It is very easy to postpone a visit to the dentist when the pain is mild, appears only occasionally, or disappears on its own. Also a little blood during brushing, bad breath, or a small sore in the mouth may seem like a temporary nuisance that does not justify clearing time on the calendar. However, specifically these small signs could be the way the mouth signals a problem that requires treatment.
Not every symptom necessarily indicates a severe disease, but waiting for a long time could allow tooth decay, infection, or gum disease to progress. In such cases, a problem that could initially be solved with a relatively simple treatment could later require more complex and expensive treatment.
Here are five signs that should not be dismissed as a minor matter.
1. Toothache, even if it passes
Pain in a tooth is not a normal condition. The common reason is tooth decay, which develops when bacteria in the mouth break down sugars and starches and produce acids that damage the enamel layer protecting the tooth. As the decay deepens, it can reach the sensitive layers of the tooth and cause sensitivity, pain, or infection.
One of the most misleading situations is pain that suddenly disappears. It is easy to think that the problem was resolved, but sometimes the disappearance of the pain occurs specifically when the nerve inside the tooth is damaged or dies. In such a situation, the pain may weaken, while the infection continues to progress toward the root of the tooth and the adjacent bone, which in many cases leads to facial swelling–
According to the US Centers for Disease Control and Prevention, about one in five adults aged 20 to 64 in the United States suffers from at least one untreated cavity in a tooth. Untreated tooth decay could cause an abscess, meaning a accumulation of pus as a result of an infection, and in rare cases the infection could spread to additional areas in the body. Therefore, even mild pain, pain that comes and goes, or a new sensitivity to heat and cold justify an examination.
2. Swollen or bleeding gums
A drop of blood on the toothbrush or dental floss is not necessarily a cause for panic, but bleeding that recurs is not a phenomenon that should be ignored. Red, swollen, or sensitive gums that bleed easily are often a sign of gum inflammation. In many cases, gum bleeding at night will stain the pillow and could cause severe bad breath.
The inflammation is usually created following the accumulation of bacterial plaque around the teeth. At an early stage, it is sometimes possible to stop the process through a professional cleaning and improving oral hygiene. Without treatment, the inflammation could progress to deeper gum disease and damage the tissues and bone supporting the teeth.
Gum bleeding may also appear following aggressive brushing, improper use of dental floss, taking certain medications, or hormonal changes such as during pregnancy and breastfeeding. Sometimes it is also linked to other medical conditions. Therefore, if the bleeding continues for more than two weeks, worsens, or appears without a clear reason, it is recommended to seek an examination.
3. A tooth that started to move
In children, a loose tooth is a natural part of the growth process. However, in adults– it is considered a warning sign. One of the main reasons for this is advanced gum disease, which could damage the bone holding the tooth in place.
You should consult a dentist even if it seems that the teeth have shifted position, that new gaps have suddenly formed, or that the bite of the jaw feels different. Sometimes the change stems from tooth grinding, trauma, or loads applied to the teeth, but in rarer cases there is a need to rule out a process damaging the jawbone.
The earlier the cause of the tooth's movement is diagnosed, the higher the chance to stop the damage and save the tooth.
4. Bad breath or an unpleasant taste that do not pass
A meal with garlic, onion, or fish can leave an odor for quite a few hours. But bad breath that remains day after day, despite brushing and cleaning between the teeth, already requires attention.
One of the possible causes is gum disease. Another possibility is an infection in the tooth or gums, which sometimes creates a sort of small drainage opening from which pus is discharged. The drainage may reduce the pressure in the area, and therefore the infection does not always cause significant pain.
Dry mouth could also cause bad breath and increase the risk of tooth decay. Saliva helps wash away food debris and reduce bacteria accumulation. Dryness can be caused by various medications or be linked to medical conditions such as diabetes and autoimmune diseases. A sour or bitter taste that recurs often may also be linked to gastroesophageal reflux.
5. A sore in the mouth that does not heal
Aphthous ulcers and small sores in the mouth are very common, and most of them disappear on their own within about two weeks. They can appear following an accidental bite, friction from a sharp tooth, emotional stress, or spicy and acidic foods.
However, a sore that does not heal, grows larger, bleeds, or becomes a lump requires an examination by a dentist or a family physician. The same applies to a new white or red spot, persistent pain, difficulty swallowing, or a numb sensation in the mouth. In most cases the cause is not cancer, but a prolonged sore can be one of the early signs of oral cavity cancer, so you should not wait for pain to appear.
When should you hurry to the dentist?
Significant swelling in the face or jaw, fever, difficulty opening the mouth, or severe uncontrollable pain require urgent dental care. If difficulty breathing, speaking, or swallowing appears, you must seek urgent medical care immediately. A dental infection does not pass on its own, and antibiotics alone do not always resolve its source.
The treatment is determined according to the problem. Early tooth decay may require a filling, an infection that reached the tooth pulp may require root canal treatment, and gum disease is treated with cleaning, gum treatment, and improving the maintenance routine. Therefore, there is no single treatment that is suitable for all symptoms.
The bottom line is simple: Absence of pain is not proof that the mouth is healthy, and the disappearance of pain is not always a sign that the problem has passed. A timely examination can prevent suffering, save teeth, and reduce the need for complex treatments later on. Preventive treatment or early treatment is far preferable to expensive and painful corrective treatment.
The writer, Dr. Eran Fermon, is a dentist and manager of the Malo Clinic in Ramat Hasharon