Dental pain

Why do I get toothache?

Toothache has many potential causes. Pain could be originating from the teeth themselves or any surrounding tissues such as the gums, the bone, the nerves or even pain originating from the skull referring to the area.

When it comes to pain, it is important to investigate the source. Your dentist should do various tests to determine where the problem lies. The character and duration of the pain indicates possible causes. The character of the pain also changes depending on how far along the infection is. Pain on biting usually means the muscles around the tooth are inflamed and/or the bone is infected, cracked tooth syndrome or a loose filling. Pain in response to hot food or drinks usually means the blood vessels and nerves inside the tooth are inflamed and could indicate irreversible pulp damage causing the need for root canal treatment. Toothache originating from the teeth themselves more often than not means there is a cavity. Cavities that are large enough require a root canal treatment or extraction of the tooth. Sensitivity is different from pain and is usually experienced during brushing or in response to cold or sugary foods and drinks. This means part of the tooth or root surface is exposed and needs to be covered by your dentist. If your gums are sore to touch or swollen it could mean that you have an abscess. This requires immediate attention.

Wisdom teeth tend to cause problems if they do not erupt properly. This happens when there is not enough space for them in the mouth. Your wisdom teeth should be out by age 21 years so it usually around the age of 17-21 years that they could start becoming a niggling problem. It could be that only the bottom wisdom teeth are affected or even just one side. Your dentist will be able to tell you if there is space for them by doing an x-ray that shows your whole mouth. Pain from wisdom teeth usually mean they are impacted (there is not enough space for them) and they will need to be removed in this case. It is, however, possible that the pain is just ‘teething pains’.

Pain following removal of a tooth can be due to damage of the nerve in the jaw or due to infection of the wound left behind. It is very important to take care of any wound in the body and the mouth is no different. If you are having a tooth removed, ensure your dentist explains the post-extraction care recommendations to you.

Referred pain is more difficult to pin-point and can take a long time and many tests to diagnose and treat. When you have toothache, an over-the-counter pain reliever such as ibuprofen or Panado can help ease discomfort but never put aspirin on the gums, as this will burn the gum tissue. Rinsing your mouth with warm salt water can ease gum swelling. A topical anaesthetic may also help the pain. At the end of the day, prevention is better than cure so keep those teeth clean (don’t forget to floss), visit your dentist twice a year for check-ups and don’t wait to seek help for pain.

References:

  • Fukuda K. Diagnosis and treatment of abnormal dental pain. J Dent Anesth Pain Med. 2016; 16(1):1-8
  • Renton. T. Dental (odontogenic) pain. Rev Pain. 2011; 5(1): 2-7

With thanks to Oral-B – Preventing Gum Diseases

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