Toothache / tooth pain
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 / decay.
- Tooth abscess / pulpitis.
- Root abscess.
- Gum disease - inflamed gums, receding gums, exposed tooth root.
- Fractured (cracked) tooth.
- Loss of tooth enamel, worn teeth.
- Emerging wisdom teeth (tooth eruption).
- Tooth impaction.
- Non-dental causes.
- Temporo-mandibular joint (TMJ) disorders.
- Teeth grinding (bruxism).
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.
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:
- Untreated tooth decay.
- Bacteria entering a tooth filling and multiplying.
- Cracked teeth.
- Extensive periodontal (gum) disease.
- Periodontitis (pyorrhea) - loss of bone and support structure surrounding the tooth.
- Failed root canal treatment (common on older root canals).
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):
- Drilling out the fracture then filling it with a bonding cement.
- Removing all the tooth except a stump, and covering the stump with a protective crown made of gold and/or porcelain.
- A root canal procedure.
- Removal of the tooth.
Loss of tooth enamel, worn teeth
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.
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.
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.
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
- Remedies contributed by visitors to GrowYouthful.com. Most of them are natural home remedies. Visitors describe their experience, and vote on the effectiveness of the remedy.
- *** By far, the most popular and successful natural remedy contributed by visitors is garlic. Mash up a clove, and place it on the tooth, abscess or painful area. At first it burns and stings. But within minutes it will relieve the pain, and many people say that within a day or two the pain, swelling and abscess has gone.
- Other natural home cures for toothache include salt, hydrogen peroxide, cloves and clove oil, and oil pulling.
- Here are detailed instructions on how to clean your teeth properly and prevent tooth decay. Improved oral hygiene will control the levels of bacteria and plaque, and raise the pH (alkalinity) in your mouth.
- World-wide list / directory of bio-compatible / holistic / mercury-free dentists.