Neglect toothache at your own peril

By Mashal Afridi
Fri, 07, 20

Let’s read on and find out what is in store for you if you have to go for it….

Most of us have an insidious but partially-expected companion accompanying us day and night – toothache. If the toothache is due to infection, it can cause a lot of pain. So, a stitch (read treatment) in time, can really save you from a lot of grief later. What can be taken care of with a filling, should not be left untreated because a filling is better than root canal treatment, or RCT. Let’s read on and find out what is in store for you if you have to go for it…

What is root canal treatment?

Your teeth contain a living, bleeding, breathing, sensitive part inside them, called the pulp. In layman terms, root canal treatment is the process of removing infected pulp.

Is it different from a dental filling?

Yes. When caries (germs) haven’t reached your pulp, a filling is done. It only requires a single visit to the dentist, and is cheaper than root canal treatment. A filling usually does not require an anesthetic shot. You may need a shot if the caries are very close to your pulp.

In contrast, root canal treatment is advised when germs have reached your pulp, or are already inside of it. The entire pulp has to be removed and the empty space is filled with a filling material. This is done in two or three appointments. A root canal treated tooth is dead (Yes, your teeth are living things, unlike your hair). You can still munch on it, although you will need to cover it with a metal or zirconium crown to protect the dead tooth from breaking apart.

Can dental filling compensate for RCT?

No, it can’t. Root canal treatment is advised when a pulpal infection is diagnosed. Fillings have nothing to do with your pulp. Fillings are done when caries are in the white portion of your tooth - the enamel and dentine.

Can RCT be delayed?

It’s best not to. After germs have gained entry into your pulp, they will spread into your body, giving you a fever, or causing pus to form within your bones, or facial spaces. This is dangerous and can very rapidly become very distended and painful.

What’s the worst that can happen to me, huh?

Believe it or not, you can die. You can choke to death from Ludwig’s Angina or die from Cavernous Sinus Thrombosis. Depends on which tooth is infected, an anterior tooth, or a posterior one. There are other Odontogenic Infections, too, but I believe this much information is enough for the ‘worst case scenario’.

How do I know I need a filling?

That’s a tricky question, because most people report toothaches even though their teeth are fine; they just need to brush regularly - or less regularly, in some cases. You know you need a filling when one or more specific teeth have the following symptoms (the same tooth should show the same symptoms everyday):

1 A tooth becomes painful when you eat or drink. The pain lasts only as long as the food item is in your mouth. It stops immediately or seconds after you swallow.

2 If your tooth has a cavity (a hole), food will get stuck in that cavity and cause continuous pain. The pain will stop immediately when you remove food that’s stuck inside it.

3 There’s a painless black spot on your tooth, which can’t be scratched away. In fact, if you poke it, a fine needle may even get stuck in it (Please don’t poke it multiple times You may break your tooth, because these ‘holes’ are actually ‘holes in the roof’. The tooth is empty on the inside.)

How do I know I need RCT?

Delaying a filling will make root canal treatment necessary. You require root canal treatment if you have the following characteristic symptoms. You may have one or all of them at a given time:

1 The pain may start when you eat, or even while you’re just sitting and chilling. It will last five minutes or more. It can last up to an hour. The pain lasts even after you remove food that was stuck in a cavity in your tooth.

2 The pain wakes you up at night and is very intense. Again, you weren’t eating in your sleep. You were just sleeping and chilling.

3 The pain spreads to the adjacent areas, like the adjacent teeth, cheeks, nose, ears and lower eyelid. Just like in a heart attack, where the pain is felt in the arms, neck and lower jaw, apart from the heart. So, you could say that root canal treatment is needed when your tooth has a mini-heart attack.

4 A tiny little pimple develops next to a tooth. Or a humongous pimple may develop. Depends on your luck. This is an indication that you have pus in your bones. Your root canal treatment is long overdue.

If you had any of these symptoms and are okay now, it doesn’t mean that you don’t need root canal treatment anymore. Pulpal infections of this nature are not reversible. You can say that your infected tooth has a sleeping cancer. This is a dangerous period because your tooth is a germ recruitment centre, but you’re asymptomatic, so you believe nothing is wrong. Pretty much like a COVID-19 infection. Then, suddenly, one night, WAM! The germs will cross the pulp and attack with might. Half of your face will swell up and you may look anywhere from a potato to a pumpkin. It may sound funny, but it has never looked funny. It has only caused distress to the patient and the onlooker.

So, readers, go to the mirror and observer those ‘batisay’. Which tooth hurts? Which tooth is black? Which tooth shows symptoms to make root canal treatment necessary? Do you happen to have ‘mouth acne’?

If your dentist advised you a dental filling, do it now, because a filling done on time can save you from root canal treatment.