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module menu icon Dental pain consultations

DENTAL PAIN CONSULTATIONS

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IN PRACTICE

  • W

    Miss Jacobs is in her mid-20s

  • W

    She has toothache around her left molars at the top of her mouth

  • H

    The pain came on suddenly last night

  • A

    She took a couple of paracetamol first thing this morning (more than 4 hours ago) and some ibuprofen about an hour ago, but they haven't helped much.

  • M

    She is taking the oral contraceptive pill

Read each of the following 'What if...' questions then select the correct response.

She says that the pain is worse when lying down, the area feels a bit swollen and it affected her sleep last night.

a. It could be an abscess, she should see a dentist as soon as possible

It sounds like the customer has an abscess. A dental abscess is a collection of pus that can form inside the teeth, in the gums or in the bone that holds the teeth in place. It is caused by a bacterial infection.

Signs of an abscess include: intense pain; pain that can spread to the jaw/neck on the side of the abscess; the pain can be worse when lying down, which then affects sleep; redness and swelling of the face; the tooth may be discoloured, loose or tender. The gums may be sore, shiny, inflamed and red. As with tooth decay, there may also be sensitivity, halitosis or a bad taste in the mouth.14

b. It could be tooth decay and she should see a dentist

The symptoms of tooth decay are: toothache (continuous or occasional); tooth sensitivity; halitosis; an unpleasant taste in the mouth; and brown, grey or black spots on the teeth. As there is swelling, this is more likely to be an abscess.15

Try again

She says she wants a product that works quickly, but not something she needs to apply as she can't bear to touch the sore gums. She also says that it's the worst toothache she's experienced and she can only eat soft food. What pain relief from the list below would you choose?

a. Paracetamol and codeine soluble tablets

Soluble tablets can get to work faster than paracetamol alone,* and the combination product is suitable as she has tried paracetamol and ibuprofen alone and they haven't helped.

*based on absorption data

b. A soothing gel for her gums

In this case, the customer does not want a topical gel, but it can be used as well as oral pain relief.

Try again

c. Soluble paracetamol tablets

As she tried paracetamol this morning, a combination product may be more appropriate.5

Try again

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