What is the treatment for persistent tooth and gum pain?

Question

Hello doctor,

I have tooth and gum ache (not sure from where it comes) but the pain is in the lower right jaw. On day one, I had continuous pain and took Naproxen. After taking the tablet, I was able to have coffee and tea. On day two, the pain was still there so, I contacted a physician on icliniq who suggested Ultracet for three days. On day three, I took Ultracet twice a day, and there was intermittent pain (continuous pain was gone). On day four, I took Ultracet twice a day, and again there was intermittent pain (I was not able to drink hot coffee).

If I drink coffee, the pain comes immediately and after gargling with water it goes away. On day five, today I had breakfast and had one Ultracet tablet. The pain was there for some time after having breakfast but now it is fine. But I am scared of taking any hot coffee or tea. I have stopped drinking it completely. I used Sensodyne paste but stopped it now. I brushed my teeth with salt for two days and I have stopped doing that also. Now, for the past two days, I have been using another toothpaste. Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I am here to answer your queries.

I have gone through your query and attachment (attachment removed to protect the patient's identity). I can see some gingival inflammation and also abrasion of teeth near the cervical area. That abrasion is also a cause for severe sensitivity to hot foods or drinks that you are having. Abrasion needs to be treated clinically with restoration. Once the pandemic of Covid-19 subsides, then you can get it treated in a dental clinic.

For the time being use Sensoform KF (Strontium chloride 10% W/W) toothpaste. First, apply it on your teeth, then keep it for 30 to 40 seconds then brush it as you do daily. This is the way to use sensitivity toothpaste. Use mouthwash for gargling at least at night before going to bed after tooth brushing.

For pain, if severe, you can take Ultracet P (Tramadol and Acetaminophen). If the pain is not severe, then you can continue with Ultracet (Tramadol and Acetaminophen) when needed. It will be better if you upload images of your teeth from the occlusal surface so that I can see if any caries or gingival infection is present.

I hope this helps.

Thank you.