Referred tooth pain can be indication of a deeper problem

To get properly treated, you need to see a dentist or a specialist. PHOTO | SHUTTERSTOCK

Tooth pain seems like a simple thing to identify especially for adults. But health experts reveal sometimes people are unable to identify the actual tooth that is causing problems. This, according to Dr Robert Kamwine is known as referred pain, a neurologic reaction in which pain in one area can be felt in another.
“Ideally doctors should be able to identify the source of the pain and treat it accordingly. But when it is referred pain it is often difficult to diagnose,” he says.

Dr Kamwine notes that in some cases, toothache can be caused by systemic diseases that include diabetes, HIV, oral cancer, hypertension, candida among many.

“The mouth has nerves whose function is meant for the oral system and in case they get affected, the dental system can greatly be disturbed. Conditions such as lung disease can cause toothache due to the location of the vagus nerve. This nerve runs from your brain to the different organs in your body, including the heart and lungs passing through the jaw,” he adds.

Dr Kamwine stressed that most of the time a toothache is simply that a toothache. He, however, encourages people to visit a dentist whenever they have a toothache.
An article by the International Journal of Dentistry 2020 indicates that Dental caries is still a major public health problem in Uganda owing to its high prevalence and incidence in several regions.

It is evident that people have little dental and oral health related information leaving them with few remedies except local herbs and tooth extraction as the last best alternative to the majority.

Referred pain
Annet Nambozo had been battling toothache for the past six months, her worry was the thought of losing her tooth which she feared would be extracted.

When she could not take the pain anymore Nambozo went to a clinic where unfortunately, the doctor ended up removing the wrong tooth. A few days later, she realised she still had pain and went back to the clinic where this time they managed to locate the damaged tooth and extract it.
Dr Kwamine says it is a common incidence especially when the tooth in the upper jaw is very painful which will cause referred pain which might be not the case.

“Referred pain can be examined by either percussion or x-ray by a dentist and cases of mis–identity can occur if the dentist does not take much care when identifying the tooth with cavity,” he adds.

He, however, notes that in some incidences bacteria penetrates and infects the root and spreads to the gums. This condition might be difficult to identify.

“Sometimes it is a case of inflammation in the pulp which is caused by cavity that can present itself as toothache,” says Dr Kamwine.

Not every tooth has to extracted
Dr Kamwine notes that on many occasions, patients complain of dental pain that has a non-dental origin and if they do not seek proper diagnosis to establish the cause of pain, they end up putting their lives in danger.

“When a patient visits a clinic complaining of dental pain they should seek for diagnosis from a qualified personnel to make an informed decision other than focusing on extracting the tooth,” he says.

He notes that besides visual diagnosis, radiography can be a better diagnosis for organic or functional abnormalities.

Reason behind your toothache
Clinician Hadijah Lule explains that much as tooth decay is the most common reason for toothaches; there are other uncommon driving conditions that can cause toothache.

“Untreated tooth decay is the most common that when unattended to; an abscess can develop which culminates in toothache,” she explains.

She however, notes that toothache can also be caused by an impacted tooth usually when a wisdom tooth is stuck in the gum tissue or bone. She adds that some cases might be due to sinusitis when there is an infection in a sinus cavity.

How to prevent toothaches
To help prevent toothaches, brush and floss at least twice a day and get dental checkups and cleanings twice a year, or as often as recommended by your dentist. Dr Kamwine notes that proper brushing, limitations to sugary and acidic drinks, protecting teeth from injury among other solutions prescribed by experts can be good but all should be supplemented by visiting the dentist regularly.

State of the sector
In March, 2020, the dentistry body Uganda Dental Association (UDA) requested government to set aside funds to equip dental facilities in public health institutions to ensure better service delivery.

The ratio of Doctor to patients in Uganda stands at 1:142,000 contrary to 1:7,000 a ratio that is prescribed by World Health organization (WHO).
According to Uganda Dental Association, Uganda has a total of 27 dental specialists and half of them work abroad.

Why your teeth hurt and what to do about it
Pain is a protective response from your body. Whether it is minor or severe; the sensory trigger is there to let you know something is wrong; something that comes from the inside out. Dental pain is no exception to this rule. It is a form of reactive nerve pain that emanates from inside your teeth when they are exposed to certain stimuli.

The answer depends on the stimuli. What stimuli? For every symptom, there is a cause. Here are common causes and what to do about them:

Sensitivity to temperature
The dental pain is momentary, but it usually signals a minor problem within the tooth itself. It could be:
. A small area of tooth decay
. A loose filling
. An exposed root due to abrasion or gum recession

What to do about it: The best thing to do is to keep your teeth and gum line clear of bacterial plaque. Do this by gently brushing with a soft-bristled toothbrush, no more than twice a day. A toothpaste containing fluoride works well for sensitive teeth.

You can use the toothpaste as an ointment by rubbing it on your teeth for about 10 minutes, as needed.

Sensitivity after dental treatment
Dental work can also cause dental pain. How? Depending on the problem, fixing it may cause inflammation inside the tooth.

What to do about it: The good news is the pain you are feeling only lasts a few days to a few weeks. Decay removal and crown work may take a week or two to settle. In the meantime, you can take over-the-counter pain relievers to manage your discomfort.

Sharp pain when chewing
This might be due to decay, loose filling or cracked tooth.
What to do about it: While a loose filling can be replaced by a dentist, the other causes of dental pain when chewing will need to be addressed by a specialist. They can remove decay, protect the root canal, and seal any spaces or cracks within the tooth.

Lingering pain after eating
Pay very close attention to this symptom, it could mean that your tooth is infected. If tooth decay or damage is left untreated, your tooth can die from the inside out.
What to do about it: This needs to be prevented before the pain becomes too severe. A root canal can remove the dead and dying pulp; saving the tooth. (Source: