WHEN Dr. Leslie Ramsammy was the Minister of Health, I chaired a forum a few years ago in which he said that there was a time when we dentists literally extracted buckets of teeth and were proud of it. Admittedly, this statement is not entirely false. I actually extracted buckets of teeth in a village called Paramakatoi. For me personally, it was a gross contradiction, because as a student practising in Brazil, patients would tell me, “Doc, do anything, but please don’t extract my tooth.” Statistical information coming from the public dental service reveals that most persons visit the dentist because of toothache. They naturally expect that the offending tooth will be extracted. But just because you have had a bad toothache does not mean the tooth will have to be extracted. Root canal therapy can save an abscessed tooth, or one with a damaged pulp (packet of nerves and blood vessels in the core), and should be a preferred procedure over extraction. Incidentally, we need to remember that even if a pain appearing anywhere in the mouth should go away by itself, it should not be ignored. Sometimes it could point to a serious condition. For example, heart problems may first manifest itself as pain in the lower jaw and teeth. You may justifiably ask: “If I suddenly get a toothache, what can I do about it other than going immediately to see a dentist (which is almost always unlikely)?” You may want to try any one of these as a temporary measure for alleviation. First, take a double dose of the analgesic you normally would take for an ordinary headache. I usually recommend, for immediate relief, 600mgs of Ibuprofen (Motrin), or better still, 100mgs of the more expensive Zerodol every 12 hours. Secondly, a tiny cotton ball soaked in clove oil and placed in the cavity invariably mitigates the pain right away. If you cannot get clove oil, pulverize a few cloves in a drop of olive oil and use that instead.
Third, apply a cold compress to the affected areas, especially if the corresponding cheek had recently begun to swell. Cold is the only physical agent known which is capable of subduing inflammation, the symptoms of which include pain and swelling. Occasionally, it may help if cold water is held in the mouth. But one should be careful when using cold or heat with aching teeth. Fourth, an increase of the blood pressure can cause toothache. Clearly, the pulp chamber cannot distend to accommodate the changes in pressure, because it is located in the centre of the tooth. The augmented pressure, therefore, compresses the nerves which results in the pain. Elevation of the head can decrease the pressure. This method may be found to be useful when the toothache attacks during the hours of slumber. However, even if relief is achieved, the pain wakes you up at the night; it is serious for the tooth. Fifthly, tooth pain after eating sweet means the acid produced from the converted sugar is acting on the exposed nerve endings in the cavity. The way to resist this is to neutralize the acid. A good home remedy is rinsing the mouth in the morning with a solution of baking soda. Baking powder has some sodium bicarbonate in it, and this can also be utilized. The sixth and final recommendation to achieve emergency relief from a toothache is to clean out the cavity (the direct application of alcohol in the cavity usually numbs it for a short while), and then plug it completely with sugarless chewing gum. It must be emphasized that these are only some temporary measures to get relief from a toothache. In every case of tooth pain, professional assistance should be sought for a permanent cure. Finally, remember that the function of a dentist is not to remove a tooth but to save it in the patient’s mouth if possible.