When most people think of a dental emergency, they picture a severe toothache, facial swelling, or a broken tooth. Unfortunately, some dental problems that need prompt attention can cause very little or no pain.
One example is a tooth with an infection. A cavity can start in the outer layers of a tooth and eventually reach the nerve inside. Sometimes this causes a significant toothache, but other times the nerve slowly dies without causing much pain. An infection can then develop around the root of the tooth. A patient may feel completely fine even though an infection is visible on an x-ray. If left untreated, that infection can spread to other teeth, other parts of the body including the brain and in some cases be life threatening.
A broken tooth is another problem that may not hurt initially. Teeth with large fillings or cracks can sometimes break without exposing the nerve. Even if the tooth is comfortable, the remaining tooth structure may be weakened. Continuing to chew on it can cause the tooth to break further and occasionally turn a tooth that could have been repaired into one that needs to be removed.
Swelling or a “pimple” on the gum should also be evaluated even when it is painless. This can sometimes be a small drainage pathway from an infection around a tooth. Because the infection is able to drain, there may actually be very little pressure or pain. The lack of pain does not mean the infection has gone away.
Dental problems are not just limited to the teeth. Lumps, sores, red or white patches, or other changes in the mouth that do not heal should be evaluated. It rare cases they can develop into oral cancer.
Of course, not every chipped tooth or unusual spot in the mouth is an emergency. The important thing to remember is that pain should not be the only reason to call your dentist. If something is broken, swollen, draining, changing, or simply does not look or feel normal, it is worth having it evaluated.
In dentistry, problems are almost always easier to manage when they are found earlier. Waiting until something hurts can sometimes mean waiting until a much simpler problem has become a much bigger one.
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