Suffering from a painful toothache and wondering what to do about it? Treatment for a toothache depends on the cause, and there are several possible culprits that could be causing your pain. A toothache is a pain in or around a tooth that may be caused by tooth decay, an abscessed tooth, a tooth fracture, a damaged filling, grinding teeth or infected gums.
Your toothache pain might be sharp, throbbing, constant, or felt when pressure is applied to the tooth. And, you might also be experiencing one or more of these additional symptoms:
- Swelling around the tooth
- Fever or headache
- Foul-tasting drainage from the infected tooth
Most toothaches are caused by tooth decay, which is the destruction of the tooth structure. Tooth decay can affect both the enamel (the outer coating of the tooth) and the dentin (the inner layer of the tooth). Tooth decay occurs when bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating cavities. In advanced stages of tooth decay, you might experience a toothache, especially after consuming sweet, hot, or cold foods or beverages. Other signs of tooth decay are visible pits or holes in the teeth. Your dentist can discover cavities during your regular dental check-up.
Your toothache could also be caused by an abscessed tooth. This is a painful infection at the root of a tooth or between the gum and a tooth. It is most commonly caused by severe tooth decay. Other causes of tooth abscess are trauma to the tooth, such as when it is broken or chipped, and gingivitis or gum disease. These problems can cause openings in the tooth enamel, which allows bacteria to infect the center of the tooth (called the pulp). The infection may also spread from the root of the tooth to the bones supporting the tooth. A toothache that is severe and continuous and results in gnawing or throbbing pain or sharp or shooting pain are common symptoms of an abscessed tooth. Other symptoms may include fever, pain when chewing, foul smell or taste, swollen neck glands or gums. Even if the toothache stops (because the root of the tooth died as a result of the infection), the infection is still active and will continue to spread and destroy tissue. Therefore, if you experience any of the above listed symptoms, it is important to see a dentist even if the pain subsides.
If you have experienced trauma to your tooth or teeth, you know what is causing your toothache. However, if the tooth associated with the pain is very loose, almost falling out, chipped, fractured, or knocked-out, you have a dental emergency and should try to see your dentist within the next couple of hours. To save the tooth, it must be put back in its socket as soon as possible (2 hours is the usual limit for tooth survival). You can do this yourself while you wait to see the dentist by following these guidelines:
- Rinse off the tooth with saliva or water. Do not scrub the tooth.
- Replace it in the socket facing the correct way.
- Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
- Bite down on a wad of cloth to stabilize the tooth until you can be seen by a dentist.
If you are not able to put the tooth back in its socket, it is very important to keep the tooth moist. Do not let it dry out. You can place the tooth in saliva or milk, or use a “save a tooth” kit.
Older fillings can become damaged and cause a toothache. This is because a damaged filling can allow decay to form within and around the tooth. If the filling is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.
Repetitive Motions (Grinding)
Most people probably grind and clench their teeth from time to time. Occasional teeth grinding does not usually cause harm, but when teeth grinding occurs on a regular basis the teeth can be damaged, causing toothaches and other oral health complications. Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache, toothache or sore jaw can be telltale symptoms of teeth grinding. If you suspect you may be grinding your teeth, talk to your dentist. He or she can examine your mouth and jaw for signs of grinding, such as jaw tenderness and abnormalities in your teeth.
Infected gums not only cause toothaches, but often lead to tooth loss. Most infected gums start out as gingivitis, also generally called gum disease or periodontal disease. In the early stage of gingivitis, bacteria and plaque build up, causing the gums to become inflamed and to easily bleed during tooth brushing. When gingivitis is left untreated, it can advance to periodontitis, during which the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults. Only a dentist or a periodontist can recognize and determine the progression of gum disease.
When to Visit Your Dentist About Your Toothache
It’s important to get treatment for your toothache, especially if it persists or is accompanied by other symptoms. See your dentist as soon as possible about your toothache if:
- You have a toothache that lasts longer than 1 or 2 days
- Your toothache is severe
- You have a fever, earache, or pain upon opening your mouth wide
Since most toothaches are the result of tooth decay, following good oral hygiene practices can prevent toothaches. Good oral hygiene practices consist of brushing regularly with a fluoride-containing toothpaste, flossing once daily, and seeing your dentist twice a year for professional cleaning. In addition to these practices, eat foods low in sugar and ask your dentist about sealants and fluoride applications.