A pain in or about a tooth.
A toothache is generally the result of tooth decay or sometimes
an infection. Tooth decay is often caused by poor dental hygiene,
although the tendency to get tooth decay is partly inherited.
Sometimes, pain in other locations is perceived as occurring in the teeth (this is called
referred pain or radiating pain).
Description of Toothache
A toothache may feel like a sharp pain or a dull ache. The tooth may be sensitive to
pressure, heat, cold, or sweets. In cases of severe pain, identifying the problem tooth is
often difficult. Any patient with a toothache should see a dentist at once for diagnosis
and treatment. Most toothaches get worse if not treated.
Causes & symptoms of Toothache
Toothaches may result from any of a number of causes:
- Tooth decay (dental caries)
- Inflammation of the tooth pulp (pulpitis)
- Gum disease, including periodontitis
- Loose or broken filling
- Cracked or impacted tooth
- Exposed tooth root
- Food wedged between teeth or trapped below the gum line
- Tooth nerve irritated by clenching or grinding of teeth (bruxism)
- Pressure from congested sinuses
- Traumatic injury.
Diagnosis of Toothache
Diagnosis includes identifying the location of the toothache, as well as the cause. The
dentist begins by asking the patient specific questions about the toothache, including the
types of foods that make the pain worse, whether the tooth is sensitive to temperature or
biting, and whether the pain is worse at night. The dentist then examines the patient's
mouth for signs of swelling, redness, and obvious tooth damage. The presence of pus
indicates an abscess or gum disease. The dentist may flush the sore area with warm water
to dislodge any food particles and to test for sensitivity to heat. The dentist may then
dry the area with gauze to determine sensitivity to touch and pressure. The dentist may
probe tooth crevices and the edges of fillings with a sharp instrument, looking for areas
of tooth decay. Finally, the dentist may take x rays, looking for evidence of decay
between teeth, a cracked or impacted tooth, or a disorder of the underlying bone.
Treatment of Toothache
Toothaches should always be professionally treated by a dentist. Some methods of
self-treatment, however, may help manage the pain until professional care is available:
- Rinsing with warm salt water
- Using dental floss to remove any food particles
- Taking aspirin or acetaminophen (Tylenol) to relieve pain. The drug should be
swallowed--never placed directly on the aching tooth or gum.
- Applying a cold compress against the outside of the cheek. Do not use heat,
because it will tend to spread infection.
- Using clove oil (Syzygium aromaticum) to numb the gums. The oil may be rubbed
directly on the sore area or used to soak a small piece of cotton and applied to the sore
Treatment will depend on the underlying 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. The dentist or a specialist called an endodontist removes the decayed
pulp, fills the space left behind with a soothing paste, and covers the tooth with a crown
to protect and seal it. If the damage cannot be treated by these methods, or if the tooth
is impacted, the tooth must be extracted.
Alternative treatment for Toothache
Toothaches caused by infection or tooth decay must be treated by a dentist. Several
alternative therapies may be helpful for pain relief until dental treatment is available.
Clove oil (Syzygium aromaticum) may be rubbed on sensitive gums to numb them or
added to a small cotton pellet that is then placed into or over a hole in the tooth. The
herb corydalis (Corydalis yanhusuo) may also help relieve toothache pain. Pain also
may be reduced using acupressure, acupuncture, or reiki. Acupuncture should only be done
by a licensed practitioner.
Prognosis of Toothache
Prompt dental treatment provides a positive outcome for toothache. In the absence of
active infection, fillings, root canal treatments, or extractions may be performed with
minimal discomfort to the patient. When a toothache is left untreated, a severe infection
may develop and spread to the sinuses or jawbone, and eventually cause blood poisoning.
Maintaining proper oral hygiene is the key to preventing toothaches. The best way to
prevent tooth decay is to brush at least twice a day, preferably after every meal and
snack. Flossing once a day also helps prevent gum disease by removing food particles and
bacteria at and below the gum line, as well as between teeth. People should visit their
dentist at least every six months for oral examinations and professional cleaning.