Toothache is one of the worst pains there is. Here is a complete guide to know why your tooth hurts and what to do about it. Toothache is generally divided in two large groups:
Pain that originates in a tooth
Pain that is conceived as tooth pain but actually originates from the tissues around the tooth, including the gums, the facial muscles and bones
Most common pain that originates from teeth are caused by:
• Cavities that have progressed deep into the tooth and caused an inflammation or infection in the tooth nerve (otherwise called dental pulp, which is in the center of the tooth) or underneath the tooth root in which case you may need a root canal treatment
•Tooth cracks or fractures close to or into the nerve. In this case, there may be need for a root canal treatment or extraction of the tooth.
•Tooth hypersensitivity due to frequent tooth grinding or clenching (can happen while sleeping). The use of a nightguard can help in these situations.
• Pain caused by external mechanical trauma (sports injuries, falls, etc) to the tooth. The trauma can damage the teeth and the surrounding tissues to a variable extent
• Hypersensitivity to temperature or sweet/acidic food due to loss of the outer layer of the tooth called enamel. This could be caused by too intense or too frequent brushing over time (abrasion), too frequent use of acidic beverages (erosion), wrong brushing technique, use of abrasive toothpastes (so-called whitening toothpastes) on a daily basis, frequent clenching and grinding which can lead to chipping of the enamel in the neck of surface of the teeth (could be happening in your sleep), and/or uncareful use of ultrasonic devices by your dental professional. Some toothpaste and use of fluoride rinses can be tremendously helpful with this kind of pain and discomfort. In more serious cases, the teeth can be repaired by fillings.
According to Dr. Maziar Shabestari, Ph.D., the first two in this list can cause intense paralyzing pain. In these cases, one should seek a dentist immediately. The pain can be spontaneous and lingering in nature. It can be aggravated by swings in temperature (cold or warm foods and beverages) or even by touch. This pain is caused by inflammation of the nerve (pulpitis) and usually requires a procedure called “root canal treatment” to resolve. Root canal treatment requires that the dentist drills a small opening into the inflamed nerve (after anesthetizing), and remove the nerve followed by sterile rinsing and disinfection. In emergency cases where an immediate visit to the dentist is no possibility, the patient is advised to take over-the-counter painkillers. A combination of acetaminophen and ibuprofen is very effective in relieving the pain temporarily before a permanent treatment and resolution. If pain-killers are out of reach, the patient can try to chew on the spice clove if it is available. The other three tend to cause milder pain, tenderness and/or discomfort. But nonetheless, the patient should visit the dentist to find out the cause of the pain or discomfort and the best treatment for it.
Most common pain that originates from other tissues but can be conceived as tooth pain:
• Pain coming from the gum or mucosa surrounding a trapped wisdom tooth which in some cases can cause difficulty opening the mouth or chewing. In these cases, the wisdom teeth should be removed to eliminate the issue once and for all. This pain can also be severe in which case, you should visit the dentist as soon as possible.
• Pain from sores on the inside of cheeks, corner of the mouth or on the tongue. Some sore have unknown causes and some are due to immunologic reactions to soap in the toothpaste or some food items. Some sores can be caused by viral infections.
• Pain in the upper teeth caused by inflammation of the sinuses.
• Pain in the chewing and facial muscles caused by frequent clenching of the jaws (can be during sleep) or some other kinds of muscular or soft tissue problems.
• Pain in the gum caused by a food particle stuck inside the gum or between the tooth and the gum. This type of pain is usually manifested as diffuse and non-localized discomfort, soreness or tenderness.
When you experience tooth pain, things might have gone too far
You may think that you don’t have any pain or issues with your teeth so all must be good. But teeth are not like other organs in your body. Generally, when you experience tooth pain, things have gone too far cause it’s very likely that you won’t feel anything up until things get bad. So, it is crucial for you with regular checkups to prevent problems and pain with your teeth.
