Dealing with a toothache

Summary

The most common origins of a toothache are from an inflamed or infected tooth nerve. This can be from either a hole in the tooth, deep pits or fissures, worn enamel or cracking within the tooth. A toothache can also be due to infection, within the bone adjoining the tooth root, from gingival infection.

Some illnesses, including sinusitis, can result in pain inside the face that may be misunderstood as toothache. Toothaches can be quite painful, however typically you can be relieved from pain after dental treatment.

Treatment

The best way to maintain healthy teeth is to brush your teeth twice a day with fluoride toothpaste and have regular visits with a dentist and a dental hygienist. If your teeth become sore, prescription-free pain medications may help. However, you must see a dentist to treat the issue properly. Common methods to treat a toothache are fillings, endodontic treatment or dental extractions.

Antibiotics may need to be prescribed by the dentist to treat an infection, though this will be prescribed by your dentist if required. When should I get dental care? You should see a dentist if you have

extended or continual aches or irritations in a tooth or multiple teeth
a tooth that is sore to touch or brush
swollen gums
a broken tooth

routine examinations as prevention If the area under the tongue is swollen, seek dental medical attention as soon as possible.

What causes a toothache?

A toothache usually indicates that one or more teeth has been damaged or irritated. Pain is a signal that something is not right, which case a dentist should examine the teeth. Toothaches are usually due to the tooth nerve becoming inflamed or infected, however there are also other reasons why a toothache will occur. Toothaches in which the tooth nerve is infected or inflamed may be due to

tooth decay/cavities
deep pits or fissures
exposed enamel
tooth/teeth damage
lost or broken fillings
enamel cracks
tooth/teeth wear

Other causes of a toothache can be

clenching or grinding teeth or chewing on hard, sticky foods
gum infection
aching after a tooth extraction
periodontitis
a dental prosthesis that is rubbing

Tooth decay/cavities

A hole in the tooth, also known as a cavity, which reaches completely through to the tooth nerve can cause a toothache. Bacteria that causes cavities can add to an already inflamed dental nerve, causing pain. Initially the tooth can be sensitive to hot or cold and then progress to a more extreme or chronic pain. If the problem isn’t treated quickly, the infection can spread through the root of the tooth to the bone tissue. The ache can then progress further into a dull throbbing pain and the tooth is usually tender to touch. The region around the jaw may also swell. This means the tooth and the jawbone have become infected due to the problem tooth.

Deep pits or fissures

Pits or fissures that go deep into the enamel near the tooth nerve can allow decay to form undetected deep into the tooth and could cause a toothache. Teeth that have had a filling are usually worse off than healthy teeth if they are not treated. If there is a deep pit, the tooth nerve can also be affected by leakage at the edge of a filling.

Exposed tooth neck

Hard tooth enamel provides the nerve adequate protection; however the enamel ends on the gum edge. If the gum recedes, the base of the tooth can be visible, exposing the root. The surface of the root is porous and does not protect the tooth nerve. Therefore, there may be sensitivity when eating hot or cold food or to touch. Even the air that flows into the mouth whilst breathing can cause pain.

Dental injuries

Due to accidents, tooth breakages can cause a lot of pain. If components of a tooth have broken off , it can become very sensitive.

Loose or damaged fillings

The filling in a tooth is used to protect the dental nerve from cold and warm objects in the mouth. If the filling loosens, the nerve can become exposed and then inflamed.

Tooth cracks

Deep cracks can cause pain and soreness. This is due to the tooth nerve becoming inflamed or infected.

Grinding or clenching teeth

Strong jaw muscles or stress can cause clenching and grinding. This usually happens when sleeping or eating

Gum inflammation while a new tooth erupts

When a tooth erupts through the gum it may emerge infected. This can be due to difficultly keeping teeth clean at the stage of the tooth breaking through. This is common when wisdom teeth erupt, but can also occur in children getting their permanent teeth.

Teeth extraction

Wound management after dental procedures should mean that pain should be minimised and well controlled with appropriate medications. An infected wound would require antibiotics and management by dentist.

Periodontitis

Advancing gum inflammation can cause infections or abcess which will be painful. The teeth become loose due to tooth attachment loss from the advancing disease.

A prosthesis that rubs

After numerous years, dental prosthesis or dentures will not fit correctly. The prosthesis can then begin to loosen and cause sore areas.

Infection underneath fillings

Sometimes, fillings loosen and begin to leak, allowing bacteria to enter the pulp. Pulpal inflammation can cause severe pain.