cause these symptoms?
Hello April, It is not uncommon for an increase in reflux following general anesthesia (hospital surgery), but I have never seen an increase in reflux in patients using topical anesthetic like Oragel. You may need to alter your reflux medication. Nexium taken 3 times per week has been documented to be quite effective. It is an over-the-counter medication and is available, even at stores like Costco. The main issue is your toothache. You need to see a dentist. Investigate ways to help you with the cost. Contact local social services and see if there are any options open to you. If you are affiliated with a church, ask the clergy for advice. Contact your local dental association and they may provide help. Also, Catholic Charities may have a clinic that will pass through your area that might be helpful. In my area in Waldorf, MD we have all of the options I’ve mentioned here available to the public. Good luck, Dr. Silberman.
Hello, Doctor!
15 years ago, I had a root canal on #31. About a week ago, it started hurting. My dentist took an X-ray and an abscess is very visible at the bottom of one root. My
He prescribed 300mg clindamycin 4x daily, but the pain and swelling continued, so he prescribed a Z-pack. After two days on the Z-pack, I still have swelling and the pain is unbearable. He scheduled me with an endodontist, but that appointment is two weeks away.
I have a history of ON and TN and I’m wondering if the pain is due to that. The problem is that TN does not explain the swelling and the pain does not feel like the “zaps” I get with ON or TN. It is constant pain with occasional throbbing and the pain sometimes increases or lessens randomly. But it is always there.
I feel like I’m losing my mind because the pain is outrageous and I can’t sleep or function. I don’t want to keep trying different antibiotics if TN is really to blame, but I saw the X-ray and the abscess is real. What are your thoughts? Thanks in advance!
Hello Laura, Sorry that you are dealing with this. Dental pain isn’t fun. It is difficult to make a diagnosis without seeing the x-ray and the extent of the abscess. Having said that, most root canals (98%) are successful for the long term. If there is a failure, it usually occurs within the first year of treatment. Given that your root canal treatment was 15 years ago, I suspect that the actual root canal treatment is not the source of the problem. I’m guessing that there is a vertical fracture of the root and there is nothing you can do but have the tooth extracted. By having the tooth extracted, it also addresses the pain issue which will stop immediately. A bone graft will be necessary in order to prepare the site for an implant. The bone graft should be done at the same time as the extraction. Another option is to not replace the tooth because it is out of your smile zone. You would lose a certain amount of chewing function on that side if you don’t replace it. It is a personal decision mostly based on the financial aspect of implant treatment. The sequence of antibiotic therapy that you have received is appropriate and I would have expected better results, but every person is different and every infection is different. Sounds like you are getting good care. If the pain still persists, I would lean towards extraction ASAP. I hope that helps. Good Luck, Dr. Silberman
Thank you so much for the information, Dr. Silberman! I called the dentist again and have a sooner appointment with the Endodontist. I will let you know how it turns out.
Keep me posted Laura. And good luck. Dr. Silberman
Hi there,
I haven’t seen a dentist in a number of years due to nerves. I’ve had bot my far, lower left wisdom tooth and molar break – to a point where there is a large cavity in my molar and only half a tooth left in my wisdom – but I’m now also experiencing severe pain in my lower right jaw – I think there may be a number of cavities forming in my lower right teeth now as well.
Will they have to remove the teeth fully? Or is there still a chance they could save/keep the teeth in with fillings? I really don’t want to lose all my teeth!
Hello Dan. We always try to save teeth whenever possible. “There is nothing like your own teeth”. The exception is the wisdom teeth. There usually isn’t room for them and they are very difficult to keep clean. So I recommend extraction of the wisdom teeth more often than not. If your cavities are not too extensive, the teeth can be saved. They may need fillings, or crowns, or root canal treatment. None of these things are difficult with modern dental techniques. Google dentists in your area and read reviews to find one that a lot of people are enthusiastic about. And don’t wait! Get seen ASAP and get acquainted so that you are comfortable. Good Luck, Dr. Silberman
I hope this wasn’t repeated by someone else and that I missed it. If so, I apologize.
20 plus years ago I had a root canal and crown. Recently I went to the dentist for routine cleaning and x-ray. He said that tooth had a failed root canal treatment when the previous dentist did not go far enough into the root to clean it and it now had an infection. No pain though. I saw an endodontist who did a bunch of diagnostics before hand (x-rays, ct scan, tapping on the teeth, hot and cold sensitivity), and then did the first half of the root canal on the tooth. I did a round of antibiotics and wait for my second part, two months later. Two weeks ago I had mild discomfort in that tooth, like too much pressure on it as if its being squeezed. It comes and goes. It is relieved with biting down/putting pressure on it. 1. Do you know what causes that? 2. Should I move my appointment with the endodontist up? It is still two weeks out.
Hello “ringwalds”, You present a very interesting situation. If a tooth that had root canal treatment wasn’t filled to the end of the canal, it could develop an infection. It doesn’t usually take 20 years to do so, but it’s possible. The CT scan should have eliminated the possible diagnosis of a cracked root which makes retreatment doable. I am unsure as to why the retreatment wouldn’t be done in one visit. And why wait two months to finish the treatment? I am interpreting from what you wrote that the root canal retreatment was started, the old filling was removed from the roots, and now they are empty and awaiting new filling. I wouldn’t leave empty canals. They are warm, dark, moist environments in which bacteria can flourish. The bacteria would move out of the tips of the root and into the surrounding area cause your discomfort. It’s better to eliminate the bacteria from the root canals and fill them at the same visit, and treat any bacteria outside the tooth with antibiotics orally. There may be extenuating circumstances of which I am not aware, and I don’t want to interfere with the treatment sequence chosen by your endodontist, but I’m mystified. To answer your questions: 1: I don’t know why biting down on the tooth gives you relief. I would have reduced the occlusion (the height of the tooth) to allow for proper healing and avoid contact with the opposing tooth. 2: I would move up your appointment with the endodontist and get the canals filled as soon as possible, and start another round of antibiotics prior to that treatment. I hope that answers some of your questions and doesn’t create more of them! Good luck, Dr. Silberman
Thank you for your response. The Dr. had a reason for waiting the two months, but I guess in my anxiety of the procedure, it didn’t register when he explained it. Occlusion on that tooth is not an issue right now. Hopefully it will all go well in the final process. Thanks!
Hi my name is Chad. I have been experiencing toothaches and gum pains since the early morning of Saturday. I’ve been getting treatment from the local health centre but unfortunately my community doesn’t have dentist in town, in order to see dentists we have to travel out of the community. How can I relieve the tooth pain and gum pain? Is it only temporary? I have pains from day to night and haven’t been feeling like myself lately. Hard to eat and stay active.
Hello Chad, Cavities and gum problems are treated differently. Gum problems can develop if you don’t have your teeth cleaned by a dentist regularly, and it sounds like you don’t have that option. Your dental home care is critical to your overall health. Typically, a round of Amoxicillin 500mg taken every 8 hours for 10 days, along with an antimicrobial mouthwash like Peridex, will get the immediate problem under control. There is likely a buildup under your gums around your teeth that needs to be removed by a dentist/hygienist. Once that is done, you can maintain it with diligent home care. As for the cavities, again, you must see a dentist ASAP. For a temporary fix, you can apply clove oil to open areas of decay to quiet the problem. It can be store-bought or you can make it at home by crushing cloves and applying the paste to the open cavities. For pain, I would recommend alternating Tylenol and Motrin (Advil, Ibuprophen). Take two extra-strength Tylenol. Four hours later take two 200mg Motrin. Alternate them every four hours as needed for pain. I hope that helps. Try to get to a dentist soon. Good Luck, Dr. Silberman
I have a dentist appt tomorrow. Believe I have a tooth infection. I have to hold cold water in my mouth otherwise I get intense unbearable pain. I’m just hoping it’s ok until tomorrow because I’m going to have to drink tons of water until then.
Hello David, I believe you are correct. You have a tooth infection. When ice water stops the pain, you have an abscessed tooth. There are bacteria that are in the root of your tooth that have a biproduct of gas which becomes trapped. Your body heat is enough to expand the gas and cause pain. Hot drinks or compresses make it even worse. Ice water causes the gas to contract and stop the pain. The treatment will be to either extract the tooth, or save it by root canal treatment. Your dentist can open the top of the tooth and release the gas as a temporary measure until the root canal can be performed. Good Luck, Dr. Silberman
To 30 and 31 need a root canal however the bottom of my whole mouth is hurtingTooth 30 and 31 need a root canal however the bottom of my whole mouth is hurting why is that
Hello McChristian, There is a nerve that runs through the center of your lower jaw, starting from under the ear all the way to your front tooth. If #30 and #31 are infected and need root canal treatment, the pain can radiate along this nerve. Sometimes the pain can even feel like it’s coming from an upper tooth too. Stay away from heat (hot drinks, heating pads, hot compresses, direct sunlight, saunas, etc). If your teeth can tolerate ice water, hold that in your mouth to get some relief. Get your root canals done ASAP. Good luck, Dr. Silberman
It’s a very long story but the end result is 2 of my teeth,both capped, fell out,leaving some of the tooth at the level of the gum. Now I am experiencing very bad pain in one of them. Throbbing pain. I am willing to go to a dentist, can not get in until after Christmas. What can I do for the infection in the mean Time? This is really painful.
Hello Chris, If you can’t see a dentist, go to an urgent care or emergency room. A round of antibiotics will quiet things down until such time that you can see the dentist. The treatment options will vary depending on the degree of infection and the amount of remaining tooth structure. Good Luck, Dr. Silberman
Dear Dr. Silberman,
Thank you so much for your time and helpful information on this website. I would have come for a consultation if your office was closer to me.
I am writing for your opinion on switching from clindamycin to augmentin. My endodontist did a root canal on 12/6. I had not been having any pain but the infection (gum swelling) which responded well to oil of oregano or goldenseal root packs went on for over a year but came back 3 times so I decided to get treatment. I had sexual trauma in the dental chair when I was 15 which made it very difficult to get dental care. The last time the infection came back it extended to my chin and I used the goldenseal again while I waited for the appointment on 12/6. Goodenseal worked but only on my facial swelling, gum was still swollen. My MD started me on clindamycin 150, tid when I saw her for a routine visit 5 days before the endo appt. My Endo. said she would continue the clindamycin if I still had swelling on the 5th day. On the 4th day I noticed swelling on my chin again. She changed the clindamycin to augmentin and I am waiting to hear the rationale.
The tooth is OK. The swelling is a little under my gum and mostly in my chin above the tooth. Would you recommend the switch? and at what dose and duration? Or stay with the clindamycin (dose and duration?) And would it help to also use the goldenseal packs (along with the antibiotic) which I resumed last night when I noticed the swelling and it did improve the swelling already.
I will call your office to see if you do phone consultations in case you don’t see this post today.
Hi Connie, My experience has been that Clindamycin is the drug of choice for an abscessed tooth. But your bacteria have had a year to develop into a very resistant strain. If 150mg four times a day seems to be working, you can increase it to 300mg four times a day. The chin has the least amount of circulation in the mouth and is the most difficult for controlling infection because getting the antibiotic to the infection site takes longer. I would stay with the Clindamycin. Augmentin is also a good option if you aren’t having complete success with Clindamycin. I suggest 10 days post-operatively, so continue the Clindamycin through December 16th. Do not apply heat to your face (no heating pads, saunas, hot compresses, etc) as this will draw out the swelling. Goldenseal can’t hurt, but I’m not sure how effective it would be. It sounds like it works for you, so I would continue using it. If the problem extends past the 16th, a decision can be made based on your progress. If you are significantly better by then, that should be enough antibiotic. If you are less than 50% better, switch to Augmentin. Good Luck, I hope this helps. Dr. Silberman
i had RCT of 2lower molar 4month back…before 15day i start getting pain in these molar i was confused about pain so i go for xray ..Dentist said all is well he put pressure on one of my RCt’s tooth crown n shake it little…. After 7days i again started paining he look xray of last molar he said wisdom tooth is coming i now bcz he just applied pressure n shake crown my gum swelled n start bleeding its not healing now Its started painting i m very scared it can infected my root canel again ?? What should i do now
Hello Manisha, It is unusual to have a problem with a root canal tooth that was done four months ago and looks normal on an x-ray, and has bleeding. It sounds to me like your problem is the wisdom tooth. Once it is extracted, I believe the problem will be corrected. You should schedule the extraction as soon as possible. Rinse with warm salt water to control the bleeding and swelling. If your appointment isn’t for a while, a round of Amoxicillin 500mg taken three times a day should keep it quiet. Good luck, Dr. Silberman
Hi doc. I have toothache 2 weeks now. My upper left incisor has cavity and dental filling done some years ago. But i can still see a black bit at the back of the tooth near the root or gums i guess. I wonder if it was done properly? I only experienced toothache once since that dental filling. Iirc within a week of that toothache my mouth was inflammation. I think there was a pus near the tooth. There was a pus but my tooth was not hurting. My dentist prescribed an antibiotic and the inflammation was gone after few days.
Now im having toothache on the same tooth. Been 2 weeks and im waiting for inflammation but it just keep hurting. Last dec 4 saturday, i took 1 advil, then the next day i took a 500g Tylenol and after few hours took a generic mefenamic tablet. On monday i tried another brand of mefenamic.
I cant go to a dentist anytime soon so im wondering whats hppening in my mouth. I took another brand of mefenamic an hour ago and my toothache is still there. I gargle water for about 10secs and its gone but its back after about 3 minutes. The pain is a sharp one and it feels like it is in another area now.
I forgot to mention that i have another problematic tooth. Its the last tooth at the upper left and its cracked about 1/4 and has cavity. Never had toothache with it before but now i feel like the pain from my front incisor is crawling to my back tooth. Im not sure.
I want to take antibiotic but i forgot the one my dentist prescribed to me and i dont want to buy one without prescription.
Sorry this post has been too long. Basically i just wanted to ask if my dental filling is not working and should i go have it replaced. And that if its ok to perform dental filling and root canal while i have toothache. Appreciate it if you have more advice. Thank you!
Hello Ar, The black area on the tooth sounds like it is decay. Your symptoms indicate the decay probably caused an infection which is what’s causing your pain. The cold water holds in your mouth will stop the pain temporarily and confirm the diagnosis. Treatment by root canal will stop the pain and correct the problem permanently. The antibiotic of choice is Clindamycin 150mg taken four times per day. It will help control the pain until you can get to a dentist for the root canal treatment. Good luck, Dr. Silberman
Thanks for the reply doc. For my broken tooth(left second molar), would it be ok to have it filled even though my front tooth is infected?
Is there a chance it would also get infected from the infected front tooth?
Can a dentist find out if my back tooth is also infected even though it doesnt hurt now?
Hello again Ar, To answer your questions: It is OK to have your broken left second molar filled even though your front tooth is infected. There is no chance that one could infect the other. Your dentist can check to see if your back tooth is infected even though it doesn’t hurt now. Good luck, Dr. Silberman
Hi so I’m trying to figure out if the pain I’m experiencing is normal I’ve previously had jaw surgery and experienced a fair deal of pain but the pain I’m in with a root canal is fair and no over the counter pain medication is even touching the pain.
So for a time line
I had an emergency partial root canal on Wednesday the 8th but they were only able at that time to remove the “painful” portion clear out the infection and put a temporary filling on top until they could bring me back I have a gastro issue also and they prescribed amoxicillin for a week I had minor pain after that but otc pain meds helped. So I went back on Monday the 13th and they removed the filling cleaned it out again and placed the posts from what I understand and put a cap over that and again placed a temporary filling ontop until it settles and I come back for the full cap over the tooth. But this time i’m in SO much pain! It’s at least a 7-8 out of 10. It’s hard to get to sleep at night. I went back on Tuesday the 14th for more fillings and I mentioned the pain and was told it’s normal but still no pain medication given and now it’s Wednesday at 3am and I can’t sleep cuz I’m in a lot of pain. First is this normal? And second I find if I apply heat to the area it seems to feel better or if I lay on the affected side of my face the pillow starts to warm up and eventually the pain is lessened enough I can finally pass out. My question is, is the heat ok to be applying? I go back to see the dentist on Thursday the 16th for more fillings and I’ll mention the pain again if it’s this bad. Just trying to establish if this pain is normal and if heats ok to apply?
The pain I originally felt was threw all of my teeth on my lower jaw on one side alot like when I had a retainer and it was pressing the teeth into line but now it’s more in my jaw and the specific tooth they did the root canal on. I’m also 2 pills away from being done the antibiotics if that matters
Thanks
Hello Jessica, Sorry to hear you are having this problem. Heat is not a good thing to apply to your face in this circumstance. Though it may feel soothing at the time, it is merely drawing out the infection towards the heat and will likely cause swelling in your cheek. That will become a lot more difficult to control with oral antibiotics. The better antibiotic is Clindamycin for tooth infection, but it is harsher on the GI system and it sounds like it might not be the drug of choice given your medical history. You could try it and see how well you handle it. If it upsets your GI system, stop taking it. You should also have the dentist check the occlusion. When you bite together, there should be no contact between the root canal tooth and the opposing tooth. The tooth height can be reduced by the dentist to allow for quicker healing, and your body will gradually push the tooth back into occlusion over several months as the healing continues. There are prescription pain medications that the dentist can offer you that are stronger than the over the counter medications. This type of pain after root canal therapy is not uncommon in patients who do not get antibiotics prior to treatment, preferably Clindamycin. One in five patients who have not been premedicated with antibiotics wind up with pain and swelling. Taking the antibiotics after the fact is playing a catch-up game with the infection. Most dentists do not prescribe antibiotics until symptoms require them. I preventatively prescribe them to avoid post-op complications. I hope this helps. Good luck.
Dr. Silberman
Hello,
2008 I had a root canal on a tooth .Bottom left.Also was crowned.2017 I started with aching on and off on the same side.It was on and off and sometimes didn’t even notice it.Had the tooth xrayed in 2018 and dentist said it was fine.Still experienced pain on and off for years.Not so bad that I had to take pain reliever.Fast forward to 2020 and the pain is daily 24-7.Have been to dentist to check it again and does not show anything.I have to take ibuprofen and Tylenol daily .My dr referred me to a neurologist.Have had MRI and ct scan of my face.Everything looks fine. Can the tooth look fine on X-ray but still have a problem it doesn’t pick up?My dentist will pull it out if I choose.Thanks for your time
Hello Joletta, It’s complicated, but yes, the tooth can look fine on an x-ray and still have a problem. It sounds like you are getting good care. Having the neurologist check to see if it is a non-tooth neurologic issue was a good call. I would test all the teeth on that side for thermal sensitivity. Sometimes another tooth can be causing the pain and it’s difficult to tell where it’s coming from. If your teeth are not too sensitive to temperature changes, try holding ice water in your mouth followed by a hot drink. Alternate between the two and see if it elicits the pain. If it does, the problem is not the root canal tooth (which cannot feel temperature change). The dentist can apply a cold stimulus to each tooth individually, or an electric pulp tester to identify the problem tooth. If the cold/hot alternating test has no effect, I would assume the problem is coming from the root canal tooth. Does it hurt to chew on it? I would have you chew on something solid on each tooth individually and see if it’s this tooth. Take a Q-Tip and bite on the stick on each tooth and see if one stands out. If it is the root canal tooth and it is a lower tooth, the dentist can check your bite with articulating paper (carbon paper). There should be no balancing side interferences. If there are blue markings on the chewing surface toward the tongue side of the tooth (balancing side), the dentist can adjust them so that they are out of contact with the opposing tooth. If it is the root canal tooth and nothing shows up on your x-ray and you have done all of these tests, I would reduce the height of the tooth slightly so that it does not contact the opposing tooth at all. I would prescribe a round of antibiotics like Clindamycin 150mg four times a day for 10 days. Sometimes this works so it’s worth a try. In a few months, the tooth will move back up into contact to overcome the slight bite adjustment. I told you it was complicated. I hope this helps. Good Luck, Dr. Silberman
I had left side wisdom teeth pulled last Thursday, 12/16. Oral surgeon said May have issue as upper was close to sinuses. I clearly have an infection in the socket-white pustule and odor when I use a q tip to clean. Noticed odor when sutures came out. Very sore, where the tooth was, on the lingual side. No antibiotics were prescribed. Of course it’s Christmas and I’m hurting. Advice?
Hello Marie, The first thing I would do is test yourself to see if there is a communication between the sinus and the oral cavity (oroantral fistula). Pinch your nose closed and gently try to blow out your nose. If you can feel air coming into your mouth from your nose through the extraction site, the surgeon will have to repair this. So prepare yourself for one more surgery. If you cannot feel the air coming into the mouth, it is an easier fix. Your instructions should have included rinsing with warm saltwater. I would continue to do so. That should help with the tenderness. Check to see if the surgeon has an emergency contact number. They should be able to prescribe an antibiotic if they feel it is necessary by calling it into a pharmacy. Or go to an Urgent Care that has hours and have them evaluated and prescribe if they feel it appropriate. Good Luck and Merry Christmas. Dr. Silberman
I had a dental filling Dec 3 on my two front teeth then after a week i feel tingling every time i bite then when i check my teeth i saw a crack in my teeth but then i ignore it now after 3 weeks it started to feel pain then when the temperature went down here its very painful and start swelling in half of my face, i also use hot compress to reduce the swelling but still the same.
Hello Ronaline, Never apply heat to your face when you have a tooth that is causing pain. If there is infection present, the heat draws the infection to the surface and dramatically increases the swelling. It makes it much more difficult to get the infection under control. You will need an antibiotic to get the swelling down. Clindamycin 150mg every six hours is the one I recommend if you are not allergic to it. If the swelling is large, you may need an intravenous antibiotic and possibly a surgical procedure to reduce the swelling. Hopefully taking the Clindamycin every six hours will quiet the problem. One or both of the teeth will need root canal treatment to save them. Contact your dentist and explain what is happening. Alternate Tylenol and Motrin every 4 hours for pain. Take two extra-strength Tylenol, and four hours later take three 200mg Motrin (Ibuprofen, Advil). Switch every four hours. And do not apply heat to your face again. If the swelling continues to increase, go to a hospital emergency room to avoid a cavernous sinus thrombosis. Google it. Good luck. Dr. Silberman
Hi
I developed an acute pain that shows up in my lower right set of teeth, sometimes rising up to the upper right too, as well as into my right cheek near the ear and the right side eye & forehead. Also below the right jaw.
After an Urgent dentist visit, dentist said my teeth and gums were all healthy and un-infected; and said my pain could be due to grinding and malocclusion with crowding.
Just did a thorough cleaning and Sent me home with Ibuprofen and a mouthwash, without any specific treatment for the pain!
It’s 2 days now and the ibuprofen doesn’t last for long, with frequent return of the pain. Interestingly every time I hold some tap water in the mouth on the right, the pain subsides for a while.
Is this a dental issue OR is it some other muscular/neuralgia issue??
Hello Rahul, You have presented enough clues to solve the mystery. You have an infected tooth. It hasn’t advanced enough to show up on an x-ray according to your dentist. Due to your grinding habit, a tooth has cracked allowing bacteria that are normally in the mouth to creep into the tooth. The inner workings of the tooth are normally sealed and protected from these bacteria. Once they have access to this area of your tooth, they are now in a warm and moist and dark environment . . . . perfect for growth. The bacteria take over and kill off the nerve and circulation that is inside. They give off a by-product of gas which is now trapped inside. Applying cold water will stop the pain because the gas contracts as you lower the temperature, taking the pressure off any nerve endings that remain in the tooth, or those in the jawbone. Do not drink or eat anything hot as the heat will have the opposite effect and expand the gas, causing pain. Do not apply heat to your face as this will draw the infection towards the heat source causing swelling and more pain. Use ice water to keep it quiet. There are two ways to identify which tooth is causing the problem. The dentist should have an Electric Pulp Tester. It is applied to each tooth individually to measure the amount of life in each tooth via very low voltage from a battery. It feels like a tingling sensation. The bad tooth will either not register, or will score a higher number than the other teeth. The other way to identify the tooth is with ice. When the tooth is hurting (you can make it hurt with warm water if you need to hold some in your mouth), apply a small piece of ice to each tooth individually for 30 seconds. Do not touch the other teeth. The bad tooth will stop hurting. The other teeth will be unaffected. The bad tooth can be saved by root canal treatment followed by a post and core, and crown. The post and core will strengthen the tooth and the crown will hold the tooth together to prevent further cracking. It is possible that the crack is too advanced to save the tooth. It may need to be extracted. The dentist should be able to advise you on this. Good luck and I hope that helps. Happy New Year, Dr. Silberman
Hi Dr. Silberman,
Thanks so much for your website. I was putting a heated washcloth on my mouth since I had an abscessed tooth and it felt good while it was still hot, but I kept having to reheat the washcloth, because as soon as it cooled off, my tooth started aching again. I had also tried letting mouthwash sit in the area for a bit, but it didn’t work like my Dr. Tishner’s did back in the day <<not sure if that’s good or bad for an abscessed tooth.
I decided to Google to see if I should put heat or cold on it and your website came up. I didn’t know that about the gasses causing swelling. I was just making things worse. My toothache woke me up in the middle of the night and I’ve been in excruciating pain for the last 3-4 hours. Seems to me that anytime I’ve had a toothache, it’s been at night. Is there a reason for this?
Anyway, as soon as I read your post, I got a popsicle and wrapped it in a wet washcloth and put it on my face. (We don’t use ice, we just keep cold water and drinks in the fridge #random comment, lol).
I wasn’t even through reading the comments and my mouth was starting to feel much better. I feel so relieved, but I got so excited that I wasn’t sleepy anymore, so I decided to write you a comment.
Again, thanks so much! You’re a life saver!!!
Looks like it’s time to stop putting off my dentist appointment. ????
Hello Melinda, I’m glad that my advice helped. The heat that you applied to your face may cause some delayed swelling in the area of the abscessed tooth. If that happens, you will need a prescription for antibiotics ASAP. You should definitely get to a dentist and have this looked at and treated appropriately. Also, it’s not uncommon for pain to worsen at night. When we are relaxing and trying to sleep, our mind is drawn to the area of pain and without other things going on to distract us, the pain feels more intense. Now, go see a dentist. Good Luck, Dr. Silberman
I put worm towel on my jaw to my infected tooth. Now it is really swollen. What should I do ?
Hello Sylvia, Now you know what happens when you apply heat to an infected tooth. It draws the infection out into the face next to the tooth and causes severe swelling. Stop using heat. Apply cold compresses off and on every 15 minutes. You need to be put on antibiotics. If the swelling is advanced and is causing you any difficulty breathing, you need to go to an emergency room for intravenous antibiotics. If you are breathing OK, you should go to the dentist as soon as possible, or an urgent care, where oral antibiotics can be prescribed. The best oral antibiotic for tooth infection is Clindamycin 150mg taken four times a day for 10 days. Once the infection is controlled, you will need to address the tooth problem. Good Luck, Dr. Silberman
I have two broken tooth can it be removed without having surgery
Hi Kimberly, A dentist will x-ray your broken teeth and decide what would be the best way of removing them. It isn’t difficult for a dentist to numb the are where the teeth are and removing them painlessly. The sooner you do so, the better. Tooth infection can be hazardous to your overall health. Good Luck to you, Dr. Silberman
I have 2 upper teeth at the back of my mouth and during the last week only at nights does the pain become unbearable. No evidence of tooth decay or otherwise. What could be the problem? Also will extraction of those teeth be the answer. I am 39 years old
Hello Zaheer, It is common for tooth pain to be more pronounced at night when the body is not being distracted by other activity. If there is no decay present there could be other underlying dental related problems: a cracked tooth, or a wisdom tooth that is partially erupted, or a chronic gum problem. It is also possible that a sinus infection can feel like a toothache. You should see a dentist for x-rays and evaluation to see what’s causing the problem. Good Luck, Dr. Silberman
I had a deep cavity and the dentist filled it, He said it was close to the nerve and may require a root canal. This was 18 hour ago and I have been up most of the night with pain. (slightly throbbing). Could this just be lingering pain from the filling that will subside or does it mean that a root canal is necessary? Also, what can I take until I see him? I took two extra strength tylenols and two Advils at the same time but they do not help.
Hello Don, It sounds like this tooth is going to need root canal therapy. The type of pain you are describing is consistent with tooth nerve pain that is infected and needs treatment. The key to controlling the pain is by controlling the infection. An antibiotic will quiet the pain as much or more than pain medication. My “go to” for an infected tooth is Clindamycin 150mg taken every six hours. Alternate the Tylenol and Motrin every four hours to take the edge off. Remember not to apply heat to your face. If the tooth is not sensitive to cold, you could get instant relief by holding ice water in your mouth. Good luck, Dr. Silberman
What can I do for the swelling
Hello Nicole, Not much information to go on here. For swelling associated with an abscessed tooth: Do not apply heat to your face. See a dentist for a proper diagnosis. It is likely that you need to be taking antibiotics to help reduce the swelling. If a dentist isn’t readily available, go to an urgent care or emergency room for appropriate antibiotic therapy. Good luck, Dr. Silberman
Can a toothache cause you’re gums to hurt as well and if so what can i do at home to help with the pain I can’t get into the dentist for a couple of weeks so I need somthing to help until I can get in
Thank you
Hello Kala, It is possible that a toothache can cause gums to ache, but it’s also possible that you have both a tooth problem as well as a gum problem. There are different home treatments that you can do to get some relief. If you can see on open cavity in a tooth, you can grind up some cloves and place it in the cavity. There are products you can buy at the pharmacy that has clove, or clove oil, that are already made. If the tooth is not sensitive to cold, hold ice water in your mouth to help with the pain. For gum pain, there are over the counter gels that have numbing agents in them. If your teeth are not sensitive to heat, swish with warm salt water to make the gums feel better. If doing so causes tooth pain, follow with ice water to cool down the teeth and take away the pain. DO NOT APPLY HEAT TO YOUR FACE. The heat application to the skin can draw infection towards it and cause swelling. Try to get to the dentist sooner. If necessary, go to an Urgent Care where they can prescribe antibiotics if indicated. Good Luck,
Dr. Silberman
I have had so many problems with my molars since my wisdom teeth started coming in. I had a top left decaying molar(right next to my wisdom tooth) pulled a couple years ago from my dentist. And as soon as that healed my wisdom tooth grew in perfectly. Now I am dealing with the same problem on the top right. But this time it’s the second tooth away from my wisdom tooth. I have had so much unbearable throbbing pain in the entire right side of my face my jaw, my gums, my ear, and my neck/throat(lymph node area). And my face has been swollen. On a scale of 1-10 probably a 12. I went to my local emergency room cause the pain was so unbearable they ended up giving me a nerve blocker shot. And prescribed my amoxicillin and hydrocodone. I have a dentist apt next week to see my dentist again. And I am suppose to take the amoxicillin twice a day for 2 weeks and the hydrocodone until my dentist apt. But I don’t feel like the pain meds have helped at all. I ended up going to the dentist back in February for the same tooth before it got as bad as it is now. And they wanted to treat it, then fill it, and then put a crown on it. But my dentist doesn’t take my insurance so I unfortunately didn’t have the money at the time to get the problem taken care of then. But I was wondering what you think I could possibly have going on?
Hello Harley, Sorry to hear you are dealing with this tooth pain. It sounds like the treatment proposed in February was a root canal treatment. That would have dealt with the infection, and now it has strengthened. Amoxicillin is the standard of care but it is usually prescribed three times per day, not twice. There is also an extended release that is administered once per day. I don’t think you are getting enough antibiotic in your system. Though it is considered standard, I prefer Clindamycin over Amoxicillin. You should consult with your dentist. I have had much better results with it. It is important to remember not to apply heat to your face because that will increase the swelling. If your teeth are not sensitive to cold, holding ice water in your mouth around that tooth could give you instant relief. It just depends on the state of the infection. It works on advanced cases extremely well. You can supplement Motrin for pain relief in addition to the hydrocodone. It has an anti-inflammatory approach that can help with the pain. Once you have the infection under control, the pain will subside. Good Luck, I hope this helps. Dr. Silberman
I started getting tooth pains a few days ago but the last two days have been very bad. I have to keep ice water with me at all times to help numb the pain but that only lasts about 50 seconds before I have to take another drink
Hello Levi, The reason the ice water is controlling the pain, even for a short period of time, is that you have an infected tooth. The infection has a by-product of gas that is trapped inside the tooth. Your body heat causes the gas to expand and put pressure on the nerve endings resulting in intense pain. The ice water causes the gas to contract and take the pressure off of the nerve, and the pain stops. The treatment is to see a dentist who can either extract the tooth, or numb it and open it to let out the gas. The tooth will need root canal therapy to fill the spaces in the roots where the gas has been trapped so that there is no void for bacteria to regrow. Unfortunately, you’ll have to keep the ice water handy until you can get to the dentist. An urgent care could prescribe and antibiotic like Clindamycin which would reduce the infection and possibly help with the pain. Do not apply heat to your face and do not eat or drink hot foods. I hope this helps. Good Luck, Dr. Silberman
Hi I had a partial root canal 4 days ago but I’m still experiencing severe pain. When I went into get the root canal my dentist had a really hard time getting my numb due to the infection. I feel as if the pain has not changed from before the partial root canal I am taking antibiotics clindamycin as well as ibuprofen 800 mg every 4 hours rotations with Tylenol but I don’t seem to help. The only thing relieving the pain is a glass of water every 2 minutes. What can I do until my next appointment on Thursday to relieve the pain?
Hello Johnnie, I would increase the dosage of Clindamycin from 150mg every six hours to 300mg every six hours. Your dosage and schedule for Tylenol / Ibuprofen is correct, so I wouldn’t change that. Cold compresses to the face will help lower the overall temperature and help stop the pain. Do not apply heat to your face. I have no further advise for you. I have been treating cases like this for a long time so my next thoughts are for your dentist. The key to getting complete anesthesia is twofold. Articaine is a better anesthetic than Lidocaine. I would then suppliment the Articaine with Carbocaine. The combination works better than with either Articaine or Lidocaine alone. Also, when necessary, a few drops of Articaine can be placed inside the tooth, and that will numb it completely. Also, it is critical to complete the root canal filling at the next visit. The half empty roots provide a perfect breeding ground for bacteria making it even more difficult to get the infection under control. I hope this helps. Good luck, and keep the ice water nearby for a while longer. Dr. Silberman
Hi, I had a small filling that in a tooth but had pain afterward. The dentist thought the filling may have been too high so filed it down some. The pain was lessened but not eliminated and a month later increased drastically including intense pain biting into hot chicken one evening. I was sent for a root canal on a Monday (tooth #19) and was prescribed a zpac. The next day I had to fly out of town for a business trip that would last a week in Denver. My pain grew much worse and I woke up one night and had lost feeling in my lower lip and chin and was swollen. That was last Tuesday night. By Wednesday afternoon, the pain was unbearable and I visited a local dentist in Denver who prescribed norco, a medrol dose pack, and clindamycin to be started when I finished my zpac.
I am back home now and have been on the clindamycin for 36 hours. I saw my endo today and he believes I need to do a root canal in tooth #20. I am afraid this may be a bad diagnoses and may worsen my problem.
Still no feeling in lower lip and chin.
Terrible pain.
Pain in ears, head, throat, near the teeth in question, and even my lower front teeth hurt.
I’m going to seek a second opinion tomorrow before getting another root canal but hoping my infection isn’t dangerous given the 300 mg clindamycin (4x per day)
Any ideas?
Hello Justin, So sorry to hear you are going through this. Did you apply heat to your face? That could be the source of moderate to severe swelling. If you have not applied heat, it would be an indication of a strong infection. The Clindamycin 300mg is the correct antibiotic for this condition. At 36 hours, you might not be feeling improvement. By 72 hours you should be feeling improvement. Hold ice water in your mouth around the lower left area where you have the swelling. This should give you some relief. You could also apply cold compresses which would help relieve the pain. It should not be difficult for the endodontist to diagnose which tooth is the culprit. Good luck. Dr. Silberman
Hi
Hello Felicia, Do you have a question for me? Dr. Silberman
I had a crown put on the left bottom tooth and a replacement filling on the bottom right side. Since then I have been experiencing sharp/throbbing pain on my top right side where no work was done. It goes back to my ear and down to the bottom. I have gone back to the dentist twice since and he did more X-rays but nothing is wrong. He adjusted my bite and said the pain could be caused from that. I am living on ibuprofen and numbing gel. If I hold cold water in my mouth it does feel a bit better. Any ideas as to what could be wrong ?
Hello Elaine, It sounds to me like the lower right tooth that was refilled has an infection and will need root canal therapy. It is not uncommon for a lower tooth to cause pain in the tooth above it. The brain gets confused. The upper and lower teeth get their feeling from different nerves. If you went to the dentist with upper jaw pain and the dentist thought the pain was from a lower tooth, a sure test would be to numb the lower jaw and see if the upper pain stops. In your case, when the upper pain starts, immediately put ice water on the lower tooth and see if the upper pain stops. That would validate the diagnosis that it is indeed the lower tooth. The dentist can’t always make a diagnosis from an x-ray. Early infection cannot be seen on an x-ray. The dentist can perform other tests to confirm the diagnosis. Cold test, heat test using a polishing cup, percussion test and vitality tests are all tools the dentist can use to make the diagnosis. This is probably more information than you need but it is what I would tell my students in the department of Oral Diagnosis at the University of Maryland when I taught there. I hope this helps. Good luck to you, Dr. Silberman
I visited the dentist today, and it turns out I’ve an inflamed molar root. A follow up is scheduled in a month as it could recover.
How may I aid my tooth’s odds of recovery?
I am already on 1200mg/day ibuprofin per unrelated vascular surgery.
Is icing 15min/hour helpful?
Hello Martin, Your tooth could be either inflamed or infected. Use a desensitizing toothpaste. Make sure it has no tartar control and no whitening. Those agents are irritants and will prolong the inflammation. If the tooth is infected instead of inflamed, it will gradually get worse. By waiting a month, time will decide for you whether it is inflamed or infected. Inflammation will heal. Infection will require root canal therapy. Good Luck,
Dr. Silberman
Sever toothache due to infection
Hello Jigyasa, Sorry to hear you are having a severe toothache. Do you have a specific question for me? Good Luck, Dr. Silberman
What if I have jaw pain and there is no tooth where the pain is
Hello Janice, There are many possibilities for having jaw pain coming from an area where there was once a tooth.
1) The most common cause is that the pain is coming from the tooth in the opposing jaw (directly above or below it). Check to see if you have a cavity in the opposing tooth.
2) If it is an upper “non-tooth” pain, it could be sinus related. If you have had a head cold in the last 4 weeks, it may have developed into a sinus infection. Antibiotics, decongestants, and antihistimines will treat this condition.
3) If the pain is in the left lower jaw and there are no teeth there, it could be referred pain from a heart condition. If the pain is worse upon exertion, you should get that checked with a cardiologist.
4) The pain could be caused by nerve inflammation. A neurologist could treat this condition.
5) It is possible that a fragment of tooth or bone from a prior extraction is working its way to the gum surface. It is comparable to teething for a baby . . . . super irritating.
I hope this helps. I would be interested to know what happens. Please write back and let me know when you get a proper diagnosis from a dentist. Good Luck, Dr. Silberman
Dr. Silberman,
I have a 20 year old gold crown, which has a 2 or 3 year old root canal. The crown was initially leaking and I believe had some decay under the crown. The endodontist cleaned it, repaired the leak and did a root canal through the crown. About a year ago that tooth was raging with pain. I went to an unfamiliar dentist on emergency who after an xray and much prodding did a bite adjustment. The tooth did settle after a week or so. I also had the endodontist do an xray. Everything looked good. Once again, a year later, this tooth is raging. I have caught myself clenching and so began wearing a temporary guard. I did eat some nuts but carefully earlier in the week and had a poppy seed muffin. The pain started mildly on Monday and has gotten worse. Can’t imagine a seed would cause this much pain. Friday was bad. As I write to you I have only had 2 hours of sleep. I am taking both Advil and Tylenol. Advil seems to help a little, but after taking 2, the pain returns in 2 hours. Tylenol does not seem to help. It seems I need Advil every 4 hours, which is not recommended. I have dentist appointment on Monday. What is going on under this crown. I am thinking that I either have a cracked root, or the clenching is the problem. But I have not been eating on that side and wearing a guard. Could pain be that bad if I have clenched? Thank you for any assistance.
Valerie
Hello Valerie, You sound quite well versed so kudos for that. If a tooth that has had a root canal is quiet and then flairs up, and then goes quiet again after a bite adjustment, I too suspect a cracked root. Bacteria grow in the crack and can force up the tooth to be a bit taller than the other teeth. The bite adjustment prevents the chewing pounding that brings on the pain. A crack is sometimes not visible on an x-ray. But over time, bone changes often take place next to the crack, so even if the crack itself isn’t visible, the bone change is. Clenching exacerbates the pain, but it is not the cause of it. The taller tooth pushed up by the infection is the cause. My guess is that this tooth will need to be extracted. It can likely be replaced with an implant. Or if there is a tooth on either side of it, a fixed bridge can be placed. Both options can treat the problem with something that stays in the mouth permanently, rather than something that can be taken in and out. As for the pain, to tide you over until your Monday appointment, you can take Advil (3x200mg)every 8 hours, and Tylenol (2x500mg) every 8 hours. Alternate them every four hours. Good luck, Dr. Silberman
Hi I had a filling done yesterday and was told it was a big one ,there was alot of drilling , when I came out I was still numb but could feel pain , its over 24 hours later and I am still in agony , the pain is there constantly , have been taking really strong painkillers ALOT. How long do I wait before contacting the dentist ?
Hello Lisa, You asked how long to wait before contacting the dentist. Don’t wait. Call now. It sounds to me like you have a tooth infection. It is not uncommon to be without symptoms until the filling is placed. The bacteria in the decay that have made their way into the circulation of the tooth are stirred up like bees in a hive. You will probably need root canal treatment to save the tooth. I expect the dentist will adjust the height of the tooth so that when you bite you won’t be hitting it, and prescribe an antibiotic like Clindamycin to quiet the tooth. Or if he has time on his schedule, he could do the root canal today. Good luck, Dr. Silberman
Hello, I have been experiencing pain from my wisdom teeth erupting, however a tooth a have a pretty deep filling in, is hurting a lot too. it hurts with the slightest touch and the only thing helping it is holding cold water in mouth. I fear that i might need a root canal done because the pain is excruciating. Please give me any advice on how to relieve the pain until my appointment. i have tried ibuprofen, amoxicillin and various numbing gels but nothing helps.
Hello Aleksandra, I find that the cillins (i.e. Amoxicillin) do not do as good a job of attacking the infection as Clindamycin. I recommend 150mg taken four times a day to quiet the infection and reduce the pain dramatically. Meanwhile, ice water is your friend. Remember to avoid heat. No direct sunlight or hot compresses on your face, and stay away from hot foods. A root canal will stop the pain too, so the sooner the better. Good luck, Dr. Silberman
Hi. I just recently had veneers on my upper part of my teeth. While my upper teeth with veneers is currently sensitive if I chew food, I also noticed my lower teeth, that after being exposed to the blue light the dentist used on my upper teeth, there is frequent toothache. And after a while some of my upper teeth also experience pain. I always take pain relievers to ease the pain. But i’m worried that this will occur everyday. Any advice for this Dr.? Thank you.
Hello Joanne, There are two possibilities that stand out as the cause of your problem. One is that your bite is off. The dentist should have you bite on carbon paper to leave marks on your teeth to determine if you are striking certain spots too firmly. It would take a minor adjustment by the dentist to fix this problem and remove the marks and the high spots. It is also possible that you are using a whitening toothpaste. Any time you have dental work done where veneers or fillings are bonded to your teeth, they can be sensitive to temperature change. But whitening toothpaste prolongs the problem. Switch to a desensitizing toothpaste with no whitening agent. The problem should pass in four to six weeks, but not overnight. Be patient. Good Luck, Dr. Silberman
I would love to book an appointment with you but as I am in England it’s not very practical. Your compassionate and helpful replies on this page are wonderful. I visited my dentist ten days ago with pain in my gums and extreme cold sensitivity, he said that I need a root canal but he can’t find time to carry out the procedure for two months, He told me to take Ibuprofen in the meantime which I have been doing. I have been in excruciating pain since seeing him and booked an emergency appointment on Friday which was cancelled due to the practice computer system being down. After a pain-filled weekend I had another emergency appointment booked for today (Monday) and when I arrived at the reception the receptionist rudely informed me that my appointment had been cancelled again. I am a private patient and have spent a lot of money at the practice over twenty-one years but even if I weren’t a paying patient where is the compassion? My face is visibly swollen and I look grey. I actually refused to leave until I had been seen and have now started a course of Amoxicillin. Even my tongue is sore and my cheek feels swollen, I feel like I cannot cope with the pain any longer. Is there anything else I can do to help myself to feel better? Thank you for taking the time to read this,
Hello Samantha, OMG this sounds awful. So sorry to hear you are dealing with this. Amoxicillin is not my first choice for tooth infection with swelling, but it’s better than nothing. It should be taken 500mg every 8 hours. If you have access to Clindamycin 150mg, I would prescribe one every six hours for 10 days instead of the Amoxicillin. But if all you can get is the Amoxicillin, stay with it. Once the antibiotic kicks in, you will feel better. It’s best not to have the root canal until the infection quiets down, but two months is a looooong time to wait. For pain, alternate Tylenol (2x500mg) with Ibuprofen (3x200mg) every 4 hours. Do not take them together. If you have been taking Ibuprofen, take the Tylenol four hours later. Then alternate the two of them until the pain stops. Do not overdose on either of them. 8 hours between Ibuprofens and 8 hours between Tylenols. Avoid applying heat to your face which makes the swelling much much worse. Don’t eat hot foods and stay out of direct sunlight. I’m guessing dentistry isn’t always this difficult in the UK? Good luck to you. Dr. Silberman
I went to er two weeks ago, mild toothache but still needed attention. They prescribed me antibiotics. After three days the swelling went down and my pain was pretty much none existent. However I work up five days later with my face swollen like a ballon and in severe pain. I was still on the antibiotics but I went back to the er. They did a ct scan, and have me iv fluids and then Released me again with two very strong antibiotics. However, it’s been five days and I’m still swollen and very much in pain. The dentist I made an appointment with knew I was antibiotics and scheduled to have an extraction done bc I should have been cleared up by then. But after five days on antibiotics I’m still swollen to where I cannot open my mouth. I can’t eat. Should I go back to the er?
Hello Stephen, If you applied heat to your face, it drew the infection to the surface which caused the swelling. Stop applying heat and the antibiotics should quiet the situation. My “go to” antibiotic is Clindamycin in situations like this instead of Amoxicillin. The secondary antibiotic would be for a different type of bacteria and is usually something like Flagyl. If you have not applied heat to your face, that is a more serious problem. You should go to the ER and they may have to put you on an IV antibiotic. Be proactive and get attention as soon as you can. Good luck, Dr. Silberman
I was having toothache until i started using colgate painout after applying it for 3 to 4 consecutive time my tooth got numb and I dont know what to do now
Hi Danny, The Colgate Painout will be a temporary fix. It controls the pain for a while, but the underlying problem is a cavity. You need to see a dentist to have the tooth decay cleaned out and the tooth filled. Do not postpone treatment because the next step will be root canal therapy to save the tooth. It’s not uncomfortable, but it is expensive to have that done. Good luck, Dr. Silberman
I understand the reason(s): for using ice water in your mouth. However, if even cool water gets near my upper front tooth, I get intense pain that is absolutely excruciating for about 20 seconds, then the tooth aches. So, is there anything else I can do to help my tooth?
Hello J.R., When a tooth is extremely sensitive to cold causing a lingering pain, it is in the early stages of infection. In that situation, you naturally want to avoid ice water or anything even moderately cold. Even inhaling cold air through your mouth can set it off. The nerve of the tooth is being irritated by the bacteria present. As the infection progresses, the nerve dies and the sensitivity to cold passes. The bacteria take over the space inside the tooth (the canal of the root) and they have a biproduct of gas that can build up. Once that happens, anything hot will cause the gas to expand and cause pain. That is when ice water application helps and you need to avoid applying heat to your face. At your present stage of the infection, the best treatment is an antibiotic like Clindamycin 150mg taken four times a day, along with alternating doses every four hours of Tylenol and Ibuprofen. Take two extra strength Tylenol and, in four hours take three 200mg Ibuprofen (Motrin, Advil). Alternate these two medications every four hours. Between the antibiotic and the pain medication, it should help quiet the tooth. It needs to be treated with root canal therapy to save it, or have it extracted. Good luck, Dr. Silberman
Wisdom tooth and little lumps around my gum in so much pain but dentist told me to ring back tomorrow
Hello Fiona, If the problem is the wisdom teeth erupting, it is like a baby teething. You can apply a numbing gel to help stop the pain. Also, the tissue over the wisdom tooth often swells preventing you from biting all the way down. Take warm salt water and hold it over the area of the swollen tissue. This will help to draw out some of the fluid in the tissue and reduce the swelling and the pressure that is causing the pain. It may also me necessary to take some antibiotics like Amoxicillin to help relieve the discomfort. The idea is to use these suggestions until such time that the wisdom teeth can be extracted. Good luck, Dr. Silberman
I have a terrible toothache which comes and go. It comes with inflamation in other teeth and a headache.
Hello Songezile, You haven’t provided me with much information. I would encourage you to see a dentist to get a proper diagnosis. When you say you have inflammation in other teeth and a headache, it is possible that your problem is gum related. Let a professional tell you what the source of the problem is and how to fix it. Good luck, Dr. Silberman
Hello, I developed a toothache so I saw a dentist that day and he did an x ray, but wasn’t sure which tooth it was out of two. He prescribed me antibiotics. I was taking Advil and Tylenol alternating doses, but the pain got worse and worse that night until I finally fell asleep. When I woke up my cheek wax swollen up towards my eye and as far as my nose. I had also been icing the area and I continued to do so for the next 24 hours. I’m wondering if I should wait another day and see if the swelling goes down after taking more does of the antibiotic or If I should be making a trip to the emergency room, and if so is there anything they would even be able to do for me there.
Hello Ashley, When the dentist saw you and took an x-ray, did he run any other tests? An x-ray is one tool that we use but sometimes, it doesn’t provide the information we need to make a diagnosis. We also tap gently on the teeth to see if one feels “different”. It doesn’t have to hurt . . . . just different. We tap from the top of the tooth and then the face of the tooth to see if there is any difference. We also can test with a cold stimulus. We compare all the teeth in the area where there is pain. If one tooth responds differently to the cold, that helps us make a diagnosis. We also press the gum area above the tooth to see if one spot is different. We also have an Electric Pulp Tester. It is a small battery operated instrument that measures how much life is in a tooth. Again, the one that registers differently is often the culprit. Any two of these tests that narrow it down to a specific tooth enables us to make a diagnosis. If your dentist only took an x-ray, it is almost impossible to identify the tooth. These tests can still be done and I’m sure the correct tooth will stand out in a crowd. You could do your own cold and tapping test to identify the tooth. Now you have swelling. Icing the area is the correct thing to do to help minimize the swelling. Also, holding ice water in your mouth around the tooth will stop the pain, but it’s a short term fix. It will help until the antibiotic kicks in. If the antibiotic is Amoxicillin, it will take longer to work than if it is Clindmycin. The only thing an emergency room would be able to do is prescribe Clindamycin over Amoxicillin. If you are already taking Clindamycin, you can increase the dose from 150mg 4 times a day to 300mg four times a day. I hope that helps. You will either need to have the tooth extracted, or have root canal treatment to save it. Good luck, Dr. Silberman
How severe is it now I’ve been putting heat on my toothache
Hello Joe, Stop applying heat and switch to cold compresses. The heat might make it feel better temporarily, but it dramatically increases the speed at which the infection can spread causing major swelling. Hopefully, the swelling hasn’t started yet and you can get to a dentist ASAP to help diagnose the problem and fix it. Good Luck, Dr. Silberman
4 years ago I wen through a extraction of the Third upper molar, the operation was a disaster and a oroantral connection was done and furthermore the roots where left inside. The dentist just covered the oroantral connection with a cementitious and said that the operation was a success. I found out later that was not true. I still have pains after 5 operations and I now developed chronic sinus. Now I need to aligned the teeth again and I have lost two teeth on the same side. Doctors already considered all options like TMJ (done some tests and nothing was found) Bruxism (I am using mouth guards). I continue to have pain and I don’t know for how long I can deal with this. I will try now to treat the rout canal of the first molar. I have also extracted the two upper wisdom teeth. Any advice on the above? I am missing anything?
Hello Jose, It sounds like you have had terrible dental experiences. So sorry to hear this. Most times, when there is intense pain, it is tooth related and a root canal solves the problem. It sounds like they have diagnosed the first molar as the source of the problem. If they do the root canal and the pain persists, it is possible to have inflammation of the nerves going to that area of the face. You may want to see a neurologist for an evaluation. I hope this root canal treatment solves the problem. Good luck, Dr. Silberman
Wha to do if my toothache feels like pumping that gives severe pain including headache and ear area pain?
Hello Jessa, It sounds like you have a tooth that has an infection. You need to see a dentist ASAP. Meanwhile, if the tooth isn’t sensitive to cold water, hold some ice water in your mouth around that tooth. It could stop the pain instantly. Of course if you are sensitive to cold water, it won’t work. Try it and see how it goes. But get to a dentist as soon as possible to get the proper diagnosis and treatment. Good Luck, Dr. Silberman
I recently had a root canal done on to top right molars. Right after that, when I would eat chocolate the left side of my mouth on the top would hurt. However there are no cavities on my x-rays. I do have a tooth on the left side that has a filling that broke off. It does not bother me any other time. My dentist did not seem too concerned about it. I use an aqua sonic pro electric toothbrush with soft bristles , and recently have been using a water flosser to replace traditional string flossing. My question is could having a root canal done on the right side of your mouth affect the left side if the root canal is done on the top right and the pain is now on the top left?
Hello Angela, The upper right and upper left teeth get feeling from different nerve sources. The pain you are having from chocolate on the left side is unrelated to the root canals done on the right side. When a tooth is sensitive to chocolate, there is some exposed area that needs to be sealed. Sometimes a filling is necessary, but the dentist might be able to apply some desensitizing liquid to fix the problem. Good luck, Dr. Silberman
What do you if your nerve is hurting what can kill it
Hello Shania, With the limited information you have given, I would recommend seeing a dentist as soon as possible. If you have an open cavity, you can crush up some cloves and place it in the hole in your tooth. Or you can go to a pharmacy and by some clove oil. That might help take away some of the pain if it is a cavity. It is difficult to know how to advise you. I can’t tell if the source of your pain is tooth or gum or something else. Good luck, Dr. Silberman
Hi doctor
Im 43. When i was a teenager i had a mercury filling on second upper molar left side. Filling covered larg part of tooth. A dentist replaced that mercury filling about 5 years ago with white filling. Part of That tooth broke off a month ago due to a new deep cavity weakening tooth. I had the deep cavity drilled filled a few weeks ago and broken tooth filled. And old filling replaced at same time. I had no pain but the filling was kinda uncomfortable and after messing with it too much part of filling fell out a week ago. I had tooth cleaned again and filling completely replaced again and all was well still no pain at first. Then i had bowl of cereal last night amd layed down amd tooth started hurting. I tried numbing with whiskey but didnt seem to help. But ice water does help. Laying down makes it worse and even causes headache sometimes. I think maybe thetes nerve damage from all prcedures or maybe the root canal. What do you think??
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Hello Joseph, The tooth needs a root canal treatment. The ice water helping the tooth also helps me diagnose the problem. There is an infection in the tooth. The bacteria trapped inside are giving off a byproduct of gas that cannot escape. The gas builds up pressure and causes pain. The ice water reduces the temperature which prevents the gas from expanding, and the pain stops. When you remove the ice water, your body heat is enough to warm the tooth back up and cause the pain. A root canal treatment opens the chewing surface of the tooth allowing the gas to escape. The canals of the root are then filled to prevent the bacteria from growing in that space again. See your dentist and have the root canal done or the tooth extracted. Good luck, Dr. Silberman
What is good for sudden tooth pain
Hello John, “What is good for sudden tooth pain?” The answer is, “It depends”. If this is the first time you are having pain and you can see there is a cavity, you can buy clove oil or tooth ache drops from a pharmacy and place it in the hole. If the cavity has been there a long time, it is possible that ice water held in the mouth might make it feel better. If the problem is a gum issue and not pain from a tooth, warm salt water holds on that gum area could help. Your best bet is to see a dentist as soon as possible to have the correct diagnosis and treatment. Good Luck, Dr. Silberman
I have a badly broken wisdom tooth on the right bottom side an I constantly feel pain on that whole side .what do I do
Hello Andrea, It is difficult to give advise when the actual cause of the pain is uncertain. If the gum inflammation around the tooth is the source of the pain, warm salt water would help to reduce the swelling and stop the pain. If the cavity in the tooth is the source of the pain, you can buy some toothache drops like liquid clove and apply it with some cotton in the hole. That would give it some relief. If you have cloves at home, you can mash it into a paste and apply it in the hole and accomplish the same thing. If the decay has caused the tooth to abscess, holding cold water in your mouth around that tooth will relieve the pain. So the treatment is determined by what is actually going on with this tooth. Your best bet is to see a dentist, get the right diagnosis and treatment plan. But because it’s a wisdom tooth, they usually just need to be extracted. Good Luck, Dr. Silberman
hi, almost all my teeth are falling out, and the ones that are left are soft and brown like wood, i get a tooth infection every few months, go to urgent care and the pain abates, i have been doing this for the past several years just trying to get by, i did have several fillings however they hav allso fallen off recently leaving just part of the sof broken tooth exposed, recently i have developed a terrible taste in my mouth that i cant seem to get rid of no matter how much i brush my teeth, and over the last few days i have developed pain(im an assuming an infection) past almost anything i have ever experienced before. the decay in this tooth is in the top back and goes so high it has raised my gum line all the way to the roof of my mouth where it can go mo further. i have been up several nights in a row do to the pain using large doses or tylenol iboprophen, and lydocane gell. I dont hav dental i surence, only medicaid, and the only clinic near me that takes it, the doctor pulled so hard on me tooth the last time i got one removed. felt like he was pulling my face off, an it came out in pieces and required stiches, just a reglar tooth. Can you reccomend anyone verry skilled dentist or surgen, who would try to save as many teeth as he could while also gently removing the others, perhaps by drilling them into pieces and then removing the pieces thrn pulling so hard till they crack. I am also looking for someone who could possible do laser dentertry as there is so much work to be done and this makes it less painful. Also an understanding bedside matter as i hav anxiery regarding this topic. I ak in the albany ny area but am willing to travel, and as for cost if i could find someone skilled who meets my needs I would be willing to pay cash or check from my savings, part of the reason I have put it off ao long it because i cant find someone who is gentle to do the work the way I want it done, as oppesed to just pulling all my teeth and reccomensing dentures, but things are just getting worse he longer i wait.thankyou..
Hello Kira, What you have described is unhealthy and I’m sorry you have to deal with it. The mouth is the gateway to the body and we need to do what we can to prevent infection. Let me see if I can find the road back to health with you. The Medicaid laws vary from State to State regarding coverage for dental treatment and sometimes they can be quirky. For example, my practice is in Maryland (400 miles from you). There are no Medicaid dental benefits for adults in Maryland unless you are pregnant, which is one of our quirky laws. The day a pregnant woman in Maryland gives birth, she loses her dental benefits. You need to find out what New York Medicaid offers for adults. You should contact the Medicaid office and/or the NY State Dental Association to find out what kind of coverage is offered to adults and which dentists accept Medicaid. The best way to find a good dentist is to take the time and read all of the reviews for each and every dentist that accepts Medicaid. Check out Google, Yelp, Healthgrade, Better Business Bureau, etc. I’m sure that you’ll find someone who does quality work and cares about his/her patients. Also check to see if there are any dental schools in your area. They can offer quality care at a lower price while the dentist in training is closely supervised. Good Luck, Dr. Silberman
Hi I had antibiotics due to a dead tooth as got infected at the pulp.I have now finished antibiotics but have two weeks to wait before my treatment.but I can still feel discomfort what’s best to do whilst waiting for treatment
Hello Carrie, I would ask the dentist for a refill on the antibiotics. My preference when doing root canal treatment is to keep the patient on antibiotics, at minimum, the day of treatment and for a week after, but that is controversial. 20% of patients who do not take antibiotics have pain and suffering after treatment. And then they go on antibiotics to correct the problem. It is far better to take the antibiotics preventively and have zero post-operative pain and suffering. Good luck Carrie, Dr. Silberman
What can be used at home for an infected abscessed tooth
Hello Carrie, There are different home remedies that depend on the exact condition of the tooth. If the tooth is “infected / abscessed” and there is no swelling and no sensitivity to cold, holding ice water in your mouth around the tooth would stop pain temporarily, but an antibiotic like Clindmycin 150mg four times a day is indicated. If the tooth is “infected / abscessed” and there is swelling and no sensitivity to hot or cold, hold warm salt water in your mouth around the tooth. Do not apply heat externally to your face. Just warm saltwater holds. Again, Clindamycin 150mg four times a day is indicated. Your best bet is seeing a dentist and get diagnosed properly, and get on antibiotics as soon as possible. Good Luck, Dr. Silberman
So basically I have a tooth which is decayed and only small but is left will the dentist remove it but cutting the gum or will they give me antibiotics but the ones that prescribed before didint work it is likely they will take it out ???
Hello Saher, It sounds like the root of the tooth is probably still intact, even if the portion of remaining tooth above the gum line is largely decayed. The root can still abscess and cause infection, so it should be extracted. Sometimes a root can simply be “elevated” out of the socket, and sometimes there is a more surgical approach necessary. I can’t advise without seeing the x-ray. Your dentist will be able to advise you at the time of treatment. If you were trying to save the tooth, I would prescribe antibiotics, but if it is going to be extracted, there is no need for them. Good Luck, Dr. Silberman
Hi Dr.
My bottom left molar already had a root canal and crown placed. Just recently I started clear aligners and after 2 1/2 months, that molar tooth started to experience severe pain especially at night that is relieved when it comes in contact with cold water. I already went to the dentist and they didn’t see anything on the X-ray but the pain is worsening and ibuprofen and Tylenol are not helping. The dentist also prescribed amoxicillin and clorhexydine and to check back in 3 days. The pain in unbearable!
Hello Princess, A tooth that has had a root canal treatment may have a canal that was not filled. It is not likely, but it is a possibility. The dentist may have to drill an opening in the top of the crown and search for the extra canal, clean it and fill it. An empty canal would allow bacteria to grow which have a biproduct of gas. The trapped gas expands upon heating and would cause pain. Ice water would cool it down and stop the pain within a minute. Hold ice water in your mouth around that tooth anytime you need relief. This would hold true for any tooth that has this condition and I suspect an adjacent tooth as being the culprit, not the root canal tooth. All of the teeth in that area of the mouth should be tested with a cold stimulus one at a time. Your dentist should be able to do this very easily. We would expect all of the teeth to respond to the cold stimulus except the root canal tooth. If the cold makes the root canal tooth feel better, it has an unfilled canal and it is the source of your pain. If one of the other teeth does not respond to the cold while the rest do, that is likely the bad tooth and it would need root canal treatment. I hope that helps. Good luck, Dr. Silberman
How long does it take antibiotics to start working on the infection from an abscess?
Hello Casey, Typically it takes 48 to 72 hours for an antibiotic to start working. Having said that, the effectiveness of an antibiotic on an abscessed tooth depends on many things. I prefer Clindamycin over other antibiotics like Amoxicillin or Augmentin. In my experience, Clindamycin is the most effective against a dental abscess. How strong is the infection? How healthy is the individual (diabetic, immunosuppressed, etc.?) So many variables come in to play. In any scenario it is important to avoid applying heat to your face as this will draw out any swelling and make the healing much more difficult and delay the effectiveness of the antibiotic. Good luck, Dr. Silberman
So I just started feeling my jaw swollen and was kind of tight when I woke up. (Around noon) I work second shift. Earlier that morning I ordered Amoxicillin, got it later that day before work and took them. I took 2 at first. And then a 3rd….and a 4th because I am impatient and stupid. Later at work around midnight I took 6 200mg ibuprofen to stave off the pain. Which helped. Got home and it began to worsen. I used cold ice compress AFTER USING HEAT because I’m an idiot. Pain was helped, and I was able to sleep very little. I woke up took more pain meds, and the amoxicillin. Jaw was stiffer and puffy. Trimmed my beard to see it better. Went through work, made it through the night, but idk if it got more swollen through the night. I took recommend dosage of amoxicillin. . But I got home and my.face still feels right by the tooth that is abscess. There is only one area on the jaw that hurts if you press it, and it feels stiffer than the other swollen area on the jaw line. No other swelling, like eyes or neck, however I am getting concerned. First taking the. Amoxicillin helped. And next day I was swollen by the tooth. I been icing and taking pain meds and amoxicillin and ice packs . Salt water rinse. And sat up all night reading up on this subject. I was trying to wait til my insurance at work got turned on, because I was instructed to go to an oral surgeon to take care of my tooth that has large cavity in it. This is my second round of amoxicillin in I want to say last three months. The ice.packs help. The alcohol did not. I’ve tried every remedy I read. I’m in complete misery, and I guess bottom line. I don’t want to die. I have two kids and, I’m scared to death of the dentist. But what should I do. Or say. Or go? I need so much help. My mouth still opens but barely to the wide open I used too. No other swelling besides next to the tooth. Am I being even more of an idiot by not going in ASAP. Is draining the abscess going to hurt. Can my mother please call in and hold.my hand as I walk in. I don’t want to die. I need advice or just some counseling or kind words. I believe in calling in work today for the day off, and see if I can. Get into the dentist. I feel like such a loser right now. I just want my face to go back down, and my teeth to feel better. I’m such a f”n loser. Please help
Hello Chad, You are not a loser. You just feel like crap. Here is what I suggest. See a dentist as soon as possible. The dentist may be able to save the tooth, or it may need to be extracted. Having taken Amoxicillin 3 months ago, you likely built up a tolerance to it so that it is not as effective on this go ’round. You need to switch to a different antibiotic. The best option is Clindamycin and it can be taken at a dose of 150 mg or 300 mg every 6 hours. If the swelling is strong, the dentist will likely wait for the antibiotic to kick in and get the swelling to go down. But it may be that they can treat the tooth. It’s a judgement call to be made by the dentist. Unless there is significant swelling with the potential of closing your airway, a drain is not usually placed. Bottom line: get to the dentist ASAP and address the problem. Dentistry is a lot easier today than it used to be. Google the dentist that will see you and make sure there are lots of positive reviews. People tend to be honest if they are willing to take the time to review things. Good luck. And remember not to apply any more heat. Also, holding ice water in your mouth will help with the pain coming from that tooth. Dr. Silberman
Hello Dr. Can abscess become hard after applying cold compress and taking antibiotics because recently I took out the tooth (first molar which got root canal earlier affected with abscess) at dental care, but the abscess did not ooze out after extraction of the tooth and the Dentist said that the abscess didn’t ooze out because it has solidified due to antibiotics and cold compress so what I’m wondering is how the pain will subside if the abscess does not oozes out or drained I even asked if it can be incision and drained out but dr. Said it will alright just take the full course of medication the abscess will go away it self or heal so what’s your suggestion, the abscess is still there and making my face swell like I’m keeping one ping pong ball in one side of my mouth, when I use cold compress and take pain killer then only I feel relief so will the abscess that became hard will heal overtime..? Waiting for your reply. Really needed to have answer of my curiosity.
Hello Joshua, An abscess can become hard. If there is no spongy feel to it, it likely cannot be drained. It’s better to treat it with antibiotics. Usually oral antibiotics like Clindamycin is sufficient to treat the problem. Occasionally intravenous antibiotics are necessary to knock out the infection. See how the swelling changes over the next few days. It should gradually decrease in size. If it is increasing, let the dentist know. Also, reminder not to apply heat to the swelling because that will increase the size of the swelling dramatically and make the job of the antibiotic much more difficult. Good Luck, Dr. Silberman
I was called in Amoxicillin and ibuprofen and I’ve took 2 so far and ate some chicken noodle soup before taking it and I’ve gotten sick 3 times . The swelling is all the way up into my nose and right eye is there anything I can do to keep from getting sick and to get some of the swelling down ?
Hi Tasha, Do not eat hot soup or anything else hot while your face is swollen. Do not apply heat to your face (no hot compress, heating pad, etc.) and avoid direct sunlight. The heat increases the swelling. Apply a cold compress like a bag of frozen peas to the swelling, 20 minutes on and 10 minutes off repeatedly to help with the swelling. Eat something more solid to line your stomach before your next dose of Amoxicillin. I like Clindamycin better than Amoxicillin for tooth infection but it is harder on the stomach than Amoxicillin. If you can’t keep the antibiotic down, you may need IV antibiotics from a local hospital. A tooth related swelling on an upper front tooth can be life threatening so don’t mess around with this. Good luck, Dr. Silberman
I have a cavity on my back tooth and everytime I don’t have any Cold water on my tooth and it hurts my dentist said after Thanksgiving day I have a appointment but I can’t wait that long
Hello Austin, Find a dentist who will see you ASAP. You have an abscessed tooth and you need to be put on an antibiotic, like Clindamycin 150mg four times a day. The antibiotic will quiet the tooth while the ice water will keep the pain at bay. The cold works by getting the gas trapped in the tooth to contract and takes the pressure off the nerve endings. Your body heat is enough to make the gas expand and start the pain again. Do not apply heat to your face or eat hot food or drink. Stay out of direct sunlight. You can apply cold compresses on your face next to the tooth to help also (20 minutes on and 10 minutes off.) Good Luck, Dr. Silberman
I’m scared of dentists and I’ve broken my back tooth and I don’t think I can afford to get it fixed. Im experiencing a higher fever and really bad earache
Hello Vincent, I encourage you to see someone, preferably a dentist, but even an urgent care can evaluate the source of your fever and earache. You probably need to be put on an antibiotic before you get treatment. So go get diagnosed ASAP. Good Luck, Dr. Silberman
How can I report the VA for negligence? I recently had a tooth implant done and someone forgot to give me my antibiotics. When I got one about four or five days later, an infection had already set in. They then gave me azithromycin instead of clindamycin which of course it didn’t work. I have had this infection for two weeks now and they might have to take out the implant and do a bone graph later. It’s been painful as heck and now the area itches. I am hoping no permanent damage is done to my jaw bone or the tooth in front. The implant is my back right molar.
Hello Michael, I am not in a position to answer legal questions. But I agree the standard of care is to take Amoxicillin 500mg three times a day beginning the day of dental implant surgery and lasting for 5 to 7 days. Clindamycin is better for treatment of tooth abscess which is why I always prescribe it for root canal therapy. Amoxicillin is better for implants. In my opinion, antibiotic coverage for both implant placement and root canal treatment are mandatory. Good luck. I hope there are no more complications for you. Dr. Silberman
I’m currently pregnant and out of nowhere became very congested. Practically, I couldn’t breathe through my nose and then the toothache started. It hasn’t been one tooth, but unbearable pain on both the top and bottom teeth in the back of my mouth. I went to the ER and they diagnosed me with a sinus infection, but I’m no longer congested and my teeth are still killing me. All I can take is the amoxicillin prescribed and Tylenol every 4-6 hours. Should I get a second opinion on this possibly being an abscess, Eventho it’s multiple teeth?
Hello Megan, It is likely that the source of your tooth pain is from the sinus infection. Even if you are no longer congested, there may still be infection. There are other antibiotics that you could take, with the permission of your OB, to fix the problem. Be careful to avoid taking more than two extra strength Tylenol every 8 hours. It can be harmful to your liver. See if you can alternate it with something else like 600mg Motrin. That way you can take something for the pain every 4 hours alternating the two medications. But again you would have to check with your OB. It should be OK in your first trimester according to the literature. You should have check-up x-rays taken by the dentist to make sure that the problem isn’t tooth related. If you are in your second or third trimester, dental x-rays while wearing a lead apron should not be harmful to the fetus. Good Luck, Dr. Silberman