Homoeopathic remedies in the management of toothache

Dr Pavan Kumar V

ABSTRACT
Poor oral hygiene can damage the tissues in the oral cavity, leading to long term problems. In daily practice, toothaches are relatively common occurrence; the cause and severity of the problem determine the appropriate treatment. Toothaches are hard to ignore. It will affect day to day life activities because of pain. The dental profession places a high value on tooth pain management and treatment. If the source of the pain is not identified and /or improper dental treatments results in tooth extraction. The homoeopathic approach to toothache will provide significant pain relief. Homoeopathic remedies can effectively treat toothaches.

KEYWORDS: Toothache, Toothache causes and symptoms, homoeopathy, homoeopathic remedies

INTRODUCTION
Pain in or around a tooth, along with unpleasant emotional and sensory experience associated with mild pain and possible or actual tissue injury.

EPIDEMIOLOGY

• According to the WHO Global Oral Health Status Report (2022), oral diseases impact about 3.5 billion people globally, with middle-income nations accounting for three out of four cases.
• An estimated 514 million children worldwide suffer from primary tooth caries, while 2 billion adults worldwide suffer from permanent tooth caries.
• Australia had the lowest pooled prevalence (20.7%), while studies from Africa had the highest (50.1%).
• Research from China (41.3%), Iran (42.6%), and India (40.4%) revealed high pooled prevalence estimates of tooth discomfort.

CAUSES OF TOOTHACHES: It is divided into three categories.

1. Dental causes
2. Non – dental causes

• Atypical odontalgia (atypical facial pain)

Dental causes:-

• Dental caries: the most common cause of toothache, cavities occur when the enamel of tooth is eroding by bacteria, causing pain due to exposed nerves.
• Gum disease (Periodontal disease): inflammation of gums, often caused by plaque accumulation, can result in toothache, especially when the infection reaches the tooth’s root.
• Tooth abscess: a localized infection at the root or between the gum and tooth can led to severe throbbing pain and swelling.
• Tooth sensitivity: some people experience sharp pain when consuming hot, cold, or sweet substances due to thinning tooth enamel or gum recession.
• Trauma or injury: physical damage to the tooth from a fall or impact can result in acute pain.
• Impacted wisdom teeth- it is very painful condition, when wisdom tooth becomes stuck below the surface of gums and grows at an odd angle.

Non dental causes: these are less common.

1. Myofascial pain.
2. Angina pectoris
3. Acute and chronic sinusitis
4. Temporomandibular disorder
5. Trigeminal neuralgia

Atypical odontalgia:  toothache without a known dental or medical aetiology is characterized by odd symptoms, such as pain that moves from one tooth to another.

PATHO- PHYSIOLOGY
A tooth’s structure consists of an interior soft tissue core called the pulp system, which contain blood vessels and nerves, and an outer shell of calcified hard tissues called enamel, dentin, and cementum, which are the hardest to softest.  The cementum covered roots of the teeth anchor the crowns, which are the visible portions of the teeth in the mouth, into the bones. The dentin makes up the majority of the tooth and envelops the pulpal system underneath the cementum and enamel layers. Coronal pulp and radicular pulp are terms used to describe portions of the pulp found in the crown and root, respectively. Teeth roots have one or more apical foramens at the root end. The gingva covers the alveolar processes, which are the jaw’s tooth bearing arches.

In the early stages, enamel involvement by dental caries or other irritants is usually painless. As it approaches dentinal tissue, the tooth will become symptomatic. Dentin is made of many microtubules knowns dentine tubules, which contain dentinal fluid, nerve fibbers, and cytoplasmic extensions of odontblasts, dentin forming cells that live in the pulp.

Dental pain is induced by nerve activation within the dentinal tubules and pulp tissue. Nerves are triggered by either exogenous (bacterial toxins, metabolic by-products, chemicals, or trauma) or endogenous (inflammatory mediators). Tooth pain also results from.

SIGN AND SYMPTOMS OF TOOTHACHE-

• A dull ache that doesn’t go away.
• Sharp, stabbing, throbbing tooth pain
• Tooth sensitivity.
• Swelling in gums.
• Discharges or bleeding gums.
• Additional symptoms may include Headaches, neck pain, Fever, Chills, bad taste or odour in the mouth.

PREVENTION OF TOOTHACHE –

• Brush your teeth two to three times a day using fluoride toothpaste and a soft-bristled tooth brush.
• Twice daily, wash your mouth with an antibacterial mouthwash.
• Reduce amount of sugary foods and beverages you consume.
• Regular visit to dentists for dental check-ups.

DIAGNOSIS OF TOOTHACHE –

• A complete medical history and oral examination typically result in a diagnosis that is appropriate.
• Panorex images and periapical x-rays are obtained.
• A magnetic resonance imaging exam or computed tomography scans, if necessary.
• Cold stimuli test can be used to assess if a tooth has pulpitis or vital, however lab evaluations are rarely performed.

PROGNOSIS OF TOOTHACHE-
The prognosis for a toothache is often favourable. With today’s advanced dental technology, doctors are able to detect issues fast and provide efficient treatment. In order to prevent more harm or the possibility of infection spreading, the best results are obtained when toothaches are treated as soon as feasible. Untreated toothaches can lead to a serious infection that spreads to the jawbone or sinuses and ultimately worsens the condition.

MANAGEMENT

It is mainly depend on the origin of pain and how much damage is present such as,

• Restorative (fillings, crowns, bridges)
• Prosthetic (dentures)
• Endodontic (root canal ) therapy
• Periodontal (gum) therapy
• Extraction of teeth
• It also includes antibiotics, sedatives, and any other drugs used in patient management.

HOMOEOPATHIC MANAGEMENT OF TOOTHACHE:

Homoeopathy is based on the principle of “like cures like.” this means that a substance causes symptoms in a healthy person can, in a much diluted form, help treat similar symptoms in a sick person.

Homoeopathy offers numerous applications within the field of dentistry. The recommended homoeopathic treatment can provide substantial relief from dental discomfort caused by micro fractures, abscesses, cavities, and neuralgia. It is frequently used to reduce inflammation, bleeding, and related pain. Depending upon the signs and symptoms, homoeopathic medications are prescribed in low, medium, or high potencies. The stage and pathology of the dental problem, such as whether it is acute or chronic, also determines potency.

The list of homoeopathic remedies for toothache and dental problems is as follows:

1. Aconite napellus: Teeth sensitive to cold. Constantly moves lower as if chewing. Gums hot and inflamed. Patient almost frantic with pain ; throbbing pain from taking cold, with determination of blood to head, stitching jerks or shocks, heat in face, red cheeks, great restlessness.
2. Aranea diadema: Toothache relieve by smoking tobacco; worse by humidity, at night, and after lying down ; pinching pressing pain in the upper incisors, regularly from 9 A.M TO 7P.M.,leaving a sensitiveness and cold feeling on drawing in air; sensation as if gums and cheeks were swollen ; constant chilliness, and worse on rainy days.
3. Arnica: After extraction of a tooth it will stop the bleeding and hasten healing of gums; ulcers, pain and swelling after operations on teeth; throbbing toothache, with sensations as if the tooth were being forced out from its socket by the blood. Drawing and pulling in teeth while eating.
4. Belladonna: This is often used when the toothache is sudden, intense, and throbbing. The pain may be worse by touch, and there may be accompanying swelling, redness in the affected area. It is particularly useful for a sharp, shooting pain.
5. Carbo veg: Teeth decay rapidly; teeth too long and very tender, he cannot bite; tearing in teeth from hot, cold, or salt food, worse when touched by the tongue; receding and bleeding gums.
6. Chamomilla: Toothache is accompanied by irritability and a heightened sensitivity to pain. Toothache worse during and after eating, warm drink, coffee, at night.
7. Coffea: Excessive pains, with weeping, trembling, anguish and tossing about. Toothache worse warm drink, from chewing, at night better when holding ice cold water in mouth.
8. Cistus Canadensis: Twitching, stitching toothache in the upper left molar which is decayed; scorbutic swollen gums, separating from teeth, easily bleeding, putrid.
9. Hecla lava: Facial neuralgia or Headache from carious teeth and after extraction. Abscess of gums, injuries to alveolar process.
10. Hepar sulp : Hallow teeth feel too long and painful ; looseness of teeth ; toothache ,worse in warm room , when biting teeth together ; gums and mouth very painful to touch , bleed easily ; painful ,erysipelatous swelling of cheeks ; jerking and drawing pain in teeth.
11. Kreosotum : Drawing toothache , extending to temples and ears ; bad odor from decayed teeth ; gums bluish red , inflamed ,on upper left side , spongy , scorbutic , and ulcerated.
12. Mercurius : Toothache from caries; tearing, lacerating , shooting into face and ears, returning in damp weather or evening air; worse from warmth of bed, from cold things; better by rubbing cheeks.
13. Plantago : Excessive boring and digging pain , profuse flow of saliva , worse by walking in cold air , and by contact; teeth feel elongated and sore ; soreness even of sound teeth while eating ; very rapid decay of teeth; bleeding of gums.
14. Staphysagria: Black, crumbling, carious teeth; gnawing tearing in decayed teeth, shooting into ears. Throbbing temples, worse from cold drinks and touch, but not from biting on them. Fistula dentalis. Toothache during menses.
15. Zincum : Drawing , smarting ,stinging in roots of upper teeth, and in hard palate; teeth feel too long and loose, with swelling of sub maximally glands; gums painful while eating ,ulcerated ,white, bleed easily ; burning , jerking , stitching in infraorbital nerve ; worse from least touch , and in the evening ;caries of lower teeth.

Conclusion
Toothache is a relatively frequent illness that affects many people all around the world. The illness affects people of both sexes and all age groups. Early treatment with a suitable homoeopathic medicine is crucial to prevent problems. Common dental causes of toothache include caries, exposed dentin and cementum, pulpal and periapical disease, periodontal disease, pericornitis, impacted food and cracked teeth.

Toothache can be effectively relieved using homoeopathic treatments. Neuralgia, cavities, abscesses and micro fractures can all be significantly relieved by the recommended homoeopathic treatment. Furthermore, constitutional homoeopathic prescribing helps patients retain good health in addition to improving dental symptoms and their psychological or emotional states. Homoeopathic medications can effectively relieve toothaches. Maintaining good dental hygiene is essential for preventing toothaches.

References:

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3. Patel TM, Acharya T. TOOTHACHE-RELIEF THROUGH HOMOEOPATHIC REMEDIES.2022 IJRAR Oct 2022,9(4)426-432.
4. Boericke W. Boericke’s New Manual Of Homeopathic Materia Medica with repertory: including Indian drugs, nosodes, uncommon, rare remedies, mother tinctures, relationship, sides of the body, drug affinities, and list of abbreviation.New Delhi:B. Jain Publisher;2007.
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6. https://www.who.int/news-room/fact-sheets/detail/oral-health.
7. https://my.clevelandclinic.org/health/diseases/10957-toothache.

Dr Pavan Kumar V
PG Scholar, Department Of Materia Medica.
Government Homoeopathic Medical College and Hospital. Benguluru – 560079
Email : pavankumar99.bgp@gmail.com.
Under Guidance of: Prof Dr. Vijay Krishna V