Healthy Smile: “I Don’t Think It’s My Tooth”

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

The beginning of that statement discussed discomfort in the lower-left area of this patient’s mouth. The pain came from this area, but it didn’t feel like a toothache. Often, the body in general and the mouth, in particular, will fool us. We feel something in one area, and in reality, it is coming from a different part of the body. The head and neck area have so many nerves present that it is easy to think that one area is a problem. We later find out that we were incorrect in the source of the issue once we seek medical help. One goal of a healthcare provider is to sort through all the information and tests and find the cause of the problem. In short, we diagnose a patient and recommend treatment to help that person.

The diagnostic component is crucial to effective and proper treatment. In dentistry, we are doers. Many people do not give enough importance to the job we do as diagnosticians. Our brains work overtime to develop the correct diagnosis. Those patients that have dental insurance know that the insurance company assigns a minimal amount of reimbursement for exams and diagnosis. This critical component of treatment is not given the importance that it is due.

My patient had a radiating toothache. It spread from his tooth up into his jaw, and the gum felt sore. All of these complaints throw up a red flag. A tooth, like the one just described, often ends up requiring removal or possibly it needs a root canal treatment. The comments made by the patient are called “symptoms.” I ask the patient to describe why they came into the office and what do they expect me to do. The answer to these and other questions give me the patient’s symptoms. I then observe and look at the patient and area of concern. I may take a photograph or possibly an x-ray. All of the observations that I make we call “signs.”

I sort through the signs and symptoms and come to a diagnostic conclusion. Often, I see the signs and symptoms that conflict with each other. More questions and investigation lead me to the correct diagnosis. Our patient in question had a toothache, but didn’t have a toothache. I listened carefully and then did an exam in the mouth.

The source of the pain was a lot of food packed into the gum area. The spot was swollen and irritated as a result of the food collecting in this area and not moving out. I found a lot of food jammed under the gum. The accumulation of food like this is unusual. There were no other areas of his mouth that looked like this. I looked a little closer and found a tooth-colored filling on the tooth. The back of the filling showed a small fracture. This location of the break was right next to the tooth behind it. Whenever he chewed, food was forced into this space and would not leave. It just sat there.

Teeth are meant to touch their neighbor. Small spaces between the teeth are a source of problem. In dentistry, we call this “contact.” Every tooth has to contact and touch the tooth on either side. The lack of this touching leads to severe problems and infection. Once I fix the break, the gum problem goes away. The treatment for that is quite simple.

Figuring out your source of a dental problem can be quite a challenge. Professional care is essential in correcting issues and restoring health. If this sounds like you, then please call us at 440.892.1810, and set aside some time for us to meet. I look forward to our visit.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 •

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