Tooth Pain - Causes, Symptoms, Treatment, and Prevention

Why Is My Tooth Paining?

A toothache can be unpleasant and frustrating and make it difficult to sleep at night. When it is severe, no amount of over-the-counter painkillers will help with the pain, unless the cause is treated. Tooth pain is often accompanied by sensitivity to cold, hot, or sweet, and chewing or biting can also be painful. When the nerve present in the inner part or surrounding the tooth gets irritated, it results in toothache or tooth pain. The most common dental causes of tooth pain include tooth decay, tooth infection, injury, or tooth fracture. Sometimes, pain radiates from other areas and mimics tooth pain, such as ear infection, sinus infection, and heart attack.

Tooth pain can be dull, throbbing, or sharp. Bacteria present inside the oral cavity can cause gum diseases and dental caries, resulting in a toothache. Most of the dental causes of tooth pain can be prevented by brushing, flossing, and maintaining good oral hygiene. Visit a dentist every six months and get your teeth cleaned. You can also talk to your dentist about getting pit and fissure sealants and fluoride treatment for your kids, as it can help prevent tooth decay.

What Are the Causes of Tooth Pain?

Dental Causes:

1. Tooth Sensitivity - Teeth with exposed nerves are prone to sensitivity. The tooth's outer protective layer (enamel) can wear off due to acidic food, teeth grinding, acid reflux, etc., which on exposure to extreme heat or cold, can cause sharp and sudden tooth pain.

2. Gum Recession - The pink tissue covering the bone and root of the tooth recedes, exposing the root. This makes the tooth vulnerable to infections and also makes the tooth more sensitive.

3. Tooth Decay (Caries) - Tooth decay or cavity is damage to the tooth's enamel, mostly by bacteria, resulting in a pit or hole. Tooth decay might not cause any symptoms in the early stages, but you might experience pain as the infection goes deeper.

4. Gingivitis and Periodontitis - Sometimes, your gums can get infected and inflamed, which is called gingivitis. Severe gum infection can affect the ligaments and other soft tissues that surround the tooth, causing periodontitis. It results in tooth pain while chewing and biting.

5. Tooth Fracture - Chipped teeth can cause tooth pain and sensitivity if the dentin or pulp gets exposed. Sometimes, tooth fracture causes pain, but it might be impossible to see it clinically. A dental X-ray can help diagnose such fractured teeth.

6. Bruxism or Teeth Grinding - Teeth grinding or clenching your jaws can wear down your teeth and result in sensitivity and pain. Excessive grinding force can also sometimes fracture the tooth.

7. Dental Abscess - The buildup of pus inside the teeth or gums is called a dental abscess. It results in pain while biting or touching the area. Your tooth might also be very sensitive to hot or cold.

8. Losing a Filling - Not getting a lost or broken filling replaced can make the tooth decay progress further and cause toothache.

9. Food Lodgement - Food getting stuck between teeth is called food lodgement. This can irritate the gums and result in pain and gum diseases. It also makes your tooth prone to caries.

10. Dental Treatments - You might have pain or sensitivity after a recent filling or other dental procedures involving drilling, as it temporarily makes the tooth's nerve endings more sensitive.

11. Teeth Bleaching - Bleaching strips or gels increase tooth sensitivity and can also cause pain. Pain and sensitivity are often temporary.

12. Malocclusion - Teeth misalignment problems can result in unbalanced distribution of force while biting or chewing, causing severe pain.

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13. Impacted Tooth - A tooth that does not have room to erupt in the oral cavity is called an impacted tooth. When an impacted tooth gets infected, or the gums get inflamed, it can cause pain.

14. Tooth Eruption - You might also experience pain when the tooth erupts into the oral cavity.

Non-Dental Causes:

1. Sinusitis (Sinus Infection) - When your sinuses get inflamed due to infection, they exert pressure on the upper teeth roots and jaw, resulting in tooth pain.

2. Cluster Headaches - Sometimes, pain from cluster headaches can radiate to the jaw and mimic tooth pain.

3. Heart Attack - Chest pain due to a heart attack more commonly also radiates to the jaw and tooth.

4. Viral Infection - Shingles, a viral infection caused by the varicella-zoster virus, can cause tooth pain.

5. Trigeminal Neuralgia - A chronic condition that affects the trigeminal nerve. This pain can radiate to the jaws, gums, and teeth.

6. Ear Infection - Ear pain due to middle ear infection can radiate to the jaws and teeth.

What Are the Symptoms Associated With Tooth Pain?

The following signs and symptoms can be seen along with tooth pain:

• Pain on chewing or biting.

• Teeth hypersensitivity to hot, cold, and sweet.

• Swelling of the gums and cheeks.

• Bleeding gums.

• Bad breath.

• Pus discharge from the gums.

Some patients might also experience:

• Ear pain.

• Headache.

• Fever.

• Jaw pain.

• Neck pain.

When to Consult a Dentist for Tooth Pain?

Make sure you consult a dentist if:

• The pain is present even after taking painkillers and trying home remedies.

• You have severe pain after an extraction, as it can be a sign of a dry socket, a condition where the blood clot gets dislodged from the extraction site, exposing the bone and causing severe pain.

• Your face or gums are swollen along with the discharge of pus around the tooth. These are signs of a dental abscess, which needs to be drained.

• Pain is accompanied by fever and chills.

• You also develop a facial rash.

In case you have chest pain, feel dizzy, have pain in the left arm, and jaw pain, go to the emergency room immediately, as these are signs of a heart attack.

How Does a Dentist Determine the Cause of Tooth Pain?

Your dentist will be able to determine the cause based on the physical examination and your symptoms. The dentist will also take a dental X-ray to determine the treatment plan and how severe the tooth damage is. Sometimes, you might also have to get an OPG (orthopantomogram), which is an X-ray that gives a panoramic view of your jaws and teeth.

What Are the Treatment Options for Tooth Pain?

Home Remedies:

These home remedies might help alleviate tooth pain until you can go to the dentist and treat it.

1. Saltwater rinse - Mix half a teaspoon of salt with a cup of warm water, and use it as a mouth rinse. Saltwater helps reduce inflammation and reduces pain.

2. Cold compresses - If your tooth is paining after a trauma, the best thing to do is to apply a cold compress. Wrap some ice cubes in a towel and apply it over the painful area for 20 minutes. This will constrict the blood vessels, reduce inflammation, and relieve pain.

3. Clove - Clove oil is an age-old remedy for toothache. Clove oil contains Eugenol, a natural antiseptic, and also numbs the area and reduces pain and inflammation.

4. Head elevation - You might notice that some types of tooth pain increase at night. This is because, when you sleep, blood pools in the head, resulting in more pressure and pain. In such cases, keeping your head a little elevated using pillows can reduce pain.

5. Hydrogen peroxide mouth rinse - 1:1 ratio of 3 % Hydrogen peroxide and water can be used as a mouth rinse. This will also relieve the pain and inflammation associated with gum diseases.

6. Peppermint tea - Peppermint is said to have antibacterial properties and can numb the affected area.

Medical Treatment:

Depending on the cause of tooth pain, your dentist might use the following treatment options:

1. Dental Restoration - For cavities or tooth fracture that involves the enamel and/or dentin, the dentist will fill the tooth with dental cement.

2. Extraction - If the tooth is beyond repair, the dentist will pull out the teeth.

3. Root Canal Treatment - For pulp infection or infection of the roots. A tooth abscess can also be drained with the help of a root canal treatment. The infected nerves and blood vessels are cleaned out, and the inside of the root is then filled with a biocompatible material.

4. Incision and Drainage - In case of swelling in the cheeks and neck, the doctor will drain the pus by making a couple or more incisions.

5. Oral antibiotics - Antibiotics are prescribed if you have a fever or swelling.

6. Analgesics - To relieve pain, the dentist might prescribe analgesics such as Paracetamol or Ibuprofen.

7. Mouthguards - If you have the habit of clenching your teeth at night, you will have to wear a mouthguard.

If the cause is not dental, then the dentist will refer you to an appropriate specialist.

How to Prevent Tooth Pain?

Most dental problems can be prevented by:

1. Brushing and cleaning your teeth properly to remove food particles, using a toothbrush with soft bristles and fluoride toothpaste. Make sure you brush twice a day.

2. Rinse your mouth with water every time you eat anything.

3. Floss at least once every day to prevent caries in between teeth.

4. Consume a healthy diet, and limit sticky and sweet food items.

5. Get fluoride varnish or pit and fissure sealants done for your kids.

6. Get your teeth cleaned by a dentist every six months.

7. Wear protective headgear and mouthguards while playing sports.

8. Quit smoking and smokeless tobacco usage.

For more information, consult a dentist online.