Toothache Recommend Encourage morning and night brushing with a fluoride toothpaste to prevent tooth decay



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Toothache

Recommend

  • Encourage morning and night brushing with a fluoride toothpaste to prevent tooth decay

  1. May present with:


  • Dental pain, teeth / tooth sensitive to hot/cold

  • Halitosis (bad breath), cavity (hole) in tooth




  1. Immediate management: not applicable




  1. Clinical assessment:

  • Obtain patient history including dental history

  • Perform standard clinical observations

  • Perform physical examination

  • inspect oral cavity, teeth, soft tissues, lymph nodes, ears



  1. Management:


  • Topical oil of cloves (Eugenol) is sometimes effective for toothache

  • Give Analgesia: oral Paracetamol/Codeine, for children < 12 years of age give Paracetamol only (for adults allergic to codeine give Paracetamol)

See Simple Analgesia Protocol (back cover)




    • Chlorhexidine mouthwash (0.2%): [4]

Rinse mouth with 10 mL for 1 minute 8-12 hourly for 5-10 days

Note – with prolonged use (more than a few days), Chlorhexidine may cause superficial discolouration of the teeth and filings. This can be easily removed by a Dentist



  • Or Normal Saline mouthwashes at least 4 times daily

  • If severe treat as for Tooth abscess




  1. Follow up:

Provide education regarding

    • Tooth brushing and interdental cleaning, dental scaling

    • Oral hygiene, smoking cessation, no soft drinks or sweets

If high caries rate (cavities, obvious or darkened and discoloured teeth)

Adults and children over 9 years of age; encourage morning and night brushing with a fluoride toothpaste and encourage once per week brushing with high fluoride toothpaste (5000 ppm F – adult toothpaste)



Children under 9 years of age; enquire about frequency of sweet drinks and in particular if given in a bottle, encourage parent supervised morning and night brushing with a fluoride toothpaste

  • See next Dentist / Dental Therapist / School Dental Service clinic




  1. Referral / Consultation:

    • See Dentist / Dental Therapist / School Dental Service as soon as possible



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