Toothache

Definition

"Toothache" usually refers to pain around the teeth or jaws. It is usually caused when a nerve in the root of a tooth becomes irritated. Generally a toothache happens if tooth decay penetrated the pulp chamber or is very close to it, which contains the nerves and tiny blood vessels.

Tooth decay is the primary cause of toothaches for most children and adults. Bacteria that live in your mouth thrive on the sugars and starches in the food you eat. These bacteria form a sticky plaque that clings to the surface of your teeth.

Causes

The most common cause of a toothache is a dental cavity. Actually dental cavities (caries) are holes in the two outer layers of a tooth called the enamel and the dentin.

The second most common cause of toothache is gum disease. Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. Gum disease is caused by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line.

And another cause of toothache occurs from inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain.

Symptoms

A toothache may be sharp, throbbing, shooting, or constant. If the tooth is not properly treated, it will eventually have to be extracted.

The pain can be dull, sharp, aching, burning, or throbbing. It may come and go, and may affect the whole mouth or only one part. Hot or cold foods and biting and chewing may increase the pain. Other possible symptoms include fever and swollen gums.

Treatment

Treatment will depend on the cause of the toothache. If the pain is due to tooth decay, the dentist will remove the decayed area and restore the tooth with a filling of silver amalgam or composite resin. Loose or broken fillings are removed, new decay cleaned out, and a new filling is placed. If the pulp of the tooth is damaged, root canal therapy is needed.

To reduce sensitivity to heat, cold, or brushing, consider using a toothpaste specifically designed for sensitive teeth. Brush with it regularly or rub a small amount of the paste on the sensitive area with your finger a 2 to 3 times a day. Floss gently between your teeth.

If the pulp of the tooth is infected you may need to have root canal treatment. Your dentist takes out the decayed pulp, fills the space with a paste, and covers the tooth with a crown to protect and seal it.

You should also try to avoid very hot or cold foods as they can make the pain worse.