Pain Relief – Part 4 – Medications / Lesions

Lesions Summary

Basically, a lesion is region the body that has suffered damage from an injury or disease, such as a wound, ulcer, abscess, or tumour.

Let’s look at the mouth.

Dental caries or decay is a lesion where bacteria have damaged the tooth.

Periodontal disease or gum disease through bacteria adhering to the tooth and root surface causing destruction of the bone and ligament.

Trauma to teeth can cause teeth to crack and break. Trauma to the jaws can also cause the bone to fracture.

Wounds to soft tissue such as the tongue, cheek, throat, palate, lip, muscles can be caused by the lesions of the hard tissue like the teeth and roots.

Sometimes whole teeth are knocked out (or avulsed) leaving a socket wound. In the right conditions the tooth may be able to be placed back.

Removal of teeth also leave a socket wound. Sometimes this wound does not heal and a dry socket occurs and needs further treatment. This condition can be brought on by bone medication such as Fosamax.

Ulcers are lesions where the surface of the skin or gums is lost exposing the connective tissue layer underneath.

Erosion lesions are where some of the surface layer of the tissue has been lost without exposing the next layer of the body. This even occurs in teeth where gastric reflux causes acid erosion of the surface of the teeth.

Abscesses commonly occur at the ends of the roots, the gums, jaw bone and gums around impacted teeth.

Colour changes in the tissues are lesions as well. They can indicate and underlying problem. White patches, called leukoplakia can indicate thickening of the gums or soft tissue layer due to trauma such as cheek biting, irritations or even cancer.

Tumours are simply abnormal growth of tissue due to trauma, irritations, medication (e.g. for epilepsy), hormones such as in pregnancy, benign or cancerous tumours.

Relief of Pain for Lesions

Let’s go through some interesting examples of pain relief of lesions:

Ulcers

Medication
This depends on the type of ulcer and needs to be assessed by a health professional. However, if the type of treatment involves the application of a gel, ointment, or liquid.

It’s important to DRY THE ULCER BEFORE APPLYING. Use a double-ended cotton bud with the material on one end. With the dry end find the ulcer and wipe it dry. Then immediately apply the material into the ulcer and massage it gently into the exposed central area. It will sting but that means you have found the correct spot.

Follow instructions of the medicine as accurately as possible. The symptoms usually clear up in 2-3 days however ulcers may take up to 2 weeks to heal. Citric acid found in e.g. orange juice should be avoided as it slows down the healing process. The pain stops once the exposed underlying layer is covered by epithelium.

Painful ulcer in cheek

Applying Medicament for treatment and pain relief

Soft tissue laser – ulcer treatment

This method is used to relieve pain by using a laser that is designed for soft tissue.

There many types of lasers containing various gases that emits various wavelengths.

Soft tissue lasers are an effective tool for treating oral ulcers in dentistry, offering benefits like reduced pain, faster healing, and decreased risk of infection compared to traditional methods.

It disinfects the ulcer, which reduces the risk of secondary infection. This is something that you will not get from any other treatment. It emits specific wavelengths into the skin, to create an increase in the production of ATP (energy) within the mitochondria at a cellular level within the dermis, which promotes an accelerated healing of damaged tissue.

The laser probe is waved over the ulcer without direct contact on the lesion,

Soft Tissue Diode Laser

Remember if the ulcer does heal…

It is important that the dentist ascertains that the ulcer has healed. If it has not then further investigations will be needed. This may involve a biopsy of the ulcer. Unfortunately, cancer can often be symptomless. Therefore it’s important to have regular examinations ideally every six months to check not only the teeth and gums but the rest of the mouth and jaws. This is so any problems are picked up early.

Dry Socket

A dry socket is a soft tissue wound that becomes a bone wound.

A dry socket is a complication that can occur after a tooth extraction. When a tooth is removed a blood clot forms, as the first step to healing. The clot covers and protects the underlying bone. Also, blood vessels grow into clot to bind it to the surrounding gum.

For some reason, not always explained, the clot fails to form or bind, and it falls out, exposing the bone and delaying healing of the wound. An initial clot forms, but usually after two days, (sometimes it can occur very quickly) the clot falls apart.

Often a bad taste occurs and food gets caught in the tooth socket. The bone then becomes exposed and an aching, throbbing, dull, deep in the bone pain occurs. The pain may radiate to other teeth or parts of the head such as the ears and eyes on the same side of the face.

During normal healing, the discomfort of an extraction should lessen over time. However, if the pain increases, this may mean that healing is delayed and a dry socket has occurred.

Exposed bone at the base of a dry socket

What is the treatment for a dry socket?

SEEK DENTAL ADVICE AND TREATMENT – Call us!

Initially, the dentist will gently irrigate to clear the socket of food debris.

Next, an analgesic medicated dressing is placed within the socket to cover the exposed bone. This usually provides immediate relief. This dressing may need to be replaced every few days during the healing process. The dressing may also contain iodine-based products. If you are allergic to iodine, make sure you tell all health professionals.

Iodine base dressing placed to fill the exposed socket

Additionally, medications are usually prescribed to manage the pain. Nonsteroidal anti-inflammatory drugs (such as Advil or Nurofen) or narcotics (such as Codeine formulations) are often used to relieve pain.

Sometimes antibiotics are prescribed.

Delaying contact with the dental surgeon could prolong the pain as well as the healing time.

We can’t read your minds… Seymour Dental will call to see how you are going after the procedure. Please let us know one way or the other if we leave a message. We are here to help; if we know!

Need an Appointment?

If you’d like to book an appointment with the dentist at Seymour Dental then call us in Dulwich Hill, Sydney on (02) 9564 2397 or
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Next week

Pain Relief - Part 5 - More Medications / Lesions