A toothache is no small matter and it is not easy to “laugh off.” Little Jake is not a whiney child. He is usually pretty stoic for an eight year old—and tough.
“Mommy” has seen him skin both knees and jump right back on his little bicycle, ignoring bruises. That is why it was very unusual for him to complain about anything, much less something as small as a toothache!
Little Jake and the Big Toothache: Mini-Case-Study
Let’s go to the beginning of our Dentistry for Children’s dental story-mini case study. We will learn with Jake’s young mother, what to do when a child has a tooth ache. Let’s Join 7 year-old Jake and his family at supper-time.
Toothache Tragedy: Slippery Liquid Everywhere
It seemed to be an ordinary supper. Then, Little Jake suddenly spilled his nice cold cup of milk. The errant cup of milk doused the table, chair and 10 year-old big sister Lisa. She screamed at Jake, “You did that on purpose! EEE-k! Mom!” shrilled ten year old Lisa, the big sister who was doused with the chilly liquid.
“I’m sorry Mommy, my tooth made me do it!” Jake spluttered. Mommy was a little mystified, but she did not pursue the subject immediately. First she dismissed Lisa to dry off. Then she and her family of four completed their meal. Mommy looked at Jake, “Lisa had on her new outfit, Jake. You know you should have been more careful.”
As he helped her clear the table, Jake said somewhat sulkily, “I didn’t mean to do it, really.”
“Mommy, I got a toothache and my milk was cold. I was shocked! It hurt.” A few minutes later, he squirmed and whined in his chair as she tried to see inside his mouth. “Why don’t you settle down and be a good boy, like you are at Dr. King’s?”
“Cause you might hurt me, Mommy! You’re not a dentist.”
Toothache Tips: Our Do’s and Don’ts For Parents
Actually, on this point, Jake and his mom were both correct. If your child complains of a toothache, you should look in his or her mouth. But, there are a few “don’ts” about children’s toothaches you should also know:
1. You should not rub aspirin or any type of pain killer on the gum. Did you know aspirin is acidic and could burn the delicate gum tissue? Needless to say, this would increase pain rather than delivering relief.
2. Also, you must avoid the Old West pain-killer of rubbing the gum or rinsing the mouth in whiskey or alcohol of any type. It will not really cure an infection in the mouth and it is not a proper local anesthetic.
Upon the promise that they would go to the dentist if necessary, Jake dutifully popped open his mouth. Meanwhile, Mommy noticed there was no fever or swelling in Jake’s jaw.
Mommy knew from her experiences with toothaches, without fever and swelling, this was probably not a serious enough situation to mandate an immediate dental “emergency.” She still made a mental note that she would be checking with Doctor King in the morning.
The fact of the matter is that experts say, “A child’s toothache (absent a fever and facial swelling) is not generally a symptom of an emergency.”
Toothache Technique: How to Examine Your Child’s Mouth for a Toothache Complaint
1. First, encourage your child to tell the story of the toothache and have the child point to exactly the spot that hurts.
Little Jake told his mom, “It’s been hurting…I don’t know…I think a whole week.” She saw real tears on his cheek.
But Mommy knew she had seen him destroy an atomic jawbreaker, probably the hardest candy known to man, only one day previously. She remembered wincing when he chomped it. So, the moral of this part of the story is that we know children are the not the best judges of time. Also, they might be prone to a little hyperbole!
2. Using a tiny flashlight, these are the areas to explore when looking for a target tooth in the toothache complaint:
a. Like Mommy, check the chewing surfaces as well as in between areas of the teeth.
b. See if you can find any brown spots or little tiny holes which would be indicative of tooth decay. Investigate each tooth for chips or cracks.
c. Search the gum area surrounding the teeth and look for any sore places or swelling. According to DearDoctor, “In the absence of a dental injury, a swelling could mean an abscess as a result of a nerve infection caused by tooth decay.”
d. The child might simply think an area near the tooth is the tooth itself giving him pain.
e. Mommy snapped off the flashlight. “Well, Jake I don’t see anything there. “Hey big guy.” She ruffled his hair, “Cheer up, it’ll be gone by the time you’re married.”
f. He sniffed loudly and pitifully. She quickly added, “–And if it’s not better tomorrow, honey, we’ll call Dr. King.”
Toothache: Home Treatments for Pain
Jake was restless. He woke up twice that night. He was being brave, but there were sniffles and a few stifled sobs.
We told you above, what not to do for pain. However, here is a short list of “Do’s” to make your child more comfortable until you can call the dentist’s office in the morning.
1. DO give aspirin or acetaminophen: Giving an aspirin or an aspirin substitute in the proper dose is recommended.
2. DO watch it closely! Remember that any dental pain that awakens a child at night or persists the next day, should be examined by a dentist. This is important. Continued pain might mean there is a problem that will worsen without treatment.
3. DO loss the area! Another “do” that might bring relief, even if you cannot perceive anything odd about the hurting tooth is—believe it or not—assisting your child with a gentle flossing. Help your child to just glide the floss in between the teeth and over the chewing area of the possibly offending tooth.
Why? “This may free a food particle or piece of candy that might be stuck, causing uncomfortable pressure.”
4. DO use Ice Power! Ice is a natural pain killer. Mommy touched it to Jake’s outer jaw just for a couple minutes at a time. She feared there might be an abscess involved because of the pain and resolved to call the dentist first thing in the morning.
Toothache: Other Considerations
Did you know that a bad bump or blow to a tooth might mean the nerve inside the tooth is damaged?
You would not be able to see this. The living pulp, part of the primary tooth, can die. Then infection can occur, even though pain has stopped. That is why you must follow-up with a phone call and an office visit, even if you “cure” a toothache.
You see, dental injuries and cavities in teeth do not spontaneously and magically heal themselves. Cavities, cracks or chips must be treated.
Experts say, “Today’s minor cavity can turn into tomorrow’s painful abscess.”
The experts at Livestong recommend that parents follow up any toothache that persists a day, with an exam from your pediatric or family dentist.
By that morning, Little Jake’s jaw was obviously swollen. Mommy called “Dentistry for Children” here in Orlando. Dr. King was able to work in a special appointment. Upon meticulous examination, he found something stuck deep under the gum. Stuck beneath the gumline and between two teeth was—you guessed it—a sliver of the fateful atomic fireball jaw-breaker. And another wicked, dagger-shaped piece was found lodged in the tissue under a lower jaw tooth. Dr. King said, “Ah, Jake, how could you bite anything named an Atomic Fireball? And why?”
“My best friend, Brad, dared me! But, don’t worry, I’ve learned my lesson! I’ll never bite one again!”