HomeAnswersDentistryapical periodontitisI have toothache while biting. Why?

What can be done for toothache while biting?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Divya Banu M

Published At July 19, 2020
Reviewed AtDecember 19, 2023

Patient's Query

Hello doctor,

I have horrible pain in my tooth and gum. If I bite down, pain shoots and my face is swollen a bit.

Hello,

Welcome to icliniq.com.

Kindly uoload an inage of the tooth to me if possible.

As a specialist, I am here to help you.

Pain upon biting means the infection from the infected pulp has reached to the root apex and got collected locally. It is known as apical periodontitis. You need Root Canal or extraction but kindly do not delay as it might progress to further infection. I am prescribing you medications for the same.

- Capsule Sporidex 500 mg (Cephalaxin 500 mg) 1 Capsule BD x 5 days

- Tab Zerodol SP (Aceclofenac+Paracetamol+Serratiopeptidase) 1 tablet BD x 5 days

- Capsule Pan D (Pantoprazole+Domperidone) 1 Capsule BD before meal x 5 days

- Betadine mouthwash, gargle in lukewarm water 2-3 times a day. (Povidone Iodine)

- Avoid sticky or sweet food as much possible.

-Brush twise daily, rinse everytime you eat.

The Probable causes

Caries with pulpal involvement.

Investigations to be done

Kindly upload a clear image to me as soon as possible. I will be waiting.

Probable diagnosis

Apical periodontitis.

Treatment plan

Root canal or extraction.

Preventive measures

Avoid sticky or sweet food as much possible.

Regarding follow up

Patient's Query

Thank ou doctor,

I will send you a picture of it.

Hi,

Welcome back to icliniq.com.

Kindly try not to use the flash as it brighten the image too much. I will assist you immidiately.

Patient's Query

Thank you doctor,

I have attached the image.

Hi,

Welcome back to icliniq.com.

As per the image (attachment removed to protect patient identity), the caries seems to be located in lower left second molar. It is an Apical Periodontitis. It needs a Root Canal. The tooth looked fine otherwise. Try to have it as soon as convenient. If the abscess increases, extraction will only be our only option left. So do not delay. You will be fine nothing to worry. Start the medications, I have already mentioned the generic names, it will be easy to get them. It will buy you enough time.

It is not so important but if you want you can upload an image showing the occlusal surface of the tooth (chewable surface of the tooth). It is not important but it will help to know whether lower left 1st molar is healthy. Medications I wrote are the safest and most effective. I would recomment start those medicines and follow the instruction as soon as possible. You will be relieved soon.

The Probable causes

Caries

Probable diagnosis

Apical Periodontitis

Treatment plan

Preventive measures

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Mousam Chattopadhyay
Dr. Mousam Chattopadhyay

Dentistry

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