Grow Youthful: How to Slow Your Aging and Enjoy Extraordinary Health
Grow Youthful: How to Slow Your Aging and Enjoy Extraordinary Health

Toothache / tooth pain

What is toothache?

Causes of toothache

Remedies for toothache

What is toothache?

Toothache (odontalgia) is an aching pain in or around a tooth. Tooth pain can extend to the gum and jaw or even cause a headache.

The severity of a toothache can range from chronic and mild to sharp and excruciating. Tooth pain can be set off by drinks and foods that are cold, hot, sweet or acidic. Toothache may be aggravated by chewing.

Causes of toothache

Dental cavities / caries / tooth decay

Dental cavities / caries / tooth decay is the most common cause of a toothache. A cavity is a bacterial infection that destroys the tooth. At first, you may not notice small, shallow cavities that don't cause any pain. Eventually, larger deeper cavities can be painful and cause a variety of other serious problems.

Tooth abscess / pulpitis

Toothaches from larger cavities that penetrate the dentin are the most common reason for visits to dentists.

If the cavity is deep enough to penetrate the dentin, the soft inner pulp is no longer sealed off from the mouth. Pulpitis is when the pulp is infected by bacteria, resulting in tooth infection (dental abscess). It can be inflamed, and smell bad as the pulp tissue dies off. Inflammation causes swelling, but because the tooth is hard it cannot expand, so there is increased pressure on the nerves. Usually it causes a prolonged throbbing pain which can be confused with neighbouring teeth (referred pain), though sometimes there is no pain. The gum surrounding the infected tooth can swell or blister (gum blister). The tooth becomes sensitive to foods and liquids that are cold, hot, acidic or sweet.

Pulpitis can also be caused by trauma, or poor quality or repeated dental procedures on that tooth.

Root abscess

A root abscess is a bacterial infection in the root of the tooth where it connects to the jaw bone. It often contains some pus and dead pulp tissue.

The pain from an abscess is continuous - gnawing, sharp, shooting, or throbbing. Pressure or warmth on the tooth makes it worse. The pain can extend and feel like a migraine.

Sometimes an abscess may be painless but still have a swelling.

There may be a swelling at the base of the tooth, the gum, the cheek or the face. In some cases, the lymph glands in the neck will become swollen and tender. An ice pack can provide some relief if there is swelling.

If an abscess is not healing, it is important to get professional advice as the consequences of the infection spreading can be serious or life-threatening.

Causes of root abscess:

Gum disease - inflamed gums, receding gums, exposed tooth root

The second most common cause of toothache is gum disease (periodontal disease), involving inflammation of the gums (gingiva) and / or receding gums.

Fractured (cracked) tooth

Toothache can be caused by a broken tooth (tooth fracture) without associated cavity or gum disease. Biting on the tooth causes sharp pain. A tooth fracture is usually caused by chewing or biting on a hard object such as a nut, bone, some candies/sweets, and most commonly, a small stone that was not removed during food preparation. A dentist can usually confirm the fracture by painting a dye on the cracked tooth or shining a special light on the tooth.

Standard dental treatment (in increasing order of severity):

Loss of tooth enamel, worn teeth

Caused by excessive brushing or by teeth grinding. Your toothbrush should be soft, and brushing should be gentle. Here are detailed instructions on how to brush your teeth properly.

Emerging wisdom teeth (tooth eruption)

Emerging wisdom teeth usually happens in the teens. Tooth pain can come from teeth that are erupting ("cutting" or starting to grow). When a molar tooth erupts, the surrounding gum can become inflamed and swollen.

Tooth impaction

An impacted tooth is one that has failed to emerge into its normal position and remains under the gum, often misaligned. 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 or surgical removal. This most commonly occurs with impacted molar (wisdom) teeth in the teens and 20's.

Non-dental causes

Toothache may also be caused by problems not originating from a tooth or the jaw.

Disorders of the nerves in the tooth, even though there is nothing else wrong with the tooth.

Disorders of the nerves around the mouth or face. Trigeminal neuralgia, prosopalgia or Fothergill's disease is an intensely painful neuropathic disorder.

Referred pain caused by other diseases such as angina, a heart attack, ear infection or sinus infection.

Temporo-mandibular joint (TMJ) disorders

The TMJ hinges the lower jaw (mandible) to the skull. Disorders of the TMJ can cause pain around the ears or lower jaw. TMJ disorders can be caused by trauma, arthritis, or muscle fatigue from habitually clenching or grinding teeth (bruxism). Sometimes the TMJ muscles can go into spasm causing head and neck pain and difficulty opening the mouth normally. These muscle spasms can be aggravated by chewing or by stress. Temporary TMJ pain can also be caused by dental work or the trauma of extracting impacted wisdom teeth.

Treatment of TMJ disorders include warm moist compresses to relax the joint areas, stress reduction, and / or eating soft foods that do not require much chewing. If bruxism is involved, a night mouth guard may be worn during the night to protect the teeth (though it may not help with joint pain).

Teeth grinding (bruxism)

Teeth grinding or bruxism can cause toothache.

Remedies for toothache