A selection of inexpensive but effective tablets for toothache

Tablets for toothache relief

Review of painkillers

Disadvantages of tablets

Painkillers for pregnant and nursing mothers

What not to do if your tooth suddenly hurts

In most cases, the first thing people do when pain occurs is take pills. This is the most common and accessible way to get rid of unpleasant sensations. Of course, the ideal solution would be to see a doctor, but there are different situations: there is no time, clinics are closed (tooth pain at night), financial situation, etc. We provide a list of the most effective remedies for toothache and we hope that you will use them only as a last resort case.

General anesthesia in dentistry

With general anesthesia, the patient falls asleep for 1-2 hours or more, i.e. for the entire duration of treatment. The drug is administered intravenously, less often by inhalation. If possible, general anesthesia should still be avoided, since its effect on many organs is quite toxic. Even despite the fact that dentistry uses “lighter” drugs than during complex surgical operations. This is a fairly large load on the body, especially on the heart, nervous and cardiovascular systems.

Review of painkillers

Table 1. Painkillers

“Remember that the pill is a temporary way to relieve pain.
The effect of the drug will wear off, and the pain may return because the cause itself has not been eliminated. If after the first “bells” you do not go to the dentist, the disease will continue to progress. Each time the pain will get stronger and stronger" Irina Vinogradova, Dentist-therapist, endodontist, head of the department of therapy and periodontology, member of the medical council of the network of clinics "STOMPRAKTIKA.RF"

Types of anesthesia in dentistry

Anesthesia in dentistry can be general or local. The first includes intravenous sedation, as well as general anesthesia. That is, the drugs do not act locally in the oral cavity, but throughout the entire body. Actually, this is ordinary general anesthesia, which is used everywhere in medicine - it’s just that certain types are used in dentistry. Local, as it is already becoming clear, includes the familiar “freezing”, which is administered by injection.

Separately, we can also distinguish xenon sedation or xenon therapy - the second name will be even more correct, since such anesthesia is used to prepare for local or general anesthesia. It allows you to reduce the level of anxiety and stress, saturates the body's cells with oxygen, due to which it has a general healing and even rejuvenating effect! It is not an independent type of pain relief, but is used in combination with other approaches.

Disadvantages of tablets

Painkillers also have a downside: almost all pills have side effects.

• Negatively affect the functioning of the digestive system. Erosion and ulcers can form on the walls of the stomach, so if there are problems with the gastrointestinal tract, it is better to choose a different method.
• Disturbs liver function.
• They can cause headache, shortness of breath, swelling, skin rashes, etc.

Most analgesics are prohibited for expectant and nursing mothers, young children and people with systemic diseases that are included in the list of contraindications. Therefore, it is recommended to consult a doctor before use.

What is local anesthesia?

Local anesthesia allows you to numb the specific area where the intervention is planned. The patient is conscious. And this is actually more than enough even for complex surgical operations.

For local administration of all types of anesthetics, special reusable syringes are used, which have a recess for inserting a carpule - this is a hermetically sealed ampoule with an anesthetic. Unlike disposable ones, carpule syringes have a thinner needle, which allows you to administer the drug slowly and thus eliminate pain. All syringes for reusable use must undergo antiseptic treatment and sterilization using modern ultrasonic and temperature sterilization equipment.

Sedation and anesthesia - is it safe?

Yes, if they are carried out by professional doctors who have extensive experience and have undergone appropriate training (and a license is also required to perform general anesthesia - this requires an anesthesiologist-resuscitator), then the procedure will be completely safe. In addition, for complex and long-term implantation, the use of sedation is even preferable - you are less tired, you do not need to focus on keeping your mouth open for several hours and fixing your head in a certain position. For you, 3-4 hours of surgery passes in an instant. You will be under the supervision of specialists, and before the operation you will undergo a fairly extensive list of tests for high-quality preparation for treatment and selection of the most suitable, safe drug.

1 Zoryan E.V. Errors and complications when performing local anesthesia in dentistry, 2007.

Treatment of acute pulpitis

Treatment goals:

• stop a pain attack;
• eliminate inflammation and stop the infectious process;
• restore the anatomical shape of the tooth.

When dealing with acute pain, the patient is prescribed painkillers to reduce pain until the dental appointment.

The disease is treated in two main ways - conservative or biological and surgical. In both, therapy is carried out with preliminary anesthesia. The injection is given approximately 30 minutes before the start of treatment. For anesthesia, a solution of lidocaine or trimecaine is most often used.

Conservative method of treating acute pulpitis

The main goal is pulp preservation. The doctor conducts step-by-step treatment:

• gives an injection for pain relief;
• removes necrotic dentin;
• opens the tooth cavity;
• treats with antimicrobial agents;
• lays down medicine;
• puts a filling.

Conservative therapy is carried out mainly in young patients. This method requires mandatory consideration of the presence of diseases of the oral mucosa, as well as the localization of caries.

During treatment, anti-inflammatory drugs are used - Calcidont, Dical. Preparations containing calcium hydroxide are necessary to stimulate dentin formation. Proteolytic enzymes are necessary for tissue regeneration and swelling removal. After placing the medicine, the dentist closes the tooth cavity for several days - from 3 to 5. Next, if there is no reaction of the pulp, a permanent filling is placed.

Operative or surgical method

The doctor carries out the following stages of treatment:

• Provides first aid for acute pain.
• Gives an injection for pain relief.
• Opens the dental cavity.
• Removes pulp.
• Treats the cavity with an antiseptic.
• Puts in medicine.
• Installs a seal.

This method is used to treat acute diffuse pulpitis. If acute focal pulpitis is diagnosed, treatment involves removing the ostial and coronal pulp, while preserving the root pulp.

Surgical treatment is carried out in one or two visits.

For surgical treatment in one visit, the order is as follows:

• The doctor administers anesthesia and removes necrotic tissue.
• Using instruments, the tooth is filled with a non-toxic material.

When undergoing surgical treatment in two rooms, the procedure has a different procedure:

• First, the dentist applies arsenic or a devitalizing paste containing arsenic to the affected area of ​​the tooth. This is necessary to kill the inflamed nerve. The duration of installation of arsenic on a diseased tooth is 24 hours on a single-root tooth, up to 48 hours on a multi-root tooth. Some types of pastes can be left for a long time - up to 7 - 15 days.
• A tampon with an anesthetic is placed in the canal and a temporary filling is placed. The patient is sent home.
• At the second visit to the dentist, the doctor extracts the arsenic or paste, completely removes the pulp and fills the tooth cavity.

The surgical treatment process is always monitored by radiography.

Infiltration anesthesia

Classic “freezing”, which is used in dentistry for almost any manipulation. The drug is injected under the mucosa, into the periosteum or directly into the bone. Depending on the procedure and the patient’s pain threshold, the required dosage is selected - for example, in case of acute pulpitis or complex tooth extraction, a higher concentration of the drug is used. If the patient is afraid of injections, topical anesthesia can additionally be used to numb the site of needle insertion, or xenon sedation.

When performing the procedure, the doctor must take into account the anatomy of the jaw system. For example, in the lower jaw the alveolar bone is denser, so anesthesia is less effective. In the upper jaw, when performing manipulations in the area of ​​wisdom teeth, there is a risk of the needle touching one of the branches of the facial nerve, which is fraught with the development of neuralgia. The clinic’s doctors have the necessary qualifications, so even the most complex anesthesia is performed completely safely for the patient.

Causes

The reasons for the development of pathology may be the following:

• Tooth injury, mechanical or chemical. Violation of the integrity of enamel and dentin makes the pulp extremely vulnerable to the effects of the external environment and pathogenic bacteria.
• Gum diseases. In this case, there is a high risk of infection entering through open periodontal pockets.
• Complications of caries. Uncured caries or its advanced form contribute to the entry of pathogenic microorganisms - streptococci - into the pulp through the dentin tubules.
• Incorrectly performed dental treatment - damage to dental tissue, opening of a tooth performed in violation of technique, burn of dental tissue by arsenic, etc.
• Incomplete removal of carious tissue during treatment. The infection persists in the dental cavity and continues to develop.
• Poor quality filling installation. It is dangerous because there is a gap between the tooth wall and the filling material. Through it, pathogenic microorganisms penetrate into the pulp.

The use of anesthesia for health pathologies

• diabetes mellitus, bronchial asthma, allergic reactions: anesthetics without preservatives and with a minimal amount of epinephrine are used. For these problems, medications are selected strictly individually, most often based on the results of additional tests,
• high blood pressure, heart disease: with minimal or no epinephrine. It is also important that anesthetics do not contain adrenaline. For these pathologies, intravenous or xenon sedation can be used,
• pregnancy and lactation: drugs with a low content of epinephrine - in minimal dosages, the active substance does not cross the placenta and practically does not enter breast milk (only in small quantities, but this does not have any negative effect, so after dental treatment you can not skip feeding and no need to express milk). It is important that the drugs cannot be used without the addition of the vasoconstrictor epinephrine - in this case, the vessels remain open and the active substance will quickly spread throughout the body, which increases the risk of its transmission to the fetus or child through breast milk.

Diagnostics

Diagnosis of pulpitis takes place in several stages. The first is an examination of the oral cavity by a dentist. The patient's complaints about acute pain, the presence of injury or a carious cavity are taken into account. All this points to pulpitis. But it is impossible to determine the acute and chronic forms of the disease by one visual examination.

To determine the stage and type of pathology, the patient is prescribed an examination:

• X-ray.
• EDI or electroodontodiagnosis. This method allows us to identify the reaction of the pulp to the influence of electric current.
• Rheodentography. It is carried out to assess the blood supply to the dental pulp.
• Thermal test.

To make an accurate diagnosis, differential diagnosis of acute pulpitis is important. This is important so as not to confuse it with other diseases that have similar manifestations.