• Tooth Ache
• Treatments

Tooth Ache

Toothache At A Glance

The most common cause of a toothache is a dental cavity. The second most common cause of toothache is gum disease. A toothache can be caused by a problem that does not originate from a tooth or the jaw.

What is a toothache?

"Toothache" usually refers to pain around the teeth or jaws primarily as a result of a dental condition. In most instances, toothaches are caused by tooth problems, such as a dental cavity, a cracked tooth, an exposed tooth root, or gum disease. However, disorders of the jaw joint (temporo-mandibular joint) can also cause pain that is referred to as "toothache." The severity of a toothache can range from chronic and mild to sharp and excruciating. The pain may be aggravated by chewing or by cold or heat. A thorough oral examination, which includes dental X-rays, can help determine whether the toothache is coming from a tooth or jaw problem and the cause.

Symptoms of a toothache may include:

• Tooth pain that may be sharp, throbbing, or constant. In some people, pain results only when pressure is applied to the tooth
• Swelling around the tooth
• Fever or headache
• Foul-tasting drainage from the infected tooth

What are dental causes of toothaches?

• Dental cavities & dental abscess

  The most common cause of a toothache is a dental cavity. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath the enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Certain bacteria in the mouth convert simple sugars into acid. The acid softens and (along with saliva) dissolves the enamel and dentin, creating cavities.

• Gum disease

  The second most common cause of toothache is gum disease (periodontal disease). Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds and holds the teeth in place.

• Tooth root sensitivities

  Toothache can also be caused by exposed tooth roots. Typically, the roots are the lower two-thirds of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The condition of exposed roots is called "recession." The exposed roots can become extremely sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone.

• Cracked tooth syndrome

  "Cracked tooth syndrome" refers to a toothache caused by a broken tooth (tooth fracture) without associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. Your dentist can usually detect the fracture by painting a special dye on the cracked tooth or shining a special light on the tooth.

• Temporomandibular joint (TMJ) disorders

  Disorders of the temporomandibular joint(s) can cause pain which usually occurs in or around the ears or lower jaw. The TMJ hinges the lower jaw (mandible) to the skull and is responsible for the ability to chew or talk. TMJ disorders can be caused by different types of problems such as injury (such as a blow to the face), arthritis, or jaw muscle fatigue from habitually clenching or grinding teeth. Habitual clenching or grinding of teeth, a condition called "bruxism," can cause pain in the joints, jaw muscles, and the teeth involved. Bruxism is often due to life "stress," family history of bruxism, and poor bite alignment. Sometimes, muscles around the TMJ used for chewing can go into spasm, causing head and neck pain and difficulty opening the mouth normally. These muscle spasms are aggravated by chewing or by stress, which cause the patients to clench their teeth and further tighten these muscles. Temporary TMJ pain can also result from recent dental work or by the trauma of extracting impacted wisdom teeth.

• Impaction & eruption

  Dental pain can come from teeth that are erupting (tooth growing out or "cutting") or are impacted (tooth has failed to emerge into its proper position and remains under gum and/or bone). When a molar (the large teeth at the back of the jaw) tooth erupts, the surrounding gum can become inflamed and swollen. Impacted teeth cause pain when they put pressure onto other teeth or bone and are inflamed and/or infected. Treatment for impacted teeth is usually pain medication, antibiotics (for infections), and surgical removal. This most commonly occurs with impacted molar (wisdom) teeth.

What treatments are available for toothache?

Treatment for a toothache depends on the cause. If a cavity is causing the toothache, your dentist will fill the cavity or possibly extract the tooth, if necessary. A root canal might need to be done if the cause of the toothache is found to be an infection of the tooth's nerve. Bacteria that have worked their way into the inner aspects of the tooth cause such an infection. An antibiotic may be prescribed. Phototherapy with a cold laser may also be used to reduce the pain and inflammation associated with the toothache.