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HEADACHES: DENTAL CAUSES (TOOTHACHE)

Occasionally toothache can mimic a headache. The teeth are notorious for causing pain which is felt in a completely different site; the technical term for this is referred pain. The teeth can cause referred pain in wildly different sites and this is the reason why dentists sometimes find it hard to isolate which tooth is the source of the pain, and may drill several fillings out before they find the culprit.

A small amount of dental decay (otherwise known as caries) at the bottom of an otherwise normal-looking and well-filled tooth can cause tremendous pain when it extends to infect the pulp space deep within the tooth (the pulp space is the only live bit of the tooth). In turn, infection of the pulp space can track down to the very bottom of the tooth and cause infection in the jaw. Infection here is called an apical abscess. The pain of an infected or decaying tooth can be referred into the head or the neck, and in some cases can mimic headaches, particularly tension headaches and sinusitis.

Toothache can be diagnosed where there is obvious infection or decay in a tooth; or where the tooth is tender on being knocked or touched. One of the first features of a pulp space infection is that the tooth feels as though it has lifted up slightly, and is more easily banged by the opposing set of teeth when clenching the teeth together. An apical abscess can also make the gum tender at the level of the top of the root of the tooth, about a quarter of an inch below the gum margin. In the very late stages of an apical abscess there may be an obvious boil or discharging abscess at this site. This is called a gum boil.

What else could it be?

Dental pain can be confused with sinusitis, especially as dental pain (particularly where there is pulp space infection or an apical abscess) is often made worse by putting the head between the knees; dental pain and the sinusitis pain behave identically in this situation. Tension headache can imitate dental pain, too, but here there are trigger points on the neck, face or scalp – touching these exacerbates the pain. However, because of the way in which pain is referred from teeth, it can often cause reflex spasm in muscles at some distance from the actual site of the pain, so local tenderness in the muscles of the head or neck does not necessarily rule out a dental cause.

Treatment

Obviously denial work is required; to scrape out the inside of the infected tooth, maybe root-fill it, or perhaps perform an apiceclomy, if there is an apical abscess.

Self-help

Simple, minor tooth decay doesn’t cause pain. The problems occur when nothing has been done and the decay has been allowed to advance. So, simply have regular dental check-ups and brush your teeth regularly with a fluoride toothpaste.

Brushing your teeth property is important. It’s not just the teeth that you need to clean, but also the gums. It’s worth remembering that as many teeth are lost by gum disease as they are to tooth decay. Unfortunately, it is all too easy for scraps of food to collect between the tooth and the gums, where they begin to fester and set up an infection called gingivitis. Gingivitis can be almost as painful as toothache: typically it’s much worse with hot and cold foods, and can be eased substantially by careful attention to brushing the teeth.

Complementary treatment

Obviously severe toothache caused by decay should be treated by your dentist, but there are a number of treatments for pain and inflammation that will provide some relief during attacks. Cloves have an analgesic oil contained in them and they can either he bitten whole, next to the offending tooth, or their oil can be applied neat to the painful area.

An infusion of marshmallow and sage can be used as a mouth rinse, and then swallowed. Mint also has antiseptic and analgesic properties and can be chewed or sucked at the site of the pain. Gum disease can be treated by chewing tarragon, sage and thyme, or by rubbing oil of thyme into the gums. Vitamin C is essential to gum health, so ensure you are getting enough.

Rinse your mouth daily with hypericum and calendula, mixed with cooled, boiled water, to prevent infection, A hot compress of camomile over the cheek, will ease the pain and draw the infection to the surface, if an abscess is present.

There are many different homoeopathic remedies available – and they will deal specifically with the kind of pain you are suffering, whether you have abscesses, or gingivitis, etc. Some suggestions are arnica, kali phos, silica and camomile. There are even homoeopathic remedies to deal with the fear of dental treatment, and discomfort following treatment.

Reflexology can sometimes ease toothache, Acupressure and acupuncture can deal with local pain, and also fear, tension and headaches.

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