Tooth Pain and Swelling: When to Seek Emergency Dental Care - Dentistry

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Tooth swelling and pain; the dentist said there are no cavities, but if it swells again, a root canal will be necessary?


Hello, Doctor.
A few days ago, I felt pain in my lower left teeth, but I wasn't sure which one it was.
By yesterday morning, Friday, the pain had subsided, but I clearly noticed swelling in the fourth tooth on the lower left.
The gums didn't appear swollen, but the sensation was very noticeable, and touching that tooth—whether brushing, biting, or tapping—caused pain.
I immediately went to see a dentist yesterday, and after examining me, he drilled a small hole and said that the tooth did not have a cavity; it might be a spontaneous inflammation.
He prescribed me some medication (but I finished all three packets yesterday, Friday).
The dentist told me that if there was no improvement by Monday, I would need a root canal.
As of today, the swelling and pain in that tooth have not improved; in fact, it feels worse, and even the nearby cheek is swollen and warm.
The tooth pain has been so intense that it has even caused discomfort in my temples.
However, the dental office is closed today.
Should I wait until Monday? I would have to endure this for two more days...
If there is still no improvement on Monday, will I really need a root canal? Or should I consider seeing another dentist? Some people say this is due to lack of sleep...
Should I see a dentist or another type of doctor?

lee, 20~29 year old female. Ask Date: 2006/07/29

Dr. Lin Qingye reply Dentistry


Miss Lee: Please check your temperature for any signs of fever.
Generally, the symptoms related to your teeth have not improved and seem to be getting worse.
Do not delay any longer; seek a nearby dentist for consultation, or consider using antibiotics to manage the inflammation.
If you experience fever or cold sweats, please go to the emergency room immediately, as it may be progressing to cellulitis.

Reply Date: 2006/07/29

More Info


Tooth pain and swelling can be alarming, especially when accompanied by symptoms like sensitivity, discomfort, and swelling in the surrounding areas. Based on your description, it seems you are experiencing significant discomfort in your lower left quadrant, specifically with the fourth tooth, which has led to swelling and pain that radiates to your temple.
Given that your dentist has already examined the tooth and found no cavities, it is possible that you are dealing with a dental abscess or pulpitis, which is inflammation of the dental pulp. This condition can occur due to various reasons, including trauma, deep decay, or even a crack in the tooth that may not be immediately visible. The fact that you are experiencing increased pain and swelling, along with the warmth in the area, suggests that the situation may be worsening and could potentially lead to a more serious infection if not addressed promptly.

In general, if you experience severe tooth pain, swelling, and fever, it is advisable to seek emergency dental care rather than waiting for a scheduled appointment. Dental infections can escalate quickly, and timely intervention is crucial to prevent complications such as the spread of infection to other areas, including the jaw or even systemic involvement.
Since your dentist recommended a root canal if symptoms do not improve, it indicates that they suspect the pulp may be affected. Root canal treatment is often necessary when the pulp is inflamed or infected, as it helps to remove the infected tissue and alleviate pain. If your symptoms have worsened since your last visit, it would be prudent to seek a second opinion or visit an emergency dental clinic if your regular dentist is unavailable.
In the meantime, you can manage your pain with over-the-counter pain relievers such as ibuprofen or acetaminophen, as directed on the packaging. Applying a cold compress to the outside of your cheek can also help reduce swelling and numb the area temporarily.
Regarding the concern about sleep deprivation, while it can exacerbate pain perception and overall discomfort, it is unlikely to be the primary cause of your current dental issues. However, addressing your sleep patterns is important for your overall health and can help improve your pain tolerance and recovery.

In summary, do not wait until Monday if your symptoms are worsening. Seek immediate dental care to address the swelling and pain effectively. If you are unable to see your regular dentist, consider visiting an urgent care dental clinic or an emergency room where dental services are available. Your health and comfort should be the priority, and timely intervention can prevent further complications.

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