Why does my toothache last for a month and still hurt?

The word "foodie" has become popular in recent years. Many people like to label themselves as foodies. Not only that, many people who call themselves foodies are thin. The thinner you are, the more you say you eat. As the old saying goes, being able to eat is a blessing, and being able to eat also increases your sense of happiness. But not everyone has the opportunity to eat a variety of foods. People with toothache are not like this. If the toothache persists, they cannot eat delicious food. What is the reason for toothache lasting for a month?

Toothache refers to the pain in the teeth caused by various reasons. It is one of the common symptoms of oral diseases and can be seen in Western medicine such as caries, pulpitis, periapical inflammation and dentin hypersensitivity. Toothache occurs or worsens when exposed to cold, hot, sour, sweet and other stimuli, which falls into the category of "toothache" and "alveolar wind" in traditional Chinese medicine. The hand and foot yangming meridians are respectively connected to the lower and upper teeth. Heat accumulates in the large intestine and stomach, or wind evil invades the meridians from the outside, accumulates in the yangming and turns into fire, and the fire evil goes up along the meridians and causes toothache. The kidneys control bones, and teeth are the remains of bones. Deficiency of kidney yin and ascending of virtual fire can also cause toothache. There are also people who eat too much sweet and sour food, have unclean mouth and teeth, and let dirt corrode their teeth and cause pain. Therefore, toothache is mainly related to the hand and foot yangming meridians and the kidney meridian.

Toothaches are mostly caused by infection of the dental pulp (dental nerve) due to gingivitis and periodontitis, caries (cavities) or fractured teeth. It is caused by not paying attention to oral hygiene, long-term stimulation of the teeth by soft plaque and hard tartar formed by food residues and bacteria around the teeth, incorrect brushing habits, vitamin deficiency and other reasons.

Clinical manifestations

Toothache is one of the common symptoms of various dental diseases and periodontal diseases. Its characteristics are mainly toothache, swollen gums, difficulty chewing, thirst and bad breath, or intermittent pain, pain when exposed to cold or hot stimuli, swelling of the cheeks, etc.

The gums are bright red or purple, swollen, and soft. Sometimes there is erosion at the gingival margin or proliferative eversion of granulation tissue. The gums are prone to bleeding when brushing teeth or eating, but there is generally no spontaneous bleeding. Patients have no obvious subjective symptoms, but may sometimes feel itchy or swollen.

examine

1. Visual examination

Check whether the upper and lower teeth on the painful side mentioned by the patient have caries. Special attention should be paid to checking the adjacent necks of the teeth, the inlaid and overlapping parts of the teeth and all hidden parts, the abutments of dentures, the tooth tissues at the edges of poor restorations, and the teeth wearing full crowns and whose crown surfaces have been worn through.

2. Percussion

Discomfort or pain with vertical and lateral percussion.

3. Bite diagnosis

Check whether there is premature contact of the jaw in the median, protrusive and lateral directions, and whether there is discomfort or pain in biting the jaw.

4. Pulp vitality test

Check for any abnormalities (including temperature test or electrical activity test).

5. Palpation

Check whether the suspected patient has pain or swelling at the root apex, tenderness in the maxillary sinus and temporomandibular joint area, and pain in the submandibular lymph nodes.