牙痛大作戰

半夜突然牙痛起來。

也許是因為最近巧克力吃太多，或是最近壓力太大的緣故，自余束髮以來一直服務我三十年而鮮少發出抱怨訊號的牙齒，竟然在半夜讓我從睡夢裏痛醒過來。

「牙痛不是病，痛起來真要命」。在人類的各種知識系統裏，有時候俗諺比什麼科學理論都來得接近真理。而這一刻我竟是與這個真理如此地接近。一向對事物很少有什麼感動而掉淚，沒想到會為了一顆牙痛而幾乎快要掉下淚來。

起床刷了一次牙，鹽水漱口，十分鐘後判定無效，右下顎臼齒穩定持續地傳來疼痛訊號。此時心中暗叫不妙，這半夜似乎也沒有牙醫可以看，難道要逼我學湯姆漢克在浩劫餘生裏自力拔牙嗎？何況頂多只是牙面上的一個齲洞，還沒有走到拔牙的田地吧？

正當各種念頭紛至沓來，此時想起兩年前Sisley回台灣前留下一個藥箱還沒丟。翻了翻藥箱，竟然有一瓶止痛藥，真是老天的恩賜。還來不及分辨有效期限是05年9月還是09年5月，連忙吞了一顆。過了一會，這要命的疼痛就突然消失了，令人不禁謳歌現代醫學的偉大。

安穩地睡著後，沒想到早上還是再次被牙痛叫醒，起床後照例吞了一顆止痛藥。

但這樣繼續仰賴止痛藥下去可不是辦法，何況這個止痛藥Ibuprofen是NSAID，對我已經不太好的胃恐怕雪上加霜（最近一個月才剛吃完兩排Zantac）。如果去看NHS的牙醫，只怕預約到的時間也要一個月後，而中間這段時間恐怕要靠自己了。於是查了一下網路，看看有沒有牙痛的緊急應對措施。這一查才發現各種救命的資訊還真不少，稍微摘錄如下：

內服類：

NHS Direct Online

"While you are waiting for an appointment with your dentist, to ease the pain you can take over-the-counter painkillers such as paracetamol or ibuprofen." 這是NHS貼心的小建議，在預約了漫長的等候牙醫這段期間，可以去藥房買普拿疼或其他非類固醇抗發炎劑(NSAIDs)等非處方藥自行止痛。

eMedicineHealth

"Over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil) may be used. Take these as directed on the package and around the clock on a schedule while you arrange a dental appointment." 要遵照包裝上的指示服用。還有記得把藥名記下來。

Home remedies

"If you feel that a small swelling has occured, you may take NSAID (Non-Steroidal Anti-Inflammatory Drugs) for its inflammatory action, like Ibuprofen and Mefenamic Acid. However, those with a history of of ulcers and those pregnant women needs a doctor's reccomendation when taking NSAID and Aspirin." 如果覺得有腫脹發炎，建議使用NSAID。但是有腸胃道潰瘍史病患以及懷孕婦女則要由醫師評估。

外用類：

Mayo Clinic

"Use dental floss to remove any food particles wedged between your teeth." 先用牙線清潔一下牙縫。

"Apply an OTC antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) also may help. Don't place aspirin or another painkiller directly against your gums, as it may burn your gum tissue." 使用含benzocaine成份的殺菌劑清潔口腔（李施德林？），丁香油可能也有用。以上藥房都有得買。注意不要把止痛藥直接放在牙肉上，它會燒。

eMedicineHealth

"Relief may be obtained from biting on a cotton ball soaked in oil of cloves. Oil of cloves is available at most drug stores." 丁香油的使用方法：用牙齒咬著沾了丁香油的棉花球。

HowStuffWorks

"Rinse. Stir one teaspoon salt in a glass of warm water, swish it around in your mouth, then spit it out." 用溫鹽水漱口，記得要吐掉。

"Apply oil of cloves. You can pick this up at the pharmacy. Follow the directions for use carefully (because ingesting too much can lead to poisoning), and be sure to put it only on the tooth and NOT on the gum. Otherwise, your burning gums may distract you from your toothache." 又是丁香油。小心使用，太多會中毒。不要接觸到牙肉，不然你會因為灼燒而忘記牙痛。

"Plug it with gauze or gum. If the tooth feels sensitive to air, cover it with a piece of gauze, a small piece of dental wax (available at many pharmacies), or a bit of chewed sugarless chewing gum (use the teeth on the opposite side of the mouth to chew the gum) until you can get to the dentist." 如果覺得牙齒曝露在空氣中就會疼痛，可以在牙齒上覆蓋層紗布或是牙臘（藥房有售），或是用EXTRA無糖口香糖塞住牙洞也可。

Home remedies

"Ice is excellent in numbing nerve endings. Try to compress the affected area with ice. But if it aggravates the pain, discontinue it." 冰敷頰部，或是含冰塊。如果疼痛加劇，停止。

行為類：

eMedicineHealth

"Avoid very cold or hot foods because this may make the pain worse." 不要吃過熱或過冷的食物。

HowStuffWorks

"Keep your head up. Elevating your head can decrease the pressure in the area and may lessen throbbing pain"抬頭以減輕局部壓力。

按壓穴道。我個人覺得合谷穴位置比較好找，按壓也方便。


另外有些網站說在牙齒上抹舒酸定(Sensodyne)，牙洞裏塞正露丸（太神奇了，來源是奇摩知識佳，有人敢信嗎？），用過的茶包或是橄欖油漱口，這些都只能說是偏方，不建議嘗試。有些網站寫到熱敷，不過如果正值急性發炎期，熱敷效果會適得其反。

不管第一時間做了什麼處置，有沒有效，最後還是要提醒各位，最重要的還是趕快去看牙醫才是正辦喔。