Managing toothache at home

Tips to help manage common dental problems at home until we are back open.

Following recent guidance from NHS Scotland and the Department of Health, all dental practices have been ordered to vastly reduce the number of patients that they see and treat. As well as reducing risk to staff and patients, this will also prevent unnecessary travel in an attempt to reduce virus transmission. This information aims to support people in managing symptoms at home until they can be seen in practice.

Image by Adam Nieścioruk

Painkillers

Combining paracetamol and ibuprofen has been shown to be most effective in treating toothache. At the present time, Ibuprofen should only be taken if not showing any symptoms of possible COVID 19.

Painkillers should always be taken in accordance with instructions on the packet. Taking too many tablets, or taking medications incorrectly will not improve your symptoms, and can cause serious stomach and liver injury which can be life threatening. 

Toothache, medicine, health care concept

Toothache

If the tooth is extremely sensitive to hot and cold then antibiotics will not help. The decay must be removed and filled.

However, good cleaning with fluoride toothpaste and reducing sugar intake will help stop decay from getting any worse.

If there is a hole in the tooth, or a tooth has cracked and is now sensitive/sharp, a temporarily filling can be packed into the space. These are widely available from supermarkets and pharamacies.

Desensitising toothpastes (sensodyne) can help. Rub toothpaste directly on the affected area and do not rinse afterwards. Anaesthetic gel such as Orajel can help ease pain.

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Wisdom Teeth

Wisdom tooth pain is usually due to inflammation of the gum overlying the erupting tooth, which can be worsened by trauma from biting. 

- Most flare ups can be managed with good home care and should settle in a few days to a week.

- Excellent cleaning (even if it is painful to brush, this area must be kept clean to encourage healing)

- Corsodyl mouthwash (avoid use for >1 week as may cause staining) or hot salty mouthwash (teaspoon of salt dissolved in a cup of lukewarm water)

- Soft diet (soft food will reduce trauma from biting)

- Painkillers (ibuprofen or paracetamol

following packet instructions)

- If you have difficulty swallowing, swelling or difficulty opening your mouth then please phone us as you may need antibiotics if the infection is spreading.

Oral hygiene, use of mouthwash for the h

Ulcers

Although painful, most ulcers will heal within 7-10 days. Non-healing ulcers/oral lesions present for more than 3 weeks should be assessed by us.

To treat ulcers, try:

- Warm salty mouthwash

- Excellent cleaning (even if it is painful to brush, the mouth must be kept clean to encourage healing and prevent more ulcers forming. Be gentle and use a soft/baby toothbrush).

- Difflam spray/mouthwash which is available from a pharmacy over the counter

- Soft diet (soft food will reduce trauma from biting)

- Painkillers (Ibuprofen or paracetamol following packet instructions)

Red Toothbrush

Bleeding Gums

Bleeding from gums is NOT a dental emergency.

Bleeding gums are usually due to gum disease, and will not stop until brushing improves.

Brush twice a day using an electric toothbrush and a fluoride toothpaste for 2 minutes. Concentrate particularly on the areas that are bleeding.

Use floss or Tepe brushes to clean between your teeth every day. 

Image by Hubi Farago

Rubbing Dentures

Denture adhesives such as Fixodent or Polygrip may help to secure a loose denture.

Seabond denture pads may make the denture more comfortable and stable.

Any sharp edges can be removed using an emery board.

Remove dentures where possible if causing trauma.

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Lost crowns or veneers

Toofypegs (widely available on Amazon or from chemists) can be used to restick crowns or veneers at home. 

- Clean and check the crown. If the crown is mostly hollow then you can attempt to recement it at home if you feel confident to do so.

- Remove any debris from the crown, you can use something like the tip of a paperclip to scrape the old cement away.  Clean your tooth thoroughly. All debris must be removed from both the crown and teeth for it to seat properly.

- Check the crown fits without cement. Check that the bite feels correct. If the tooth feels too tall, it is not fitted correctly so double check for debris. NEVER force a crown or post into your tooth as this can cause the root to fracture.

- Once you have practiced placing the crown, dry the tooth and the crown. Mix the cement as instructed on the packet and fill the crown. Place the crown directly onto the tooth and bite firmly to press it into place.

- Remove any extra cement with a toothpick and floss between your teeth to make sure that do not stick together.

Good oral hygiene will stop the tooth becoming decayed or sensitive.

Denture adhesives can also be used to stick it temporarily back in place if going outside for a short while.