PROBLEM

An 11-year-old female patient is complaining of occasional pain in the lower right quadrant of her mouth in the evenings and at night for two weeks now.  The patient’s mother is concerned about possible “swelling”. This teledentistry photo taken with TelScope Telehealth System shows there is a permanent second molar emerging (“erupting”) in a normal position.

DIAGNOSIS

The tissue over the back of the tooth will recede with time as the tooth erupts into the mouth further. There is no inflammation or infection, and no treatment is indicated. The patient’s mother was instructed that the patient should brush the emerging tooth as normal. She could give her child an over the counter pain medication like acetaminophen or ibuprofen if needed.

INTERESTING FACT

Children grow, and teeth move, in the evenings and nighttime, as their growth hormone increases during this time. It is not uncommon to occasionally have discomfort from tooth movement that may come and go with no other symptoms – dental “growing pains”.

However, other more significant oral health issues can also cause night time pain. A photograph and a teledentistry consult with a dentist can help determine if an in-office examination is indicated.

About the Author: Dr. Richard Simpson, DMD

Dr. Richard is a board certified pediatric dentist in private practice.
His achievements include:
• Diplomate in the American Board of Pediatric Dentistry
• Fellow in the American College of Dentists
• Fellow in the International College of Dentists
• Fellow in the American Academy of Pediatric Dentistry
• Advisory Board Member of The TeleDentists
• Advisory Board Member of Holland Healthcare
Dr. Richard’s experience and active interests include telehealth, child advocacy, health disparities, policy, and advancing improved medical-dental access to care. Dr. Richard is also a veteran with 15 years of military service.
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INFORMATION & CONTENT DISCLAIMER

This content is for information only. This content is not for advice, diagnosis, or
guarantee of outcome for patients. No patients should use the information,
resources, or tools contained within to self-diagnose or self-treat any health-related
conditions. 

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