Bite pain

Introduction Biting pain is more common in root pain. Toothache is one of the problems often encountered in daily life. Almost all oral diseases are manifested in the situation of toothache. However, there are many causes of toothache. There are local factors such as: when it is cold, hot, sour or sweet, it feels toothache, caries, etc., systemic diseases such as hypertensive patients with pulp congestion, diabetic patients with vascular vascular ignitation , necrosis, etc. Therefore, when a toothache occurs, it is first necessary to find out the cause, in order to solve the problem, to alleviate and eliminate the suffering of the patient, and to treat the dental disease.

Cause

The cause of biting:

There are many causes of biting, there are local factors, as well as systemic diseases.

If the pain is stimulating, that is, when it encounters cold, heat, acid, and sweetness, it will feel toothache. After the stimulation is eliminated, the toothache will also disappear. The condition is mostly dental caries, which is what we call the tooth. If the pain is spontaneous, it also occurs when there is no external stimulus (such as cold, heat, acid, etc.). When the pain is paroxysmal and intense, it is mostly acute pulpitis. When the pain turns into persistence, and the use of cold water to contain sputum can reduce the pain, this indicates that the disease has turned into suppurative pulpitis. If it is acute periodontitis, it is characterized by severe toothache. Sustained pain, teeth can not chew, self-feeling painful teeth grow more than other teeth, there is a feeling of floating teeth. There are gingival covered parts on the tooth surface and redness and persistent pain caused by food impaction. It is acute wisdom tooth pericoronitis.

In addition to the above-mentioned diseases of the oral cavity, patients with systemic diseases can also present as toothaches, such as hypertensive patients with pulp congestion, diabetic patients with pulp vascular igniting, necrosis, etc., and sometimes acute myocardial infarction, angina patients Typical performance also has toothache.

an examination

Related inspection

General photo inspection

Check and diagnose the bite:

(1) Visual inspection and probing:

1. The presence or absence of damage to the upper and lower jaw teeth of the pain side should be carefully examined for concealed parts of the teeth, such as the adjacent neck, the overlap with or adjacent to the adjacent teeth, the denture base, the teeth at the edge of the defective prosthesis, and the crown. Broken teeth.

2. Whether the tooth has a filling, whether the edge of the filling is in close contact with the tooth, and whether the upper and lower teeth of the bite contact have different metal fillings or restorations.

3. Tooth defect with or without neck wedge-shaped defect (wedge-shapeddefect), severe attrition, crackedtooth, abnormal central cusp, dens invaginatus, teeth Fold (tooth fracture).

4. Periodontal condition with periodontal pocket (Periodontal Pocket), whether there is redness or necrosis of the gingival nipple, whether there is red or swollen facial surface of the periodontal, lip or cheek in the mouth, swelling of the upper jaw, whether the mouth opening is normal, whether there is any Infected tooth extraction wounds.

(2) Percussion:

Appropriate discomfort or pain when slamming your teeth vertically and laterally.

(3) bite diagnosis:

When the median and lateral occlusions are combined, there is no early contact or occlusal pain.

(4) Endodontic temperature test:

The pulp temperature test is a test of the pulp feel. It is cold stimulation below 10 °C, thermal stimulation above 60 °C, and sensitive to cold and heat stimulation when the pulp has lesions, but sometimes false positive reactions may occur, so it can only be used as a reference for diagnosis.

(5) Percussion:

Whether there is tenderness or swelling in the apical part of the suspected tooth; whether there is squeaking and tenderness in the temporomandibular joint area; whether there is tenderness in the anterior wall of the maxillary sinus; whether the submandibular lymph node is swollen and there is tenderness.

(6) Anesthesia test method:

When acute pulpitis cannot determine the location of the painful part, local anesthesia can be performed at the onset of pain. For example, the pain stops after anesthesia, indicating that the source of pain is in the anesthesia area, and vice versa that the source of pain is not in the anesthesia area.

(7) Imaging examination:

It helps to find the hole in the hidden part, the distance between the filling and the medullary cavity, and the density-reducing area between the filling and the wall; whether there is medlar, absorption in the tooth, absorption outside the root, fracture of the root, root branching There were no lesions in the periapical and alveolar bone tissues, whether there were teeth and ambushed teeth pressing the roots; whether there were any mass in the maxillary sinus and jaw; and whether the temporomandibular joint was abnormal.

(8) Other inspections:

After excluding the toothache caused by the pathogenic and oral lesions, if necessary, please consult the relevant department for further examination according to the medical history to determine whether the toothache is related to systemic diseases such as heart, blood or spirit.

Differential diagnosis

Identification of symptoms that are easily confused by bite:

Gum pain: Gingivitis is caused by bacterial invasion, which is characterized by bleeding gums, redness, pain, and continued development of invasion of hard tissues, resulting in periodontal inflammation.

The teeth are hot and cold: the cause of cold and hot teeth is mainly due to the problem of stimulating the pulp. There are nerves in the pulp. Usually, under the protection of the dentin and enamel of the teeth, there will be no hot and cold irritations, when the enamel is enamel. After being damaged or the roots are atrophied, the unprotected teeth will be painful due to various hot and cold stimuli.

Pain in the teeth: Pericoronitis is a complication caused by the inconsistent position of the molars, mainly due to the pain of soft tissue around the crown. The third molar of the mandible (commonly known as wisdom tooth) is more common in clinical practice. Secondly, the maxillary third molar can also occur. The disease mostly occurs between the ages of 18 and 30.

Upper toothache: Patients with odontogenic maxillary sinusitis often have toothache due to maxillary sinusitis. Odontogenic maxillary sinusitis is a chronic maxillary sinusitis caused by diseased teeth. It is called odontogenic maxillary sinusitis. The cause is relatively simple. Not all teeth can cause this disease, but limited to those with close relationship with maxillary sinus. The teeth are the first premolar second premolar and the first molar in the upper dentition, that is, the fourth, fifth and sixth teeth from the incisors. Usually, the first inflammation of the teeth, such as acute periarthritis, periodontitis, alveolar abscess, etc., infects the bottom of the maxillary sinus, further expanding into maxillary sinusitis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.