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Toothache!

Toothache is a painful condition in your jaw and facial area. It usually occurs when a nerve in the tooth root is inflamed or irritated. It could also occur because of tooth decay, infection or even tooth loss.

We don't all experience the same kind of toothache, and very often a toothache can be a sign of a much deeper condition. The severity of the toothache may also vary, in terms of the sensitivity of the tooth and the pain intensity. Regardless what type of toothache you suffer from, you should get it investigated.

Sharp tooth pain or sensitivity
When your teeth become extremely sensitive to cold, causing a sharp pain when you eat or drink very cold items, it could be due to loss of tooth enamel. This deterioration of tooth enamel occurs because of excessive brushing, as a natural part of the ageing process, recession of the gums or the deterioration of a tooth cavity. If your teeth are overly sensitive to heat, this could be because of dental cavities, abscesses or a severely decayed tooth.

Chronic toothache
A consistently aching tooth can be the result of nerve damage. The nerves of the tooth may get damaged because of severe dental decay or because of excessive grinding of the teeth. It could also occur because of any kind of injury or trauma to the tooth.

Excruciating pain
Intense, agonizing pain, including a throbbing sensation, is most often because of an abscess or dental infection. Very often, when the pain is this intense, there is also a noticeable swelling in the face.

Pain while eating
If you experience pain while eating, it could be either due to a crack in the tooth or dental decay.

Pain the in back of the jaw
If the pain is mainly concentrated in the back of the jaw, it could be due to impacted back molars. People, who have a habit of grinding their teeth or TMD can also experience jaw pain.

Serious health issues
A little known fact is that a toothache can often be a symptom of serious underlying health problems. Studies have shown that a pain on the left side of the jaw can be the first sign of a heart attack. Your toothache can also be a sign of sinus infection. Inflammation of the jaw, and pain while eating can be one of the earliest symptoms of a maxillofacial condition called temporomandibular joint disorder (TMD).

Pain from extraction site

Dry socket is a condition characterized by severe pain after a tooth extraction. The pain generally begins a day or two following the extraction and can last for one to several weeks. It occurs when the blood clot that protects the tooth socket  either does not form normally or is dislodged, leaving the bony socket open and exposed. Dry socket is more likely to occur following the extraction of teeth on the lower jaw than the upper jaw and is most common after wisdom teeth are extracted. Dry socket occurs most commonly in people with diabetes, people who smoke and women, especially those taking oral contraceptives.

The severe pain of dry socket typically radiates out from the site of extraction and cannot be relieved by over-the-counter painkillers. If the extracted tooth was on the lower jaw, there is usually additional pain around the ear on the side of the extraction. Dry socket may also cause bad breath, a bad taste in the mouth and spasms in the jaw muscles.


  • the most common cause of a toothache is a dental cavity

  • the second most common cause of toothache is gum disease.

  • a toothache can be caused by a problem that does not originate from a tooth or the jaw!


Symptoms of toothache

The symptoms of toothache can come on suddenly, and can range from simple discomfort in your tooth to high intensity pain. At one end, you could have a mild irritation, while on the other, you may experience intense pain in your jaw, head and ear. The pain may worsen when you eat or drink, especially if what you are consuming is very hot or cold. Toothache can quickly spread to the entire jaw area, making it tender and sensitive. You may notice that the pain worsens when you lie down, because of the increased pressure on the tooth.

Generally, you will notice:

  • Sensitivity to hot or cold foods and drinks.

  • Bleeding in the gums or around the tooth.

  • Swelling of the tissue around the tooth.

  • Swelling of the jaw.

  • Pain while eating.

Causes of toothache

  • Dental caries

  • Tooth cavities.

  • Tiny tooth fracture.

  • Sensitivity – this can also be caused by gum recession, which leaves the sensitive areas of the teeth exposed.

  • Dental treatment – sometimes after a dental treatment, the tooth pulp may become irritated, leading to pain.

  • A periodontal abscess in the gum.

  • Acute ulcerative gingivitis, which causes ulcers on the gums.

  • Sinusitis, which can lead to pain in the upper jaw.

  • Inflamed gums around a tooth that a just beginning to emerge, like a wisdom tooth.

  • Temporomandibular joint injury – this is the joint that connects the jaw to the skull.

  • Teething – when babies and children begin to sprout new teeth, this can cause toothache.

  • Dry Socket - when a socket doesn't heal as it should after an extraction.

Treatment for toothache

Fortunately, these days a toothache cure doesn’t have to involve the extraction of the tooth. Depending on the cause of your toothache, we will use different methods to treat it:

Tooth decay
Dental decay resulting from inadequate dental hygiene and a poor diet can lead to toothache. Treatment will involve removing the decayed portion of the tooth, and replacing it with a composite or amalgam filling. When a number of tooth surfaces are decayed, fillings may not be sufficient to treat the problem, and we may suggest dental crowns as a solution.

Loose filling
If an earlier filling breaks or becomes loose, we will remove the filling, clean out any decay that has been formed, and replace it with a new filling.

Pulpitis
When your tooth pulp becomes infected, we may suggest root canal treatment. We will remove the decayed pulp and fill the empty space with a paste. We may then advise that we cover the tooth with a dental crown.

Gum recession
Receding of the gums away from the teeth can be reversed using a gum graft procedure. It is possible to graft tissue that has been removed from the palate, use synthetic gum tissue, or a sliding graft in which the root is covered by gum tissue from the neighboring areas. We would refer you to a periodontal specialist for these delicate procedures.

Loss of enamel
Tooth enamel can be lost either due to an improper diet or aggressive brushing. Desensitizers can treat the sensitivity and sharp pain that results from the loss of tooth enamel.

Abrasion
Your teeth can be exposed to all kinds of wear and tear in the form of minute chips and cracks, irregular teeth and loss of enamel. If there are uneven surfaces, we may fill these with composite fillings. When there is extreme wear and tear, we may suggest dental crowns or veneers.

Infections
Infections can result in abscesses, and these are caused by dental decay or injury. We may prescribe a course of antibiotics, and will suggest root canal treatment after the pain has subsided. The tooth that has become weak can be restored with a dental crown.

Teeth grinding
People who are in the habit of grinding teeth can experience tooth pain as a result of minute fractures, or even a shift in the position of the teeth. We may prescribe mouth guards to use while sleeping to protect your teeth.

Tooth fracture
Fractures in the tooth can result from abrasion, trauma or as a result of teeth grinding. We will treat a fracture using a protective covering, like a dental veneer or crown.

Wisdom teeth
Impacted wisdom teeth cause intense pain, trismus (unable to open your mouth) and fever - the classic pericoronitis. We would prescribe specific antibiotics and advise using a warm, salty water mouthrinse (teaspoon of table salt stirred into a tumbler of warm water).

Dry socket 

Treatment of dry socket is generally very effective in reducing the pain while the tooth socket heals. We rinse the affected tooth socket to remove any debris. Then, a medicated dressing containing analgesics and antiseptics is lightly packed into the open socket. This helps to relieve pain, prevent bacterial or fungal infection or other forms of irritation, and prevent food particles from building up in the socket. The dressing will be replaced daily or more frequently if necessary.

 

logo Top Tips:

To handle the pain while you wait to see the dentist, take paracetamol or ibuprofen. However, if you have a history of liver or kidney problems or peptic ulcers, or suffer from asthma, ibuprofen is not recommended for you. Also, avoid very hot and cold foods and drinks, because they worsen the problem.