Tooth pain

If a tooth hurts, is swollen or has broken, message us. Within clinic hours we give you the next available appointment. We keep set hours and are not a 24-hour emergency service.

You may know this as pallu vedana (tooth pain). What you want is pallu vedana maran, for the tooth pain to go.

If it is night

Kallada Smile keeps set hours, and it is not a 24-hour emergency service. The clinic is open every day, Sundays included, 10 am to 7 pm. A message sent outside those hours is read and answered when we next open, so a message sent at night is not a way of being seen that night.

For severe swelling, heavy bleeding, a knocked-out tooth or an injury at night, do not wait for us to open. Go to a hospital casualty department the same night. The nearest one to Potta is on the Chalakudy side of NH 544. If breathing or swallowing is difficult, dial 108 for an ambulance rather than travelling yourself.

What it is

Tooth pain is a symptom, not a diagnosis. The same ache can come from decay, from an infected nerve, from the gum, from a wisdom tooth or from a crack. Each needs a different treatment, so the first job is to find out which one it is.

What you feel	Likely cause	Usual treatment
Sharp pain with sweet or cold food, gone in seconds	Decay, a leaking filling, a worn neck of a tooth or a cracked cusp	An examination first; often a filling
Constant throbbing, worse when lying down	An infected nerve, called the pulp	Root canal treatment, or removing the tooth
Swollen gum, bad taste, pus	An abscess. It comes from the nerve inside a tooth more often than from the gum, and the two are treated differently	An examination and a picture decide which. Draining it, then root canal treatment or removal where the nerve is the source; cleaning where the gum is
Pain at the back, a sore flap of gum	A wisdom tooth	Cleaning under the gum; removal if it keeps returning
Pain on biting, tooth looks fine	A crack, a filling that is too high, or inflammation at the root tip	An examination first. A crack often needs root canal treatment as well as a crown, and removal if it runs deep
Sensitivity across many teeth	Worn enamel or receding gums	Varnish, toothpaste advice, sometimes fillings
Ache in several upper back teeth, worse leaning forward, with a blocked nose	Pain referred from the sinus, not from a tooth	Treating the sinus. A healthy tooth is not drilled for this

Every row in this table is a starting point, not a diagnosis: the same symptom has more than one cause and only an examination separates them.

Signs you might need it

Message us today

• A tooth that stings with hot, cold or sweet food.
• A filling or a crown that has come out.
• A tooth that has chipped, with little or no pain.

Call us now

• Throbbing pain that keeps you awake or stops you eating.
• Swelling of the gum, the cheek or the face, or bleeding that will not stop.
• A knocked-out adult tooth: put it back in its socket at once, at the place it happened, and come the same day. If you cannot put it back, keep it in milk and come within the hour.

Go to a hospital now

• Difficulty breathing or swallowing: dial 108 for an ambulance.
• Swelling that is spreading towards the eye or down the neck, or swelling under the tongue or in the floor of the mouth.
• A jaw that will not open.
• A high fever with the swelling, or a blow that may have broken the jaw.
• Jaw or tooth pain together with chest tightness, breathlessness or sweating. That can be the heart rather than the tooth, and it is treated as such until proved otherwise.

What happens at Kallada Smile

Options

What can be done at the first visit depends on the cause.

• A dressing. Decay is cleaned out and a medicated dressing is placed. The tooth is filled properly later.
• Drainage. A gum swelling is opened so the pus can escape. This usually settles the pain quickly.
• The first stage of a root canal. The infected nerve is removed and the tooth is left open or dressed.
• Removing the tooth. Chosen when too little sound tooth is left, or when the infection allows nothing else.
• Smoothing a sharp edge. A broken tooth that is cutting the tongue is smoothed the same visit.

Dr. Pavya explains what each option involves, what it costs and what happens if you wait. You decide.

What can go wrong

A tooth with a live infection can be hard to numb, and more than one injection is sometimes needed. Opening a tooth or draining a swelling can leave it aching for a day or two before it improves. A spreading infection sometimes needs more than a dental clinic can give, and the honest answer is then to tell you to go to a hospital the same day rather than to start here. The first visit is aimed at settling the pain; it is not the treatment that finishes the job, and pain that has stopped is not the same as a problem that has gone.

How long it takes and how many visits

Plan for 30 to 45 minutes at the clinic for a pain visit. The aim of that visit is to settle the pain.

The treatment that finishes the job is usually a root canal or a crown. It is done at later visits, generally one to three.

People in pain, children included, are seen before routine check-ups. Message first if you can, so a chair is held for you.

Looking after it afterwards

• Take the medicine exactly as prescribed, and finish the course if antibiotics were given.
• Chew on the other side until the tooth has been treated properly.
• Rinse with warm salt water two or three times a day, starting the day after any procedure.
• Keep the temporary dressing in place. If it comes out, message us; the tooth is open to infection until it is replaced.
• Come back for the planned treatment even after the pain has gone. The dressing is a holding measure, not the treatment.
• If the pain or the swelling returns, tell us the same working day rather than waiting for the next appointment.