What is a toothache? What causes a toothache?
A toothache is pain that occurs in or around a tooth. The pain originates from within a tooth or the surrounding gum and bone structures. Toothache pain is usually felt as a constant or intermittent ache that does not go away. A toothache can be stimulated by temperature changes such as exposure to cold drinks or pressure on the tooth while chewing. In other instances, a tooth can arise spontaneously without any stimulation.
It’s hard to ignore an aching tooth while eating or going about one’s day. Persistent pain urges us to find out how to get rid of a toothache. While bothersome, it is a way for the offending tooth or area to signal that some attention and care is needed before things get worse.
What causes a toothache?
Causes of toothache include the following:
- Abscessed tooth: This is an infection that originates from within the tooth and spreads to the root and the surrounding bone.
- Damaged or fractured tooth: Fracture of a tooth can expose the sensitive dentin or even the pulp. Sometimes fractures are not obvious even though the fracture line can run deep into the tooth, causing pain every time one puts pressure on it with biting or chewing. This is called “cracked tooth syndrome.”
- Dental work: After a filling or crown is done, the tooth can feel more sensitive. This is especially the case if the decay removal was large or deep. Dental work, although necessary, can sometimes irritate the nerve. Over time, the sensitivity can resolve if the tooth is healthy enough.
- Teeth clenching or grinding: This habit is called bruxism and is oftentimes done unconsciously and at night. Unfortunately, bruxism causes damage to teeth and sometimes irritates the nerves to the point where teeth become sensitive.
- Gum infection or gum disease: The gum, gum ligament, and bone that surround and anchor the teeth are collectively called the “periodontium.” Pain is usually felt during the later stages of gum disease (or “periodontitis”) where there is advanced loss of bone around the teeth. Because of bone loss, a gum abscess (infection) can form in the space that develops between the tooth and the gum, causing pain.
- Exposed root surfaces: When the roots of teeth are no longer covered with the protective bone and gum, these surfaces can be sensitive to stimuli such as brushing the teeth or temperature changes.
- Sinusitis: Because the roots of the upper molars are very close to the maxillary sinus cavities, inflammation from the sinus cavities can cause these molars to be sensitive and feel like a toothache.
- Third molars (“wisdom teeth”): Third molars are the very last permanent teeth to appear in the mouth. More often than not, there is not enough space for these molars in the mouth. As a result, third molars become fully or partially trapped (impacted) within the jawbone and below the gum. Because of poor accessibility, it is difficult to properly clean partially exposed third molars; therefore, these areas are susceptible to problems. Problems with third molars can cause dull to severe pain from pressure of eruption, gum infection, or dental decay.
What are toothache symptoms and signs?
Signs and symptoms that can might indicate a tooth problem are
- pain with biting or chewing,
- teeth hypersensitivity to changes in temperature,
- cheek or gums swelling near tooth,
- discharge or bleeding of gums,
- constant throbbing within a tooth.
A toothache can present as a dull or sharp pain that may arise spontaneously on its own or by stimulation.
Additional symptoms may include:
- neck pain,
- bad taste or odor in the mouth.
What is the treatment for a toothache?
Treatment for a toothache depends on the cause of the pain and how much damage is present. In general, the best way to stop a toothache is to remove any present infection or decay and repair the damage to protect exposed, sensitive areas. For a shallow cavity on a tooth, the decay is removed and a filling is placed to seal the tooth. If the cavity is very deep and gets into the pulp, “root canal treatment” is performed because the pulp has been exposed and infected with bacteria.
This procedure essentially removes all the vital contents of the tooth (nerves and blood vessels) and seals the inner aspects of the tooth (root canal system) with an inert filling material. Root canal treatment along with antibiotic therapy is usually needed for an abscessed tooth that has very localized infection. If the infection has become widespread, antibiotic therapy and additional steps may be needed to properly drain the infection. Sometimes extraction of the tooth may be the only option for treatment if the tooth or surrounding gum and bone are too damaged.
For a periodontal abscess, a simple drainage procedure is performed under local anesthesia. Additionally, the affected gum pocket is thoroughly cleaned to remove any tartar buildup and debris. Once the area has been cleaned up, the pocket is irrigated with an antimicrobial rinse.
Sometimes, antibiotics are locally-administered into the pocket to further aid in healing. Depending on the extent of the abscess, oral antibiotics may also be prescribed. A follow-up visit is recommended to make sure the infection has completely resolved and develop a plan to properly maintain the area.
toothache, causes a toothache, treatment for a toothache, Oral Health