A guide to toothache and how to deal with it

toothache picture
  • Cost: Treatment costs vary depending on the cause
  • Symptoms: Sharp or dull aches, sensitivty, headaches
  • Treatments: Root canal, pain killers, visit a dentist
  • Available: From dentists that offer emergency dental care

What is toothache?

Toothache is a painful condition in your jaw and facial area. It usually occurs when a nerve in the tooth root is inflamed or irritated. It could also occur because of tooth decay, infection or even tooth loss.

Types of toothache

Everybody doesn’t experience the same kind of toothache, and very often a toothache can be a sign of a much deeper condition. The severity of the toothache may also vary, in terms of the sensitivity of the tooth and the pain intensity. No matter what type of toothache you suffer from, you should get it evaluated by a dentist.

Sharp tooth pain or sensitivity
When your teeth become extremely sensitive to cold, causing a sharp pain when you eat or drink very cold items, it could be due to loss of tooth enamel. This deterioration of tooth enamel occurs because of excessive brushing, as a natural part of the aging process, recession of the gums or the deterioration of a tooth cavity. If your teeth are overly sensitive to heat, this could be because of dental cavities, abscesses or a severely decayed tooth.

Chronic toothache
A consistently aching tooth can be the result of nerve damage. The nerves of the tooth may get damaged because of severe dental decay or because of excessive grinding of the teeth. It could also occur because of any kind of injury or trauma to the tooth.

Excruciating pain
Intense, agonizing pain, including a throbbing sensation, is most often because of an abscess or dental infection. Very often, when the pain is this intense, there is also a noticeable swelling in the face.

Pain while eating
If you experience pain while eating, it could be either due to a crack in the tooth or dental decay.

Pain the in back of the jaw
If the pain is mainly concentrated in the back of the jaw, it could be due to impacted back molars. People, who have a habit of grinding their teeth or TMD can also experience jaw pain.

Serious health issues
A little known fact is that a toothache can often be a symptom of serious underlying health problems. Studies have shown that a pain on the left side of the jaw can be the first sign of a heart attack. Your toothache can also be a sign of sinus infection. Inflammation of the jaw, and pain while eating can be one of the earliest symptoms of a maxillofacial condition called temporomandibular joint disorder (TMD).

Symptoms of toothache

The symptoms of toothache can manifest themselves suddenly, and can range from simple discomfort in your tooth to high intensity pain. At one end, you could have a mild irritation, while on the other, you may experience intense pain in your jaw, head and ear. The pain may worsen when you eat or drink, especially if what you are consuming is very hot or cold. Toothache can quickly spread to the entire jaw area, making it tender and sensitive. You may notice that the pain worsens when you lie down, because of the increased pressure on the tooth.

Generally, you will notice:

  • Sensitivity to hot or cold foods and drinks.
  • Bleeding in the gums or around the tooth.
  • Swelling of the tissue around the tooth.
  • Swelling of the jaw.
  • Pain while eating.

Causes of toothache

  • Dental caries.
  • Tooth cavities.
  • Tiny tooth fracture.
  • Exposed root of the tooth – this can happen when the gums recede, exposing the root.
  • Sensitivity – this can also be caused by gum recession, which leaves the sensitive areas of the teeth exposed.
  • Dental treatment – sometimes after a dental treatment, the tooth pulp may become irritated, leading to pain.
  • A periodontal abscess in the gum.
  • Acute ulcerative gingivitis, which causes ulcers on the gums.
  • Sinusitis, which can lead to pain in the upper jaw.
  • Inflamed gums around a tooth that a just beginning to emerge, like a wisdom tooth.
  • Temporomandibular joint injury – this is the joint that connects the jaw to the skull.
  • Teething – when babies and children begin to sprout new teeth, this can cause toothache.

Diagnosis of toothache...isn't it obvious?

Even if the toothache you are suffering from is mild, you must get it checked by a dentist immediately. Very often, pain in a tooth has got nothing to do with that tooth. The pain could easily be in another tooth, or in some cases, the other jaw. Your dentist will conduct an examination of your teeth, and look for signs of any damage to the tooth or inflammation. He may also look for sensitivity to heat. If your dentist suspects dental decay, jaw bone injuries, or minute fractures in your teeth, he will take an X-ray before he can confirm these conditions.

Treatment for toothache

Fortunately, these days a toothache cure doesn’t have to involve the extraction of the tooth. Depending on the cause of your toothache, your dentist will use different methods to treat it:

Tooth decay
Dental decay resulting from poor dental hygiene practices and a faulty diet can lead to toothache. Treatment will involve removing the decayed portion of the tooth, and replacing it with a composite or amalgam filling. When a number of tooth surfaces are decayed, fillings may not be sufficient to treat the problem, and your dentist may suggest dental crowns as a solution.

Loose filling
If an earlier filling breaks or becomes loose, your dentist will remove the filling, clean out any decay that has been formed, and replace it with a new filling.

When your tooth pulp becomes infected, your dentist may suggest root canal treatment. This procedure can be performed by your dentist or an endodontist. He will remove the decayed pulp and fill the empty space with a paste. Then he will cover the tooth with a dental crown.

Gum recession
Receding of the gums away from the teeth can be reversed using a gum graft procedure. Your dentist will either graft tissue that has been removed from the palate, use synthetic gum tissue, or a sliding graft in which the root is covered by gum tissue from the neighboring areas.

Loss of enamel
Tooth enamel can be lost either due to an improper diet or aggressive brushing. Desensitizers can treat the sensitivity and sharp pain that results from the loss of tooth enamel.

Tooth sensitivity
Your dentist may apply desensitizers, which require frequent reapplication to treat sensitivity. He may also prescribe desensitizers to be used at home.

Your teeth can be exposed to all kinds of wear and tear in the form of minute chips and cracks, irregular teeth and loss of enamel. If there are uneven surfaces, your dentist may fill these with composite fillings. When there is extreme wear and tear, he may suggest dental crowns or veneers.

Infections can result in abscesses, and these are caused by dental decay or injury. Your dentist may prescribe a course of antibiotics and painkillers, and will suggest root canal treatment after the pain has subsided. The tooth that has become weak can be restored with a dental crown.

Teeth grinding
People who are in the habit of grinding teeth can experience tooth pain as a result of minute fractures, or even a shift in the position of the teeth. Your dentist may prescribe mouth guards to use while sleeping to protect your teeth.

Tooth fracture
Fractures in the tooth can result from abrasion, trauma or as a result of teeth grinding. A dentist will treat a fracture using a protective covering, like a dental veneer or crown.

Wisdom teeth
Impacted wisdom teeth (back molars that don’t surface) can result in crowding of the teeth, and can shift the other teeth. Your dentist may have to perform oral surgery, and remove the impacted wisdom teeth.

If these methods don’t help ease the pain, the tooth may have to be extracted. In cases where the tooth has become wedged between the jaw and another tooth, tooth extraction may be required.

First aid for toothache

To handle the pain while you wait to see the dentist, take paracetamol or ibuprofen. However, if you have a history of liver or kidney problems or peptic ulcers, or suffer from asthma, ibuprofen is not recommended for you. Also, avoid very hot and cold foods and drinks, because they worsen the problem.

Prevention is better than cure...

Toothache can easily be prevented by maintaining good dental hygiene practices.

  • Cut down the amount of sugar in your diet. Excessively sweet foods and drinks should be consumed only occasionally.
  • Follow a twice-a-day brushing routine, using a fluoride-containing toothpaste. Remember to brush your gums and tongue.
  • Use dental floss to clean between your teeth, and a mouthwash to rinse your mouth.
  • Avoid smoking
  • Get your teeth check regularly, and have them cleaned at least once a year by a dental hygienist.