Toothache – what to do in the dental practice

If the toothache persists for a long time, a dental practice must be consulted urgently, as the underlying problem can quickly lead to irreparable damage in some cases. The dentist’s first task is to determine the cause of the toothache and then to decide what to do. For this reason, it is very important to obtain a complete status of the teeth and gums.

If the reason for the toothache is in the area of the tooth structure, caries therapy must often be initiated. In the course of this treatment the dentist will remove the carious defect completely with a drill and close the resulting hole with a suitable filling material. A so-called amalgam filling is fully covered by the statutory health insurance companies.

Patients, however, who value a much more inconspicuous plastic filling, must expect a co-payment of 40 to 75 Euros. In the case of caries, which extend very far into the dentine or have already destroyed parts of the dental pulp, a simple filling therapy is usually no longer sufficient. In these cases the dentist has to take an x-ray of the affected tooth and decide what to do based on the degree of destruction.

In most cases, a so-called root canal treatment, in which the defective tooth root is completely removed, must be carried out. In the course of this treatment, various hand instruments are used, which enable the complete removal of the root cavity. Then the pulp chamber must be cleaned and drained with special antibacterial and anti-inflammatory rinsing solutions.

As a rule, the treating dentist will then provisionally close the tooth and allow it to heal for about three to four days. Only after this period can it be assessed whether filling the root cavity is promising and the tooth can be preserved.In a further session the dentist decides whether a root filling can be connected or whether the affected tooth still requires medication. In the course of the root canal filling, the entire pulp cavity is filled with a rubber-like material and the fit of the filling material is then checked with the help of an X-ray.

However, if the toothache does not originate from the tooth substance but rather from the gums, other therapeutic measures must be taken. On the one hand, the cleaning behaviour and the effectiveness of oral hygiene of the patient concerned must be analysed. On the other hand, a so-called professional tooth cleaning should be performed to remove plaque deposits in the area of the gum line. This measure alone, together with the targeted optimization of the patient’s oral hygiene, can help to quickly get gum-related toothache under control.