Toothache

What Is a toothache?

A toothache occurs when there is pain in or around the tooth. Toothaches can happen for a variety of reasons including cavities, tooth decay, gum irritation, nerve pain, infection, poor dental hygiene, injury, or other medical conditions. Tooth pain can sometimes be treated at home, but often requires professional dental treatment.

If you are experiencing a fever and chills with your tooth pain, or the pain is severe and unbearable, this is considered a dental emergency. It is important to contact your dentist immediately, or go to the emergency room. Although rare, an infection in your mouth can spread to the brain or bloodstream.

Signs and Symptoms

There are different types of toothaches or tooth pain. Tooth pain can come in different frequencies or intensities, ranging from short bursts of pain, to waves of pain, to long-lasting intense pain that does not get better with medication.

Symptoms in or around the tooth may include:

  • An unrelenting dull ache
  • Sharp and jabbing sensation (especially when biting down or touching the tooth)
  • Throbbing sensation
  • Tooth or teeth sensitivity (hot or cold foods and drinks)
  • Irritated, inflamed, or bleeding gums
  • Swollen jaw
  • Headaches
  • Fever or chills
  • Bad breath

Causes

There can be several causes for a toothache. Some causes are more common than others.

Toothache causes can include:

  • Tooth decay. Also known as cavities, tooth decay is the most common cause of tooth pain. Tooth decay happens when the acid in plaque combines with bacteria from old food and saliva and wears the tooth down. Tooth decay can cause holes or cavities in the tooth. Additionally, certain medications may contribute to tooth decay.
  • Dental abscess. This happens when the tooth or the area around the tooth becomes infected and usually appears swollen and filled with pus.
  • Gingivitis. This occurs when inflammation from tarter and plaque buildup destroy the gums and other tissue in the mouth.

Other causes of tooth pain include:

  • A broken or cracked tooth
  • Damaged dental restoration (filling or crown)
  • Teeth grinding
  • Jaw or mouth injury
  • Issues with braces
  • Sinus infection
  • Earache
  • Referred pain

Referred pain is when pain from one part of the body results from injury to another part of the body.

Diagnosis

There are several ways to diagnose or determine the cause of tooth pain. A dentist will perform an oral examination, listen to your symptoms and medical and dental history, and will take X-rays of your mouth and teeth.

  • Oral examination. A dentist will check the affected tooth and area around the tooth and may also check areas of the neck and jaw.
  • Gathering information. A dental hygienist and dentist will collect information regarding your symptoms, including symptom duration, frequency, and intensity. They will also take a thorough medical and dental history.
  • X-rays. Imaging tests, like X-rays, allow the dentist to detect specific issues within structures of the mouth.

Treatment

Specific treatment will be determined based on the cause of your toothache. There are several different treatment options for tooth pain, which may include:

  • Toothache medications. Antibiotics and pain medicine can be prescribed to bring temporary relief from tooth pain. However, even if the antibiotic clears the infection, it will return until the underlying tooth issue is resolved.
  • Dental fillings. This procedure is recommended when tooth decay has caused a small cavity, or if a piece of the tooth has broken off. A dentist removes any damaged portion of the tooth and fills it with dental material.
  • Dental crowns. When there is a tooth fracture or the cavity is too large for a simple filling, a dentist may recommend placing a crown. A crown is a dental “cap” that provides more support to the damaged tooth and decreases the risk of further damage.
  • Inlays or onlays. This procedure is used when a fracture or cavity is too big for a filling, but not big enough for a crown. A dentist will insert a custom ceramic piece into the affected area like a puzzle piece.
  • Root canal. This procedure is used when the fracture, crack, or cavity has invaded the tooth pulp. The procedure will remove the inflamed nerves, blood vessels, and connective tissue from inside the tooth. Next, a dentist will clean all surfaces inside the tooth and fill the pulp chambers and root canal with filling material. Typically, a crown will also be placed on the tooth to help strengthen the tooth and prevent further damage.
  • Tooth extraction. If a tooth is damaged badly enough, your dentist may recommend a tooth extraction. This procedure consists of the dentist removing the damaged tooth from the socket and cleaning the area from any infection. Your dentist may discuss tooth replacement options with you, such as a dental bridge or implant.

Additionally, there are some home remedies that can temporarily alleviate mild tooth pain or help kill harmful bacteria.

Home treatments include:

  • Saltwater rinse. Salt is a natural disinfectant and rinsing with salt and warm water can help to reduce inflammation, decrease tooth pain, and heal wounds in the mouth.
  • Hydrogen peroxide rinse. This remedy can help to reduce pain, inflammation, and bleeding gums. It is important to dilute the hydrogen peroxide with equal parts water and remember to never swallow the hydrogen peroxide solution (swish and spit).
  • Ice packs. Applying ice packs to the affected area will help to reduce pain and inflammation by shrinking the blood vessels in the area.

Prevention

Not all tooth pain can be prevented, but there are ways to reduce your risk of developing a toothache.

Preventative measures:

  • Brush your teeth at least 2-3 times a day, using a soft-bristled toothbrush and toothpaste that includes fluoride
  • Floss at least once a day to help remove food from in-between your teeth
  • Use an antibacterial mouthwash twice a day
  • Regular dental exams (1-2 times a year)
  • Reduce or limit sugary foods and drinks
  • Talk to your dentist about sealants and fluoride treatments

Learn More about Toothaches

It is important to recognize and treat dental issues as they arise to prevent any further complications. If you are having tooth pain, contact your dentist for the best treatment outcomes and to prevent any further complications.

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