What has to be done for hole in tooth with pain and swelling?

Question

Hello doctor,

My mother is 45 years old. She got a hole in her teeth, and she has been complaining of a toothache for three days, and since yesterday, she has developed swelling on the right half of her face.

Is this any sort of emergency?

Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand the concern.

After going through your query and image sent by you (attachment removed to protect patient identity), this seems to be a case of severe infection inside the right tooth. Tooth decay has resulted in infection in the innermost part of the tooth called the pulp that contains nerves and blood vessels.

Deep dental caries is the probable cause of the condition; therefore, an intraoral periapical radiograph (X-ray) should be taken for proper evaluation.

Based on the clinical findings, the differential diagnosis may include an acute periapical abscess or a buccal space infection, while the most probable diagnosis is an acute exacerbation of a chronic periapical absces.

After analyzing the X-ray, the treatment plan can be decided. Initially, to reduce pain and swelling, antibiotics and anti-inflammatory drugs can be given for 3 to 5 days. If the infection beneath the root is not excessive, root canal treatment can be performed. However, if there is excessive pus and infection, pus drainage followed by extraction should be done, although immediate extraction is not advisable.

To prevent worsening of the condition, hot fomentation should not be done, the face should not be covered, massage should be avoided, and biting from the affected side should also be avoided.

I hope this helps you.

Take care.