What are the common causes of tooth pain. How can you identify different types of tooth pain. What are effective treatments for toothaches. When should you seek professional dental care for tooth pain. What home remedies can provide relief from tooth discomfort.

Understanding the Root Causes of Tooth Pain

Tooth pain can be a debilitating experience, often interfering with daily activities and quality of life. But what exactly causes this discomfort? Let’s delve into the primary culprits behind tooth pain:

• Dental decay (cavities)
• Gum disease
• Tooth fractures or cracks
• Exposed tooth roots
• Infected pulp (pulpitis)
• Dental abscesses
• Teeth grinding (bruxism)
• Impacted wisdom teeth

Dental decay, often referred to as cavities, is one of the most common causes of tooth pain. When bacteria in the mouth produce acid that erodes tooth enamel, it can lead to small holes in the teeth. As these cavities progress, they can reach the sensitive inner layers of the tooth, resulting in pain and discomfort.

Gum disease, another frequent culprit, occurs when bacteria accumulate along the gum line, causing inflammation and potentially leading to tooth sensitivity and pain. In advanced stages, gum disease can even result in tooth loss.

Tooth fractures or cracks, often caused by trauma or biting down on hard objects, can expose the sensitive inner layers of the tooth, leading to pain when pressure is applied or when consuming hot or cold foods and beverages.

The Role of Tooth Sensitivity in Dental Pain

Tooth sensitivity is a common issue that can cause significant discomfort. But what causes teeth to become sensitive? Exposed tooth roots, often a result of receding gums or aggressive brushing, can lead to heightened sensitivity to temperature changes and sweet or acidic foods. This occurs because the root surface lacks the protective enamel layer found on the crown of the tooth.

In some cases, recent dental procedures such as fillings, cleanings, or whitening treatments can temporarily increase tooth sensitivity. While this typically subsides within a few weeks, persistent sensitivity may indicate a more serious underlying issue.

Recognizing the Symptoms of Tooth Pain

Identifying the specific symptoms of tooth pain can help determine the underlying cause and appropriate treatment. Common symptoms include:

• Sharp, throbbing pain
• Sensitivity to hot or cold temperatures
• Pain when biting or chewing
• Swelling around the affected tooth
• Persistent bad breath or taste
• Fever (in cases of infection)

How can you differentiate between various types of tooth pain? Sharp, sudden pain often indicates a cavity or cracked tooth, while a dull, constant ache might suggest an infection or abscess. Pain that lingers after exposure to hot or cold stimuli may indicate pulp inflammation or damage.

When Tooth Pain Signals a Dental Emergency

While some tooth pain can be managed at home, certain symptoms warrant immediate professional attention. Seek emergency dental care if you experience:

• Severe, unrelenting pain
• Significant swelling of the face or jaw
• Difficulty breathing or swallowing
• Signs of infection, such as fever or pus discharge

These symptoms could indicate a severe infection or abscess, which can spread to other parts of the body if left untreated. Prompt intervention is crucial in these cases to prevent potentially life-threatening complications.

Diagnosing the Source of Tooth Pain

Accurate diagnosis is crucial for effective treatment of tooth pain. Dental professionals employ various methods to identify the root cause of discomfort:

1. Visual examination
2. Dental X-rays
3. Percussion tests
4. Thermal tests
5. Bite tests

During a visual examination, the dentist will look for signs of decay, damage, or infection. Dental X-rays provide a more detailed view of the tooth structure and surrounding bone, revealing hidden issues such as abscesses or impacted teeth.

Percussion tests involve tapping on the tooth to assess sensitivity, while thermal tests use hot or cold stimuli to evaluate pulp health. Bite tests help identify problems related to cracked teeth or misaligned bites.

The Importance of Early Detection

Why is early detection of dental issues crucial? Addressing tooth pain promptly can prevent minor problems from escalating into more severe conditions. Early intervention often results in less invasive treatments, reduced costs, and better long-term oral health outcomes.

Effective Treatment Options for Tooth Pain

Once the cause of tooth pain is identified, various treatment options are available depending on the severity and nature of the problem:

• Dental fillings for cavities
• Root canal therapy for infected pulp
• Dental crowns for damaged teeth
• Gum treatments for periodontal disease
• Extractions for severely damaged or impacted teeth
• Antibiotics for bacterial infections

For minor cavities, dental fillings can effectively restore the tooth and alleviate pain. In cases of severe decay or infection reaching the pulp, root canal therapy may be necessary to remove the infected tissue and save the tooth.

Dental crowns provide protection for teeth that have been significantly damaged or weakened, while gum treatments address issues related to periodontal disease. In some cases, extraction may be the best option, particularly for impacted wisdom teeth or teeth that are beyond repair.

The Role of Antibiotics in Dental Treatment

When are antibiotics prescribed for tooth pain? Dentists may recommend antibiotics in cases of severe infection, particularly if there are signs of systemic involvement such as fever or swelling. However, it’s important to note that antibiotics alone are not a cure for dental problems and should be used in conjunction with appropriate dental treatments.

Home Remedies for Temporary Tooth Pain Relief

While professional treatment is often necessary for long-term resolution of tooth pain, several home remedies can provide temporary relief:

• Over-the-counter pain relievers (e.g., ibuprofen, acetaminophen)
• Salt water rinses
• Cold compresses
• Clove oil application
• Peppermint tea bags
• Garlic paste

How effective are these home remedies? While they can provide temporary relief, it’s important to remember that they do not address the underlying cause of tooth pain. These methods should be used as a stopgap measure until professional dental care can be obtained.

The Benefits of Salt Water Rinses

Why are salt water rinses often recommended for tooth pain? Salt water has natural antibacterial properties and can help reduce inflammation in the mouth. To create a salt water rinse, dissolve half a teaspoon of salt in a cup of warm water and gently swish it around your mouth for about 30 seconds before spitting it out.

Preventing Tooth Pain Through Proper Oral Hygiene

Prevention is always better than cure when it comes to dental health. Maintaining good oral hygiene habits can significantly reduce the risk of tooth pain and other dental problems:

• Brush teeth twice daily with fluoride toothpaste
• Floss at least once a day
• Use an antiseptic mouthwash
• Limit sugary and acidic foods
• Avoid tobacco products
• Schedule regular dental check-ups and cleanings

How often should you replace your toothbrush? Dentists recommend replacing your toothbrush or electric toothbrush head every three to four months, or sooner if the bristles become frayed. Using a worn-out toothbrush can be less effective at removing plaque and may even damage your gums.

The Impact of Diet on Dental Health

What role does diet play in preventing tooth pain? A balanced diet rich in vitamins and minerals, particularly calcium and vitamin D, is essential for maintaining strong teeth and healthy gums. Limiting sugary and acidic foods can help prevent tooth decay, while crunchy fruits and vegetables can help clean teeth naturally.

Understanding the Link Between Oral Health and Overall Well-being

The connection between oral health and general health is becoming increasingly recognized in the medical community. Poor oral health has been linked to various systemic conditions, including:

• Cardiovascular disease
• Diabetes
• Respiratory infections
• Pregnancy complications
• Alzheimer’s disease

How does oral health impact these conditions? The mouth serves as a gateway to the body, and bacteria from dental infections can enter the bloodstream, potentially affecting other organs and systems. Additionally, chronic inflammation associated with gum disease may contribute to the development or progression of certain systemic diseases.

The Importance of Regular Dental Check-ups

Why are regular dental check-ups crucial for overall health? Routine dental examinations allow for early detection and treatment of oral health issues before they become more serious. These visits also provide an opportunity for professional cleaning, which can remove tartar buildup that regular brushing and flossing can’t eliminate.

During check-ups, dentists can also screen for oral cancer and other potentially serious conditions. Early detection of these issues can significantly improve treatment outcomes and overall prognosis.

Addressing Dental Anxiety and Fear

Dental anxiety is a common issue that can prevent individuals from seeking necessary dental care. However, modern dentistry offers various solutions to help patients overcome their fears:

• Sedation dentistry options
• Pain-free injection techniques
• Relaxation techniques and mindfulness
• Clear communication with the dental team
• Gradual exposure therapy

How can sedation dentistry help anxious patients? Sedation dentistry uses medication to help patients relax during dental procedures. Options range from mild sedatives that leave you awake but relaxed to general anesthesia for more complex procedures or severe anxiety cases.

The Role of Technology in Modern Dentistry

How has technology improved the dental experience? Advancements in dental technology have led to more comfortable and efficient treatments. Digital X-rays reduce radiation exposure, while laser dentistry can provide more precise and less invasive treatments for certain procedures. These innovations not only improve patient comfort but also contribute to better treatment outcomes.

In conclusion, understanding the causes, symptoms, and treatment options for tooth pain is crucial for maintaining optimal oral health. By practicing good oral hygiene, seeking prompt professional care when needed, and addressing dental anxiety, individuals can significantly reduce their risk of tooth pain and related complications. Remember, a healthy smile is not just about aesthetics – it’s an essential component of overall well-being.

Causes, Symptoms, Diagnosis, Treatment, Remedies

Written by WebMD Editorial Contributors

Medically Reviewed by Robert Brennan on March 22, 2023

• Why Does My Tooth Hurt?
• Toothache Causes
• Could It Be Sensitive Teeth?
• Could It Be a Damaged Tooth?
• Do You Grind Your Teeth?
• Could It Be Your Wisdom Teeth?
• Could the Problem Be Outside Your Mouth?
• Toothache Symptoms
• When to Seek Medical Care for a Toothache
• Exams and Tests for Toothaches
• Treating a Toothache at Home
• Medical Treatment for Toothaches
• Toothache Treatment Follow-Up
• Toothache Prevention
• Outlook for Toothaches
• More

Whether it’s sharp and sudden or dull and constant, tooth pain is hard to ignore. A toothache or tooth pain is caused when the nerve in the root of a tooth or surrounding a tooth is irritated. Dental (tooth) infection, decay, injury, or loss of a tooth are the most common causes of dental pain. Pain may also occur after an extraction (when a tooth is pulled out). Pain sometimes comes from other areas and goes to the jaw, thus appearing to be tooth pain. The most common areas include the jaw joint (temporomandibular joint, or TMJ), ear, sinuses, and even occasionally from heart problems.

Bacteria growing inside your mouth can contribute to gum disease and dental decay, both of which can cause pain. Often, gum disease will not result in any pain.

You can prevent most dental problems by flossing, brushing with fluoride toothpaste, and having your teeth professionally cleaned twice a year. The dentist may apply sealants and fluoride, which are especially important for children’s teeth.

Toothache occurs from inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain. Inflammation of the pulp, or pulpitis, may be caused by dental cavities, trauma, and infection. Referred pain from the jaw may cause you to have symptoms of a toothache. The first step toward relief is to find out what’s wrong.

If your teeth are healthy, a hard outer layer of enamel covers them to protect the nerves inside. The enamel can wear away over time. When the middle layer of your tooth is exposed, anything you eat or drink can reach your nerve endings. 

Gum disease can make your teeth sensitive. Your gums shrink away from your teeth, and that exposes the roots. You also can damage your gums if you brush too hard.

A recent cleaning or a new filling may make you sensitive for a few weeks. Many people feel it after whitening treatments. An old filling that’s loose or damaged can cause it, too.

Your teeth come under attack every time you eat. Bacteria cling to them until you brush them away. They produce acid, which makes the holes in your enamel called cavities.

Or you could have a crack in a tooth that’s exposed the sensitive inner layers. Maybe you bit down on a cherry pit or were hit in the face during softball.

A cavity or a crack can cause sharp pain and make your mouth sensitive when you bite down. The longer the pain lingers, the more serious the damage is likely to be.

If it’s deep enough, a cavity or crack can let bacteria into the inner layer, called pulp, of your tooth. The pulp can become infected, and that can lead to a buildup of pus called an abscess. The infection can spread to tissue and bone, too. 

This is a common problem brought on by stress, sleep disorders, or a bite issue. If you grind your teeth while you sleep, it can wear away your enamel and even cause a crack. 

Teething hurts whether you’re a baby or an adult. You’re likely to feel it when your wisdom teeth start to push through your gums. Food can get stuck under the gum and cause decay and infection.

Your teeth may hurt because of an issue somewhere else in your body. That’s called referred pain. It can come from:

• Certain kinds of headaches, like cluster and migraine
• Clogged or infected sinuses
• Problems in the joint or muscles that connect your jaw to your skull

In rare cases, a heart attack can cause tooth pain. It’s also a symptom of certain nerve diseases.

Toothache and jaw pain are common complaints. There may be severe pain from pressure, or from hot or cold stimuli. The pain may last for longer than 15 seconds after the stimulus is removed. As the area of inflammation increases, the pain becomes more severe. It may spread to the cheek, the ear, or the jaw. Other signs and symptoms that may lead you to seek care include the following:

• Pain with chewing in your teeth or jaw 
• Headaches
• Your teeth are sensitive to heat or cold. You’ll feel a couple of seconds of pain when something hot or cold hits them. Sweet or acidic foods may bother you, too.
• Bleeding or discharge from around a tooth or gums
• Swelling around a tooth or swelling of your jaw
• Injury or trauma to the area
• Bad breath
• Fever
• Bad taste in your mouth
• Swollen glands

These signs and symptoms may sometimes be linked to dental decay, tooth fracture, or gum disease (periodontal disease). Dental decay or an area of redness around the tooth’s gum line may point to the source of pain. If you tap an infected tooth, it may make the pain more intense. This sign may point to the problem tooth even if the tooth appears normal.

Don’t put off a trip to the dentist if your teeth hurt. Cavities and cracks get worse over time. You should call your doctor or dentist about a toothache when:

• Pain is not relieved by over-the-counter drugs
• You have  severe pain after a tooth is pulled; this may occur on the second or third day after tooth extraction. This is a result of the clot falling out and bone exposed until a new clot can cover the exposed bone. The condition is known as alveolar osteitis or “dry socket syndrome.” If you develop this condition, you should see a dentist within 24 hours.
• Pain is linked to swelling of the gums or face, or you have discharge around a tooth; fever is an important sign of infection in dental disease. Simple dental decay (caries) does not cause fever. These signs may mean there’s an infection surrounding the tooth, the gum, or the jawbone (mandible). Fever and swelling may be signs of an abscess. Dental abscesses may require antibiotics and surgical opening (drainage) of the abscess. When this procedure is recommended to be done inside the tooth (endodontic drainage), “root canal” therapy is performed.
• Broken or knocked out teeth occur from an injury; unless associated with more severe injuries, your dentist should be contacted as soon as possible. Swallowed teeth and permanent tooth loss are considered dental emergencies. Tooth loss due to injury (traumatic loss) is treated differently in children who have lost their primary teeth than in older children and adults with injury to their secondary – or permanent – teeth. If a child’s permanent (adult) tooth is fully knocked out, try to gently rinse it off and re-implant it as soon as possible and seek dental care. If you are not able to get it back in, put it in a small amount of milk or even water and seek dental care.
• Pain is present at the angle of your jaw; if every time you open your mouth widely you have pain, it is likely that the TMJ has been injured or inflamed. This can occur from an injury or just by trying to eat something that is too big. Your dentist may be able to suggest solutions to this problem.
• Wisdom teeth are causing pain; as wisdom teeth (third molars) are coming into the mouth – or erupting – they cause inflammation of the gum around the visible portion of the crown. The gum overlying the crown may become infected. The tooth most commonly involved is the lower third molar. The pain may extend to the jaw and ear. There may be swelling in the affected area so that the jaw cannot be closed properly. In severe cases, pain in the throat and the floor of the mouth may make it difficult to swallow.

Any history of trauma, chest pain, heart disease, or rashes may suggest causes of pain other than of purely dental origin. These symptoms with toothache or jaw pain mean that you should visit your doctor or a hospital’s emergency department.

• High fever or chills: This may indicate a more widespread infection that might require more than antibiotics by mouth.
• Recent head or face injury: If you have a headache, lightheadedness, nausea, vomiting, or other symptoms that concern you after an injury to your face or mouth, you may have a more serious injury in addition to your dental injury.
• A facial rash linked to a toothache: This condition may improve with medication. The doctor should be able to decide what is appropriate.
• Any jaw pain that comes with chest pain: Although jaw pain is most commonly caused by dental disease, it is sometimes referred pain from other areas. People with heart disease, especially people who have had stents placed, people with diabetes, or those who have had heart surgery, may have jaw pain as a symptom of a heart attack or angina. If your jaw or tooth pain is comes with lightheadedness, sweating, or shortness of breath, you should see a doctor.
• Trouble swallowing or excessive pain or bleeding from gums: If you have a history of a weakened immune system, diabetes, or steroid use, you may be more likely to get infections. Infections can often be more severe and extensive or caused by unusual organisms. Dental and gum infections in people with these conditions may require more aggressive treatment. An abscess may need draining or IV antibiotics, for example.

A thorough medical history and oral exam usually lead to the right diagnosis.

Sometimes, X-rays called periapical and Panorex views (panoramic X-rays of the teeth and jaw) are taken. Rarely, lab evaluation, including EKG tracings of the heart, will assist the doctor. If the cause is something other than a dental or jaw problem, the doctor may prescribe drugs directed at the problem. If the condition is more severe, the doctor may admit you to the hospital for further care. You may be referred to a dentist for further treatment.

For toothaches:

• Over-the-counter pain medications such as acetaminophen or ibuprofen may be used. Take these as directed on the package while you arrange a dental appointment.
• Avoid very cold or hot foods, because they may make the pain worse.
• You may get relief from biting on a cotton ball soaked in oil of cloves. You can get oil of cloves at most drugstores.
• Special toothpastes can make your teeth less sensitive. And you can reverse early gum disease when you brush and floss correctly.

For jaw pain:

•  Aspirin may be helpful for problems in the joint of the jaw in adults.
•  Acetaminophen (not aspirin) should be used for children and teenagers.
• If pain happens every time you open your mouth widely, the temporomandibular joint (TMJ) may be the source of the pain. Yawning or taking a large bite of food may worsen the pain. An appointment with your doctor or dentist will help you find the cause.

In most cases, toothaches or jaw pain signifies a problem that must be cared for by a dentist.

A referral to a dentist for follow-up will usually be arranged. In some cases, the doctor may try a shot around the tooth for pain control. If there is swelling in the gums or face, or if you have a fever, antibiotics may be prescribed.

• At the dentist’s office, fillings, pulling teeth, or other procedures may be performed as required. A tooth extraction will be the most likely procedure with a primary (baby) tooth. On permanent teeth, if the problem is severe, root canal therapy (cleaning out the nerves and blood vessels and sealing off the root canals of the tooth) and crown procedures are generally performed.
• An antibiotic will usually be prescribed if a fever or swelling of the jaw is present. Such procedures are generally done in stages, with pain and infection being cared for right away and reconstructive procedures being performed at a later time (weeks to months). You will be able to return to work or school while you recover. Dentists and oral surgeons may plan other procedures at the most appropriate time.
• If causes other than the teeth or jaw are responsible for the pain, management will depend on the condition.

After toothache treatment at your dentist’s office, continue to practice good dental care. Routine and prompt follow-up appointments with the dentist should relieve your dental pain faster.

When you leave the emergency department, take the medications as prescribed and keep your follow-up appointment. If you have any concerning signs or symptoms, call your doctor.

Stopping smoking may help improve some dental conditions. If you are having trouble quitting, talk to your doctor about assistance.

Most people can avoid toothaches and severe dental problems with regular dental care. Have your dentist’s telephone number easily available in case of an emergency.

• Maintain a healthy diet. Bacteria thrive on refined sugar and starch and need this in order to burrow through the enamel on your teeth. Watch what you eat, and be careful about food that sticks to and between your teeth. Brush your teeth after eating.
• Establish a good program of cleaning your teeth to remove food particles. Brush your teeth after eating, and brush your gums to encourage gum health. Use a soft toothbrush with fluoride toothpaste as recommended by the American Dental Association. Floss between teeth daily. Water jets are effective at removing trapped particles, but flossing your teeth does a more thorough job when done carefully. Rinse daily with an antiseptic mouthwash to help get rid of bacteria that cause plaque and early gum disease.
• Prevent tooth decay with fluoride. Fluoride is effective in preventing tooth decay in children. Fluoride is a natural element and is found in many water supplies and vegetables. Check and see if your tap water is fluoridated. If your water is not fluoridated, your dentist can prescribe fluoride tablets or fluoride supplements for children younger than 10 years.
• Arrange to have your teeth cleaned by a dentist or dental hygienist at least twice a year. It may help in preventing both decay and gum disease. Dental X-rays may be needed every 3 to 5 years to identify problem areas.
• Keep your bridge or dentures clean. Your dentist can offer suggestions. Even if you do not have all of your original adult teeth, you can prevent new dental problems if you try these preventive tips.
• Wear a protective dental guard or headgear while playing sports to help prevent injury.
• Do not smoke. Tobacco smoking may make some dental conditions worse.

For most common causes of toothaches, the prognosis is good with the right dental care. Following good dental hygiene, such as brushing with a fluoride toothpaste, flossing, rinsing with an antiseptic mouthwash, and routine check-ups by the dentist, helps to prevent dental problems.

For conditions other than dental and jaw problems, prompt diagnosis and treatment usually improve long-term outcome.

Top Picks

Causes, Symptoms, Diagnosis, Treatment, Remedies

Written by WebMD Editorial Contributors

Medically Reviewed by Robert Brennan on March 22, 2023

• Why Does My Tooth Hurt?
• Toothache Causes
• Could It Be Sensitive Teeth?
• Could It Be a Damaged Tooth?
• Do You Grind Your Teeth?
• Could It Be Your Wisdom Teeth?
• Could the Problem Be Outside Your Mouth?
• Toothache Symptoms
• When to Seek Medical Care for a Toothache
• Exams and Tests for Toothaches
• Treating a Toothache at Home
• Medical Treatment for Toothaches
• Toothache Treatment Follow-Up
• Toothache Prevention
• Outlook for Toothaches
• More

Whether it’s sharp and sudden or dull and constant, tooth pain is hard to ignore. A toothache or tooth pain is caused when the nerve in the root of a tooth or surrounding a tooth is irritated. Dental (tooth) infection, decay, injury, or loss of a tooth are the most common causes of dental pain. Pain may also occur after an extraction (when a tooth is pulled out). Pain sometimes comes from other areas and goes to the jaw, thus appearing to be tooth pain. The most common areas include the jaw joint (temporomandibular joint, or TMJ), ear, sinuses, and even occasionally from heart problems.

Bacteria growing inside your mouth can contribute to gum disease and dental decay, both of which can cause pain. Often, gum disease will not result in any pain.

You can prevent most dental problems by flossing, brushing with fluoride toothpaste, and having your teeth professionally cleaned twice a year. The dentist may apply sealants and fluoride, which are especially important for children’s teeth.

Toothache occurs from inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain. Inflammation of the pulp, or pulpitis, may be caused by dental cavities, trauma, and infection. Referred pain from the jaw may cause you to have symptoms of a toothache. The first step toward relief is to find out what’s wrong.

If your teeth are healthy, a hard outer layer of enamel covers them to protect the nerves inside. The enamel can wear away over time. When the middle layer of your tooth is exposed, anything you eat or drink can reach your nerve endings. 

Gum disease can make your teeth sensitive. Your gums shrink away from your teeth, and that exposes the roots. You also can damage your gums if you brush too hard.

A recent cleaning or a new filling may make you sensitive for a few weeks. Many people feel it after whitening treatments. An old filling that’s loose or damaged can cause it, too.

Your teeth come under attack every time you eat. Bacteria cling to them until you brush them away. They produce acid, which makes the holes in your enamel called cavities.

Or you could have a crack in a tooth that’s exposed the sensitive inner layers. Maybe you bit down on a cherry pit or were hit in the face during softball.

A cavity or a crack can cause sharp pain and make your mouth sensitive when you bite down. The longer the pain lingers, the more serious the damage is likely to be.

If it’s deep enough, a cavity or crack can let bacteria into the inner layer, called pulp, of your tooth. The pulp can become infected, and that can lead to a buildup of pus called an abscess. The infection can spread to tissue and bone, too. 

This is a common problem brought on by stress, sleep disorders, or a bite issue. If you grind your teeth while you sleep, it can wear away your enamel and even cause a crack. 

Teething hurts whether you’re a baby or an adult. You’re likely to feel it when your wisdom teeth start to push through your gums. Food can get stuck under the gum and cause decay and infection.

Your teeth may hurt because of an issue somewhere else in your body. That’s called referred pain. It can come from:

• Certain kinds of headaches, like cluster and migraine
• Clogged or infected sinuses
• Problems in the joint or muscles that connect your jaw to your skull

In rare cases, a heart attack can cause tooth pain. It’s also a symptom of certain nerve diseases.

Toothache and jaw pain are common complaints. There may be severe pain from pressure, or from hot or cold stimuli. The pain may last for longer than 15 seconds after the stimulus is removed. As the area of inflammation increases, the pain becomes more severe. It may spread to the cheek, the ear, or the jaw. Other signs and symptoms that may lead you to seek care include the following:

• Pain with chewing in your teeth or jaw 
• Headaches
• Your teeth are sensitive to heat or cold. You’ll feel a couple of seconds of pain when something hot or cold hits them. Sweet or acidic foods may bother you, too.
• Bleeding or discharge from around a tooth or gums
• Swelling around a tooth or swelling of your jaw
• Injury or trauma to the area
• Bad breath
• Fever
• Bad taste in your mouth
• Swollen glands

These signs and symptoms may sometimes be linked to dental decay, tooth fracture, or gum disease (periodontal disease). Dental decay or an area of redness around the tooth’s gum line may point to the source of pain. If you tap an infected tooth, it may make the pain more intense. This sign may point to the problem tooth even if the tooth appears normal.

Don’t put off a trip to the dentist if your teeth hurt. Cavities and cracks get worse over time. You should call your doctor or dentist about a toothache when:

• Pain is not relieved by over-the-counter drugs
• You have  severe pain after a tooth is pulled; this may occur on the second or third day after tooth extraction. This is a result of the clot falling out and bone exposed until a new clot can cover the exposed bone. The condition is known as alveolar osteitis or “dry socket syndrome.” If you develop this condition, you should see a dentist within 24 hours.
• Pain is linked to swelling of the gums or face, or you have discharge around a tooth; fever is an important sign of infection in dental disease. Simple dental decay (caries) does not cause fever. These signs may mean there’s an infection surrounding the tooth, the gum, or the jawbone (mandible). Fever and swelling may be signs of an abscess. Dental abscesses may require antibiotics and surgical opening (drainage) of the abscess. When this procedure is recommended to be done inside the tooth (endodontic drainage), “root canal” therapy is performed.
• Broken or knocked out teeth occur from an injury; unless associated with more severe injuries, your dentist should be contacted as soon as possible. Swallowed teeth and permanent tooth loss are considered dental emergencies. Tooth loss due to injury (traumatic loss) is treated differently in children who have lost their primary teeth than in older children and adults with injury to their secondary – or permanent – teeth. If a child’s permanent (adult) tooth is fully knocked out, try to gently rinse it off and re-implant it as soon as possible and seek dental care. If you are not able to get it back in, put it in a small amount of milk or even water and seek dental care.
• Pain is present at the angle of your jaw; if every time you open your mouth widely you have pain, it is likely that the TMJ has been injured or inflamed. This can occur from an injury or just by trying to eat something that is too big. Your dentist may be able to suggest solutions to this problem.
• Wisdom teeth are causing pain; as wisdom teeth (third molars) are coming into the mouth – or erupting – they cause inflammation of the gum around the visible portion of the crown. The gum overlying the crown may become infected. The tooth most commonly involved is the lower third molar. The pain may extend to the jaw and ear. There may be swelling in the affected area so that the jaw cannot be closed properly. In severe cases, pain in the throat and the floor of the mouth may make it difficult to swallow.

Any history of trauma, chest pain, heart disease, or rashes may suggest causes of pain other than of purely dental origin. These symptoms with toothache or jaw pain mean that you should visit your doctor or a hospital’s emergency department.

• High fever or chills: This may indicate a more widespread infection that might require more than antibiotics by mouth.
• Recent head or face injury: If you have a headache, lightheadedness, nausea, vomiting, or other symptoms that concern you after an injury to your face or mouth, you may have a more serious injury in addition to your dental injury.
• A facial rash linked to a toothache: This condition may improve with medication. The doctor should be able to decide what is appropriate.
• Any jaw pain that comes with chest pain: Although jaw pain is most commonly caused by dental disease, it is sometimes referred pain from other areas. People with heart disease, especially people who have had stents placed, people with diabetes, or those who have had heart surgery, may have jaw pain as a symptom of a heart attack or angina. If your jaw or tooth pain is comes with lightheadedness, sweating, or shortness of breath, you should see a doctor.
• Trouble swallowing or excessive pain or bleeding from gums: If you have a history of a weakened immune system, diabetes, or steroid use, you may be more likely to get infections. Infections can often be more severe and extensive or caused by unusual organisms. Dental and gum infections in people with these conditions may require more aggressive treatment. An abscess may need draining or IV antibiotics, for example.

A thorough medical history and oral exam usually lead to the right diagnosis.

Sometimes, X-rays called periapical and Panorex views (panoramic X-rays of the teeth and jaw) are taken. Rarely, lab evaluation, including EKG tracings of the heart, will assist the doctor. If the cause is something other than a dental or jaw problem, the doctor may prescribe drugs directed at the problem. If the condition is more severe, the doctor may admit you to the hospital for further care. You may be referred to a dentist for further treatment.

For toothaches:

• Over-the-counter pain medications such as acetaminophen or ibuprofen may be used. Take these as directed on the package while you arrange a dental appointment.
• Avoid very cold or hot foods, because they may make the pain worse.
• You may get relief from biting on a cotton ball soaked in oil of cloves. You can get oil of cloves at most drugstores.
• Special toothpastes can make your teeth less sensitive. And you can reverse early gum disease when you brush and floss correctly.

For jaw pain:

•  Aspirin may be helpful for problems in the joint of the jaw in adults.
•  Acetaminophen (not aspirin) should be used for children and teenagers.
• If pain happens every time you open your mouth widely, the temporomandibular joint (TMJ) may be the source of the pain. Yawning or taking a large bite of food may worsen the pain. An appointment with your doctor or dentist will help you find the cause.

In most cases, toothaches or jaw pain signifies a problem that must be cared for by a dentist.

A referral to a dentist for follow-up will usually be arranged. In some cases, the doctor may try a shot around the tooth for pain control. If there is swelling in the gums or face, or if you have a fever, antibiotics may be prescribed.

• At the dentist’s office, fillings, pulling teeth, or other procedures may be performed as required. A tooth extraction will be the most likely procedure with a primary (baby) tooth. On permanent teeth, if the problem is severe, root canal therapy (cleaning out the nerves and blood vessels and sealing off the root canals of the tooth) and crown procedures are generally performed.
• An antibiotic will usually be prescribed if a fever or swelling of the jaw is present. Such procedures are generally done in stages, with pain and infection being cared for right away and reconstructive procedures being performed at a later time (weeks to months). You will be able to return to work or school while you recover. Dentists and oral surgeons may plan other procedures at the most appropriate time.
• If causes other than the teeth or jaw are responsible for the pain, management will depend on the condition.

After toothache treatment at your dentist’s office, continue to practice good dental care. Routine and prompt follow-up appointments with the dentist should relieve your dental pain faster.

When you leave the emergency department, take the medications as prescribed and keep your follow-up appointment. If you have any concerning signs or symptoms, call your doctor.

Stopping smoking may help improve some dental conditions. If you are having trouble quitting, talk to your doctor about assistance.

Most people can avoid toothaches and severe dental problems with regular dental care. Have your dentist’s telephone number easily available in case of an emergency.

• Maintain a healthy diet. Bacteria thrive on refined sugar and starch and need this in order to burrow through the enamel on your teeth. Watch what you eat, and be careful about food that sticks to and between your teeth. Brush your teeth after eating.
• Establish a good program of cleaning your teeth to remove food particles. Brush your teeth after eating, and brush your gums to encourage gum health. Use a soft toothbrush with fluoride toothpaste as recommended by the American Dental Association. Floss between teeth daily. Water jets are effective at removing trapped particles, but flossing your teeth does a more thorough job when done carefully. Rinse daily with an antiseptic mouthwash to help get rid of bacteria that cause plaque and early gum disease.
• Prevent tooth decay with fluoride. Fluoride is effective in preventing tooth decay in children. Fluoride is a natural element and is found in many water supplies and vegetables. Check and see if your tap water is fluoridated. If your water is not fluoridated, your dentist can prescribe fluoride tablets or fluoride supplements for children younger than 10 years.
• Arrange to have your teeth cleaned by a dentist or dental hygienist at least twice a year. It may help in preventing both decay and gum disease. Dental X-rays may be needed every 3 to 5 years to identify problem areas.
• Keep your bridge or dentures clean. Your dentist can offer suggestions. Even if you do not have all of your original adult teeth, you can prevent new dental problems if you try these preventive tips.
• Wear a protective dental guard or headgear while playing sports to help prevent injury.
• Do not smoke. Tobacco smoking may make some dental conditions worse.

For most common causes of toothaches, the prognosis is good with the right dental care. Following good dental hygiene, such as brushing with a fluoride toothpaste, flossing, rinsing with an antiseptic mouthwash, and routine check-ups by the dentist, helps to prevent dental problems.

For conditions other than dental and jaw problems, prompt diagnosis and treatment usually improve long-term outcome.

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Acute toothache | Dentistry Beskudnikovo

Acute toothache is always an emergency that requires medical attention. It usually occurs suddenly and can be triggered by biting, eating hot, cold or sour foods. Reception of such patients is carried out by the doctor on duty without an appointment and on the day of treatment. Before visiting the clinic, it is recommended to call the reception and clarify the conditions of the visit.

Causes of acute dental pain

The most common cause of acute toothache is damage to the neurovascular bundle of the pulp. As a rule, this occurs as a result of deep caries, when it affects the dentin, or pulpitis – inflammation of the pulp, which occurs as a result of the action of various irritants.

Usually, the main provoking factor of pulpitis are microorganisms that penetrate into the pulp from carious foci, infected periodontal tissues, as well as with the blood flow in general infectious diseases. Another important etiological factor is the impact of chemicals, in particular those that are part of the reconstructive and filling materials. Pulpitis can also be provoked by injuries received during impact or orthodontic treatment, as well as thermal burns, which can occur, for example, if the tooth is not properly prepared during treatment.

Other reasons for the development of acute toothache are:

• Periodontitis. Periodontitis is the periodontal tissue that fixes the tooth in the hole. As in the case of pulpitis, the causes of its occurrence are untreated caries. It can also be provoked by infections of the soft tissues of the oral cavity, sinusitis, trauma and chemical damage. The latter can occur as a complication of endodontic treatment, for example, when it is impossible to prepare the dental canals, if the filling material goes beyond it, or when allergic reactions develop.

• Periapical abscess – purulent inflammation of the tissues located near the top of the tooth root. The reasons are the same as for periodontitis – pulpitis, trauma, reactions to chemicals, complications in the treatment of tooth roots, etc.

• Pericoronitis is an inflammation of the gums in the area of ​​an erupting tooth. This is one of the main problems with teething wisdom teeth. Pericoronitis is accompanied by pain, inflammation, and soft tissue swelling. In some cases, inflammatory reactions are so pronounced that patients cannot even open their mouths normally. The inflammatory process can spread to neighboring tissues and cover nearby teeth, leading to periodontitis, the formation of cysts and other problems.

• Conditions after treatment and prosthetics of teeth. Some medical manipulations are quite traumatic, for example, implantation. After such interventions, pain is a natural phenomenon and requires preventive measures, in particular, the appointment of strong painkillers. If the pain does not decrease within a few days, but, on the contrary, becomes more intense, signs of progressive inflammation join (swelling increases, local temperature increase, redness of the mucous membranes, the appearance of specific tissue protrusions), you should seek medical help.

Acute toothache symptoms

Under different conditions, acute toothache differs in its intensity and the presence of additional symptoms.

With deep caries, the pain is episodic and occurs under the influence of provoking factors:

• Exposure to hot or cold.

• Eating irritating food – spicy, sour, salty, sweet.

• Teeth cleaning.

• Chewing.

If the impact has stopped, the pain subsides before a new episode. Some patients do not rush to the dentist and simply avoid the action of provoking factors until the situation escalates and pulpitis or other complications develop. The pain of deep caries does not require emergency treatment, and the patient can visit their doctor routinely. But it is still not worth delaying visiting the clinic.

Pain in acute pulpitis

In the initial stages, pain in pulpitis is similar to pain in deep caries – it occurs under the influence of provoking factors and gradually subsides. But with the progression of the process, it becomes more intense and is paroxysmal in nature, when the period of pain is replaced by rest. Usually the pain occurs at night or in the evening, during the day it can be provoked by biting, eating, hot or cold drinks.

At the initial stages, the patient can easily determine the diseased tooth, but with severe inflammation, half or even the entire jaw begins to hurt, and it can be difficult to determine the diseased tooth. In this case, pain can be given to the temple, temporomandibular joint, neck.

Symptoms of acute periodontitis and periapical abscess

At the initial stage of acute periodontitis, the pain is constant, aching, intensifies at the slightest touch – biting, brushing your teeth, etc. It is localized, while the general condition does not suffer.

At the stage of exudation and periapical abscess, the pain intensifies and becomes throbbing. It extends to half of the jaw, and patients find it difficult to point to the diseased tooth. The symptom of an “enlarged tooth” may also develop. It occurs as a result of the accumulation of exudate under the top of the root of the tooth, which makes it especially sensitive to the slightest touch. Pathological tooth mobility may also develop.

During this period, general symptoms may also occur – intoxication, headache, fever. With an increase in the volume of exudate, the surrounding tissues are involved in the process, and here 4 stages of distribution are distinguished:

• Periodontal – only periodontal tissues are involved in the process. The pains are localized, aching, aggravated by biting.

• Endossal – the bone tissue of the alveoli is involved in the process, the pain becomes severe, swelling of the tissues begins, irradiation to the trigeminal nerve can be observed. The gum tissue appears bright red, feels firm, and grows in size.

• Subperiosteal. Exudation extends into the subperiosteum, the pain is unbearable. Edema continues to increase, patients may experience difficulty opening their mouths, and facial asymmetry occurs.

• submucosal stage. Pus extends beyond the jaw. The swelling builds up and spreads further down the face, up to the eyes or neck.

If the pus finds a way out in the form of a fistula, then the patient becomes a little easier. The pain subsides, the symptoms of intoxication become less pronounced.

Symptoms of pericoronitis

The main symptom of pericoronitis is pain in the gum area, where the tooth erupts. The gum becomes inflamed, swollen, reddens. With the development of pericoronitis in the upper jaw, headaches, disruption of the temporomandibular joint, and swelling may occur.

Diagnosis of acute toothache

Diagnosis of acute toothache requires a comprehensive examination, which will determine the cause of the disease and make the correct diagnosis. The first step is a dental examination, during which the appearance of the face, the presence of visible edema and asymmetry are assessed, each tooth is examined and the condition of the periodontal tissues is assessed.

If there is a carious cavity, it is probed and a number of instrumental studies are carried out. For example, with the help of electrodontometry, the sensitivity of pulp tissues to electric current stimulation of the specified parameters is determined. Normally, this impact is felt as a vibration or push. If the pulp tissue becomes inflamed, the electrical conductivity is reduced and more current is required to produce symptoms. With the help of electroodontometry, the depth of pulp damage is assessed, differential diagnostics is carried out between pulpitis, periodontitis, neuralgia and other diseases that cause similar symptoms of acute toothache.

X-ray studies are carried out in order to identify anatomical and structural changes in the tooth and surrounding tissues. With their help, the depth of carious lesions, the involvement of the pulp, periodontal tissues in the process, the presence of abscesses, complications of filling dental canals, the presence of unerupted teeth and other pathologies are determined.

Treatment of acute toothache

The first question that interests patients is: “what to do with acute toothache before going to the doctor?”. First of all, you need to take care of anesthesia. To do this, it is recommended to take a non-steroidal anti-inflammatory drug, such as meloxicam or ketorol. For some, it helps to rinse the mouth with warm water and dissolved soda or apply a cool compress to the sore side.

Painkillers relieve pain for several hours, and some patients consider this a way out of the situation. They start taking pills regularly and put off going to the dentist. In some cases, for example, in acute pulpitis, as pulp necrosis develops, the pain subsides. But the situation can easily get out of control, and periodontitis, or even worse, an abscess, will develop at the site of pulpitis. And then you will need not just endodontic treatment, but also tooth extraction or even surgery.

But what you can’t do with acute toothache is to use warming up and use antibiotics without a doctor’s prescription. Warming up can be dangerous with purulent inflammation. It can increase the formation of purulent exudate, which will increase pain, inflammatory reactions, and swelling. In some situations, pus can “erupt” in the most unexpected places with the formation of a fistula.

With uncontrolled use of antibiotics, resistance to them (bacterial resistance) can develop. This complicates the selection of therapy in the future, in addition, antibiotics can blur the clinical picture.

Where to go with acute toothache

Acute toothache requires emergency dental care. It is provided in any dental clinic on a first-come, first-served basis. The patient is seen by the doctor on duty. On weekends and holidays, emergency care is provided in on-call medical institutions. Tactics of treatment depends on the disease.

Treatment of pulpitis

In the treatment of pulpitis, the carious cavity is prepared and the pulp is opened. After that, its viability is evaluated. If there is evidence that it can be saved, a so-called vital amputation is performed. In the vast majority of cases, with acute toothache, depulpation is necessary. In a normal situation, there are several ways to do this, but with acute pain, the field for maneuvers is greatly narrowed – devital amputation is used. At the first appointment, the pulp is opened and a devitalizing paste is placed in it. A few days later, a second appointment is prescribed, during which the channels are cleaned and sealed. This is not the best method of treatment, and it can lead to the development of unpleasant complications. Therefore, it is better to treat caries in a planned manner, when the doctor has several options, and you can choose the right one for each patient.

Treatment of periodontitis

With periodontitis, treatment also begins with the opening of the pulp chamber, its cleansing and treatment with antiseptics, enzymes and other drugs that affect exudation. With drug-induced periodontitis, the filling material is removed, antidotes are administered, if we are talking about a toxic reaction. The tooth is sealed and left for several days.

If there is a pronounced exudate, provide conditions for its outflow. For example, the apical openings of the root apex are expanded to allow drainage. If there is a pronounced abscess, it may need to be opened through incisions in the gums and periosteum. Restoration of the tooth and filling of the canals is carried out only after the inflammatory process subsides.

Treatment of pericoronitis

Treatment of pericoronitis begins with conservative methods – adequate anesthesia, the use of anti-inflammatory drugs, antiseptics. If the result is not achieved, or if relapses occur, the option of surgical treatment is considered. For example, the gum hood is excised in the area of ​​an erupting tooth. As a result, the tooth opens, becomes available for regular hygiene, plaque does not accumulate under the gum, which is a source of infection. If the tooth cannot erupt normally, for example, when it is dystopic or crooked, its removal is indicated.

Prevention of acute toothache

Prevention of acute toothache is the timely treatment of dental diseases, in particular caries. In addition, it is recommended to carry out professional oral hygiene at least once every six months. If there is evidence of increased plaque formation, hygiene should be carried out more often, at least once every three months.

During professional cleaning, each tooth is also examined. If carious foci are found, they need to be sanitized without delay. There are situations when a small hole at autopsy turns out to be very extensive and affects not only the dentin, but also the pulp tissues.

Why does the tooth hurt, what to do and how to reduce the pain

Medical consultation

Toothache or dental pain is pain that occurs in the tooth or tissues surrounding it. It can appear for various reasons. It has different localization and intensity. About what to do with a sore tooth, why the pain appeared, what it can be confused with, how to get rid of it at home, when it is worth visiting a doctor, how dental treatment is carried out, prices, we will tell further.

This pain is usually caused by:

• pulpitis;
• caries;
• secondary caries;
• periodontal disease, periodontitis;
• flux;
• wisdom tooth eruption;
• increased tooth sensitivity to cold, hot drinks;
• allergy.

As we can see, there can be many reasons for such pain. But often a person confuses toothache with other symptoms and cannot understand what exactly hurts him.

Mistaking toothache for

It happens that a patient’s toothache is not due to the teeth.

Usually caused by:

• Inflammation of the trigeminal nerve. It is located very close to the root of the tooth. That is why, when it is inflamed, a person complains of a pulling pain that radiates to the tooth. Moreover, such pain affects the entire jaw.
• Disease localized in the ENT organs. Usually the appearance of a toothache provokes sinusitis, sinusitis, otitis media. It is very difficult to help if the child has a severe toothache. He still cannot say where he hurts, whether it is a tooth.
• Stress. It is interesting that people even experience severe pain under the tooth. Such pain manifests itself at night.

How to relieve pain at home

Experts recommend purchasing non-steroidal anti-inflammatory drugs (NSAIDs) for people experiencing severe toothache. They:

• reduce swelling;
• help get rid of pathogenic bacteria;
• quickly and effectively relieve pain, inflammation.

Remember: according to the purpose and strength of the impact, all drugs differ from each other.

But each of them helps where the tooth hurts a lot. The drug anesthetizes, removes swelling, relieves inflammation, brings down the temperature.

Do not forget that such drugs have a negative effect on the mucous membrane of the stomach and intestines. Therefore, citizens with a problematic gastrointestinal tract should be taken with caution. They should not be taken for a long time.

In addition, such drugs thin the blood, have a negative effect on the kidneys and liver. That is why pregnant, lactating ladies, children should not use them. You can take them, but carefully and at the dosage indicated by the doctor.

Do not mix these preparations with alcohol.

And if you use several drugs from the same group, the effect will come faster, but there will be more side effects.

In addition, the patient may:

1. Apply a cold compress, ice wrapped in a cloth to the cheek. It will narrow the blood vessels, relieve swelling, and stop the infection. But ice should be used with caution. Otherwise, hypothermia cannot be avoided. Do not apply ice to the skin for a long time.
2. Gently but thoroughly brush your teeth. They can be cleaned with dental floss or a toothbrush. Rinse your mouth after brushing. So you can get rid of the pieces of food stuck in your teeth. And this method also helps to get rid of the feeling of fullness and discomfort.
3. Place a cotton swab soaked in alcohol in the hole. It can also be moistened in diluted alcohol, vodka, alcohol tincture of calendula flowers, propolis. So you can get rid of infection, inflammation.
4. Rinse mouth with diluted 3% hydrogen peroxide solution. It will disinfect the problem area, soften plaque, relieve inflammation, relieve inflammation. The liquid must not be used undiluted. This will lead to burns of the mucous membrane. That is why you should read the instructions before use. Typically, hydrogen peroxide is diluted 1 to 11.

When to run to the dentist

A patient should definitely consult a specialist if he/she has:

• the pain does not go away within a day. Remember: you should consult a doctor for people who have a toothache after extraction, implantation, surgery, i.e. where the pain has not gone away for two days;
• there is pain of varying intensity, which is accompanied by fever, general malaise;
• self-examination of the oral cavity revealed an open gingival hood, on which redness, purulent inflammation appeared, swollen gums;
• the intensity of pain gradually increases;
• gums become painful, bleed heavily.