Toothache can have various causes, from grinding your teeth at night, to tooth decay, a dental abscess or problems with your wisdom teeth. If your toothache is persistent and/or recurring, you should see a dentist as soon as possible. Following an assessment, your dentist will recommend a suitable treatment. If your pain is caused by a more serious condition, you may require a root canal treatment, wisdom tooth removal or bonding. The best way to prevent toothache is to maintain good oral hygiene, including brushing your teeth twice a day with fluoride toothpaste and having regular check-ups with your dentist.
Toothache or tooth pain is most often caused by the dental pulp, or the ligament surrounding a tooth, becoming inflamed. This causes pain in and around the teeth and jaw. Dental pulp is a delicate tissue in the centre of a tooth that contains sensitive nerves and blood vessels and it can become inflamed for several reasons.
Toothache can range from mild, occasional discomfort to a severe, constant throbbing and the pain can be made worse by eating or drinking. There are also a number of conditions that cause pain similar to toothache. The actual cause can be correctly identified by your dentist or GP.
If you have toothache for more than a couple of days, you should visit a dentist as soon as possible. Left untreated, inflamed dental pulp could become infected, which is likely to lead to a dental abscess and pain that will continue to worsen.
What could be the cause of my toothache?
Also known as dental decay or dental caries, this is the most common cause of toothache and is caused by a build-up of plaque. This plaque produces acid, which breaks down the outer layer of a tooth and can eventually enter and damage the pulp within.
Cracked tooth/broken fillings
Occasionally, a tooth could crack or fracture for reasons other than cavities, such as by biting down on something unexpectedly hard. These cracks can lead to damage to the dental pulp if not attended to.
The later stages of gum disease causes the gums to start to shrink away from the teeth. This process can eventually expose the softer, more sensitive parts of the tooth root. Excessive brushing can also cause the gums to recede, causing a pain like toothache.
A dental abscess is the result of a bacterial infection which causes a collection of pus, either within the dental pulp (periapical) or in between the tooth and the gum (periodontal).
Abscesses within the tooth can develop as a result of dental decay breaking down the protective layers of the tooth, allowing bacteria to enter the dental pulp, or if the nerve dies as the result of an accident or injury. Periodontal abscesses (around the tooth) often develop as a complication of gum disease, where bacteria can form in the pockets of gum that have come slightly detached from the tooth.
Abscesses can cause swelling of the gums, swelling of the face, a severe throbbing pain, teeth and gums that are tender to touch, a high temperature and generally feeling unwell.
If there is not enough room in your mouth, wisdom teeth may emerge from your gums at an angle or get stuck when they grow, resulting in what is know as impacted wisdom teeth (or third molars). There is often wisdom tooth pain, swelling and even infection, cysts and abscesses related to this condition. Normally it is a gum infection that causes the wisdom tooth pain. The pain radiates around the jaw making it feel like it is the ligament or bone around the wisdom tooth that hurts. Initial treatment for wisdom teeth is to irrigate and wash out the area with a disinfectant, with removal of the tooth being the last resort if the pain reoccurs every few months.
Sinusitis is a viral or bacterial infection that causes an inflammation of the lining of the sinuses. Symptoms include a blocked or runny nose, pain and tenderness in your face and a high temperature. Sinusitis can also cause bad breath and toothache. Studies have revealed that sinusitis is commonly linked to other dental problems, such as gum disease or generally poor oral health.
Temporomandibular joint (TMJ) dysfunction
This condition can be caused by the grinding of teeth, rheumatoid arthritis or gout and can result in tightness or spasms in your jaw muscles. Symptoms can include headaches, toothache, as well as difficulty opening your mouth or eating food.
Teeth grinding or clenching (bruxism)
If you grind your teeth, it can bruise the ligament around a tooth and the sensation can resemble toothache. Around 1 in 4 people are estimated to have problems with teeth grinding, and it is often caused by stress. In this case, a nocturnal bite guard can help. Resolving the underlying stress condition should also be a priority.
How can I treat my toothache?
Not all cases of toothache will require dental treatment, and it is important to get a proper assessment of its cause before you book a particular treatment. The most common treatments linked to toothache include:
Wisdom tooth removal
If your toothache is caused by an impacted wisdom tooth, you can have it removed. After a local anaesthetic injection to numb the area, an incision will be made into the gum in order to access the tooth to extract it. Sometimes a small piece of bone that covers the tooth may also need to be removed. The incision will be stitched up and should heal within 10 days. Upper wisdom teeth are usually much easier to remove than lower wisdom teeth and recovery can be as quick as 4 to 5 days.
If a tooth is infected and there is no chance of saving it with a root canal treatment, the tooth may need to be removed. A local anaesthetic will be injected into the gum by the tooth and the dentist will widen the tooth socket and rock the tooth side to side until it is loose enough to pull out. The open socket will then either be stitched up or be allowed to clot and heal.
Most people do not feel anything during the treatment but recovery can require anti-inflammatory medication to help with discomfort and pain.
Root canal treatment
The space within your tooth that houses the dental pulp, blood vessels and nerves is called the root canal. If an infection has led to an abscess or the nerves have died, you may need root canal treatment. This procedure requires drilling a hole in the crown of the tooth, removing the infected pulp and cleaning the area, then filling the canal and sealing the hole.
If a tooth has cracked allowing the root to be exposed, it is occasionally possible to repair the tooth with a composite bonding resin. This is a simple procedure, comparable to getting a filling or inlay/onlay.
How can I prevent toothache?
The most straightforward way to avoid toothache is to maintain good oral hygiene in order to keep your teeth and gums as healthy as possible. This means brushing your teeth twice a day with fluoride toothpaste, flossing between the teeth and moderating your intake of sugary foods and drinks. Smoking and excessive drinking can also lead to dental problems.
Ensure you visit your dentist as often as advised for a dental check-up so any signs of gum disease or tooth decay can the spotted and treated early and quickly.
This article was provided by Toothpick, the leading provider of online dentist appointments in the UK.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.