Tooth Pain Causes and Its Management

Tooth Pain or toothache is a pain that occurs around a tooth, teeth, or jaws. Most often it is caused due to a dental condition such as a tooth infection, dental decay that forms cavity, injury to tooth, cracked tooth, exposed tooth root, gum disease, or loss of tooth itself. Pain can also occur after tooth extraction. Pain can sometimes originate from other areas that radiates to the jaw, thus appearing like a tooth pain. Disorders of the jaw joint, sinuses, ear infections, or throat pain can also cause pain that is referred to the tooth and experience as toothache. Dental pain can also be caused by remote causes such as occasional heart problems like the pain of angina ie. deficient supply of oxygen to the heart. Nerve disorders like neuralgias and other nerve ailments also rarely cause tooth pain.

Dental Causes of Tooth Pain

Common dental causes of toothache include dental cavities, dental abscess, gum disease, irritation of the tooth root, cracked tooth syndrome, broken filling, temporomandibular joint (TMJ) disorders, impaction, and eruption.

1. The most common cause of toothache is dental caries. Dental caries cause dental cavities, which are holes in the two outer layers of a tooth such as the enamel and dentin. The bacteria in the mouth convert simple sugars into acid. The acid softens and dissolves the enamel and dentin, creating cavities. The pulp of the tooth can become irritated by bacterial toxins or by foods and liquids that are cold, hot, sour, or sweet, thereby causing toothaches.

2. Severe injury to the pulp can lead to the death of pulp tissue, resulting in tooth infection. A dental cavity or decay that has inflamed the pulp if left untreated will progress to an abscessed tooth. It creates pressure in the root portion of the tooth and produce swelling and blisters near the tooth.

3. Gum disease or periodontal disease refers to inflammation of the soft tissue, the gingiva and the abnormal loss of bone that surrounds which holds the teeth in place. Gum disease is caused by toxins secreted by the bacteria in the plaque and debris that accumulate over time along the gum line.  Gum disease can expose tooth roots making them more sensitive to hot and cold foods.

4. Cracked, split, or fractured teeth can cause inflammation of the pulp and the tissues around the tooth. Cracked tooth syndrome is a toothache that is caused by a broken tooth without any associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually caused by chewing candies, hard food substances such as a bone, fish bones etc. or accidental biting on objects such as pencils, nuts, falls etc.

Other Causes

1. Temporomandibular joint disorders can cause pain which usually occurs in or around the ears or lower jaw. The TMJ hinges the lower jaw to the skull, which is responsible for chewing or talking. TMJ disorders can be caused by different types of problems such as injury, arthritis, or jaw muscle fatigue from habitually clenching or grinding teeth.

2. Sinusitis, ear and throat infections may sometimes cause referred pain to the tooth.

Tooth Pain Symptoms

Toothache along with the jaw pain is the common complaint noticed. There may be severe pain to pressure, hot, or cold stimuli. The pain may persist for longer than 15 seconds after the stimulus is removed. As the area of inflammation increases, the pain becomes more severe. It may radiate to the cheek, the ear, or the jaw.

Pain with chewing

Hot or cold sensitivity

Bleeding or discharge from around a tooth or gums

Swelling around a tooth or swelling of the jaw

Injury or trauma to the area

Associated dental decay or gum disease

Toothache needs to be differentiated from other sources of pain in the face

Treatment for Tooth Pain

For toothaches

Over-the-counter pain medications such as acetaminophen or ibuprofen can be used. These are needed to be taken as directed on the package at a given schedule. Avoiding very cold or hot foods will moderate the pain. Temporary relief may be obtained from biting on a cotton ball soaked in the oil of cloves. A consultation with a dentist will be needed. Clearing away of decayed tissues and proper restoration of the tooth is recommended. Treatment of the gum and periodontal tissues may be necessary in certain cases. Extraction of the tooth may be necessary in irreversible damage to tooth and surrounding tissues.

For jaw pain

Aspirin may be helpful for problems of pain in the temporomandibular joint in adults. An appointment with a doctor or dentist will need to relieve the pain symptoms.