FIRST AID
Over-the-counter products containing lidocaine or benzocaine, such as Anbesol, Orajel, and Campho-Phenique, can be used topically to provide temporary relief for toothache. Over-the-counter pain relievers such as Tylenol are also helpful. Do not rub aspirin or other analgesics on the gums. These contain strong acids and may burn the gum tissues. A small piece of cotton saturated with clove oil and placed on the tooth will give temporary relief. Avoid sweets and hot and cold foods.
Over-the-counter products can be used to plug a cavity until you see the dentist. Or you can make your own temporary filling by mixing 1 tablespoon of powdered goldenseal with 1/2 teaspoon of warm water until a smooth paste is formed; add 1 drop of clove oil and mix till smooth. Place the mixture in the hole with a rounded toothpick or the wooden end of a cotton-tipped swab.
Use a chamomile poultice or drink hot hops tea for relief of pain. Take Arnica 30X for a toothache that is worse at night. Use Plantago major tincture for a toothache that is sensitive to the touch and worsens in the presence of cold.
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CAVITIES (DENTAL CARIES)
A cavity or tooth decay is a bacterial disease that affects all the structures or layers of the tooth. Tooth decay is very much influenced by lifestyle-specifically one's family and social environment. In Western society, cavities are the most common human disorder.
When the environment in the mouth becomes too acidic, calcium and phosphate ions are lost from the enamel crystals that constitute the surface layer of the tooth. If the acidity level remains, bacteria, especially Streptococcus mutans, and other organisms produce toxins from ingested sugars. These toxins form a sticky mass that allows food debris and bacteria (plaque) to stick to the tooth surface. The plaque acts as a direct application of acid to the teeth, further demineralizing the enamel and leading to cavities. The chances for cavity formation increase with increasing consumption of carbohydrates. Similarly, the more refined the carbohydrates in your diet, the greater the chances for cavity formation.
If the loss of minerals continues, the tooth surface begins to disintegrate and the cavity becomes deeper. If the loss of minerals ceases and new minerals are deposited, then the cavity stops growing and somewhat reverses. However, this reversal occurs only at the surface layer or enamel of the tooth. Once the bacteria have reached the dentin, or inner layer, the cavity usually continues to grow.
Cavities are more prone to develop in pits on top of the back teeth, in between the teeth, and near the gum area where the bristles of a toothbrush cannot reach. Soft root surfaces, exposed when gums have receded, develop cavities that spread to other surfaces of the tooth.
The rate at which a cavity progresses depends on the bacteria involved and the
body's resistance to disease. This is true for disease in any part of the body, but resistance to dental disease also depends on heredity, diet, hygiene, fluoride content of teeth, and general dental health.
The first sign of a cavity is a white spot. Depending on the factors listed above, it will stay like this or progress to a brown color.
Conventional Treatment
The dentist uses a tool called an explorer (see Figure 3.6 on page 174) and x-rays to determine the extent and depth of the cavity. Usually, if the spot is in the tooth's enamel, no treatment is needed. If the spot has extended into dentin, which will be evident on the x-ray, treatment is required. Treatment depends on the size and depth of the cavity. A small cavity can be filled. Filling materials can be amalgam, composite resins, porcelain, or gold. (For detailed information on treatment for cavities, see Filling a Cavity in Part Three.)