Learn to Tell Similar Problems Apart

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HealthWiki > Where There Is No Dentist > Chapter 6: Examination and Diagnosis > Learn to Tell Similar Problems Apart

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In this chapter:

 

In this chapter:

If a person comes to you with a toothache or a sore or a loose tooth, there are many possible causes for each problem. The first thing you notice — the toothache, sore or loose tooth — is your first step to a diagnosis. To this you must add more information before you can point to the most probable cause.

Put together what you have found with what you already know about teeth and gums. You can make a good diagnosis of a problem without knowing a special name for it.

Usually it is easy to make a diagnosis. However, sometimes you will not be sure, and these are the times to seek the advice of a more experienced dental worker. Never pretend to know something you do not. Only treat problems that you are sure about and have supplies to treat properly. See Where There Is No Doctor, p. w4.

Use the charts beginning here to help you make the diagnosis. For more practice using charts to tell problems apart, see Chapter 21 of Helping Health Workers Learn.

IF THE PERSON HAS	AND YOU FIND OUT THAT		THEY MAY HAVE
	It hurts only after eating or drinking. There is a cavity, but the tooth does not hurt when you tap it.		a cavity
	Part of the filling has fallen out, or is cracked and ready to fall out. Eating and drinking make the tooth hurt.		a cavity under an old filling
A TOOTHACHE	The tooth hurts when chewing food. It may hurt when tapped, but there is no cavity and the tooth looks healthy.		tartar between the teeth
	It hurts all the time — even when person tries to sleep. The tooth hurts when you tap it and it feels a bit loose.		an abscess
	It hurts when person breathes in cold air. The tooth was hit recently.		a cracked or broken tooth
	He cannot open his mouth properly. Steady pain and a bad taste are coming from the back of the mouth.		a new tooth growing in
	Several top teeth hurt, even more when you tap them. She had a head cold and can only breathe through her mouth.		an infected sinus

IF THE PERSON HAS	AND YOU FIND OUT THAT		THEY MAY HAVE
A SWOLLEN FACE	He had a toothache recently. The bad tooth hurts when you tap it.		a tooth abscess
	She is young, about 18 years old, and has trouble opening her mouth.		third molars ("wisdom teeth") growing in
	He was hit on the face or jaw. The bone hurts when you touch it. The teeth do not fit together properly.		a broken bone
	The swelling is under or behind the jaw. It gets worse when he is hungry and smells food.		an infection inside the spit gland
	The swelling has been there for a long time. It does not seem to get better.		a tumor

	Food and tartar are attached to the tooth. The gums around it are loose and swollen.		infection inside the root fibers — from gum disease
A LOOSE TOOTH	There was pain in the tooth before, but it does not hurt so much anymore. It has a cavity and there may be a sore on the gums near it.		infection in the bone — from an old tooth abscess
	The tooth was hit some time ago.		a root broken under the gum
	When the loose tooth moves, the bone around it and the tooth beside it also move.		a broken bone around the tooth’s roots OR
	Bone broken under the gum		infection inside the bone from Vincent’s Infection
	When you ask the person to slowly close his teeth, one tooth hits another, before the other teeth come together.		a tooth is out of position and biting too hard against another

IF THE PERSON HAS	AND YOU FIND OUT THAT		THEY MAY HAVE
	The gums are red and swollen. They bleed when the teeth are cleaned..		gum disease starting
A SORE MOUTH from INFECTED GUMS	Between two teeth the gums are sore and swollen, like a small tumor.		something caught under the gum
	The gums between the teeth have died and are no longer pointed. Pus and blood around the teeth make the mouth smell bad.		Vincent’s Infection (a more serous gum infection)
	The gums are bright red and sore, but between the teeth they are still pointed.		fever blisters on the gums — from Herpes Virus

	A sore on the inside of the cheek, lips, or under the tongue, is yellow with the skin around it bright red. Food touching it makes the sore hurt more.		a canker sore
or A SORE MOUTH from a SMALL SORE in another place	A sore spot around or under a denture hurts when you touch it.		a sharp place on a denture, or an old denture that needs to be refitted
	A kind of white cloth seems to be stuck to the top of the mouth or tongue. It may stop a baby from sucking.		thrush
	The sore is near the root of a bad tooth.		gum bubble
	The corners of the mouth are dry. The lips crack and are sore.		malnutrition
	Small painful blisters on the lips soon break and form dry scabs.		fever blisters — from Herpes Virus
A SORE THAT DOES NOT HEAL PROPERLY MAY BE CANCER

IF THE PERSON HAS	AND YOU FIND OUT THAT		HE/SHE MAY HAVE
A SORE ON THE FACE	Inside his mouth, he has a tooth abscess or a broken tooth near the sore.		abscessed tooth draining pus to the outside of the face
	A dark sore is eating through the cheek. Her gums are badly infected. A bad smell is coming from the dying skin on the face, and from inside the mouth.		a condition called Noma — starting from Vincent’s Infection of the gums
	A 1-month-old sore on the lips is not healing with medicine.		cancer

	He is young, between 16–24 years, with some swelling behind his jaw.		third molars ("wisdom teeth") growing in
TROUBLE OPENING THE MOUTH	He recently had an accident.		a broken jaw — probably in front of the ear
I cannot open any more than this.	He had a toothache before in a back tooth with some swelling.		an abscess in a back tooth
	When she tries to open her mouth, there is a clicking sound from in front of her ear. It also hurts in that place whenever she tries to open her mouth or chew food.		pain in the joint where the jawbone joins the head
	Swallowing is difficult and the jaw grows stiff. Germs have gone into the body from dirty instruments or an infected wound.		tetanus

TROUBLE CLOSING THE MOUTH	After opening wide to eat or yawn, his mouth became stuck there. He has many missing back teeth.		a dislocated jaw
	He had an accident and now something is stopping the teeth from coming together.		a broken jaw

This page was updated:17 May 2024