Most of us aren’t strangers to toothaches. Toothaches simply refer to pain around the teeth and jaws, typically caused by tooth decay. Nevertheless, it is critical that you have a complete oral examination to discover the cause.
Toothaches occur when the dental pulp, the innermost layers containing blood vessels and nerves, becomes inflamed and irritated. In most cases, dental pulp inflammation is caused by:
- Tooth decay. Decay leads to cavities forming in the surface of the tooth, exposing the denta and making the pulp more prone to inflammation.
- Cracked tooth. Sometimes the crack is too small to be seen with the naked eye and often goes unnoticed.
- Receding gums. Gums contract and shrink exposing the sensitive parts of the tooth to air and food.
- Loose and broken fillings. This may expose the sensitive root.
- Periapical abscess. Caused by a bacterial infection, this refers to the accumulation of pus at the end of the tooth, making it more susceptible to pain. Periapical abscesses can be very painful and you may need emergency dental treatment.
Other possible causes include grinding teeth (bruxism), gum disease (gingivitis), trauma to the tooth, an abnormal bite and tooth eruption in babies and young children.
In the case of cavities and gum disease, the first sign of decay is often a toothache that is felt when you consume something hot, cold, sweet or acidic.
Temporomandibular Joint Disorder (TMJ/TMD), tension in facial muscles and sinus or ear infections may cause a more generalized discomfort that may be similar to a toothache but isn’t associated with a specific tooth. These problems are often accompanied by a headaches and other symptoms; therefore, immediate medical assistance is crucial.
Pain around the jaws and teeth can also be a symptom of a heart defect, such as angina. The dentist may refer you to a general medical practitioner (GP) if he or she suspects an underlying health issue is the cause of the toothaches.
Symptoms accompanying a toothache
Since symptoms of toothaches may resemble other dental problems or medical conditions, diagnosis can be difficult without a complete examination by a dentist. If you have a foul-tasting drainage or you notice pus near the painful area, the affected tooth may have been abscessed. This can cause an infection to the surrounding bone tissue. The pus can also indicate gingivitis that is often characterized by bleeding gums, inflammation of soft tissue and abnormal loss of bone tissue around the teeth.
See a dentist immediately if you have any of the following:
- Nausea and vomiting
- Foul-tasting drainage
- Pain when you bite
- Swelling around the affected tooth
- Difficulty swallowing or breathing
- Continuous lasting discomfort
In case of a tooth decay, you may experience the following:
- Pain triggered by eating or drinking certain foods
- Mild or severe pain that’s sharp and sudden. Pain worsens in the night, particularly while lying down.
- A lost filling or broken tooth
- Pain may feel like it’s coming from the ear, if the lower molars are affected. Therefore, it may be difficult to identify whether pain is coming from the upper or lower teeth. Similarly, toothaches in the upper jaw may feel like it’s originating from the sinuses – small air-filled cavities behind the cheekbones and forehead.
Treatment for a toothache will often depend on the cause. The dentist will therefore, first identify the cause of the pain by performing a complete examination of your mouth, followed by an X-ray, if needed.
If tooth decay is the culprit, the dentist will remove the decayed portion and replace it with a filling. In case of a broken filling, he or she will place a new filling to cover the exposed region.
For infections, you may need a root canal treatment, which involves removing the infected pulp and placing a special type of filling to cover the tooth and prevent the infection from recurring. If the toothache is not responding to any of the treatments or if it is impacted, the dentist may have to extract the tooth and perform an implant.