Tooth Pain – Likely causes and what can be done

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Dear Doctor,
I have been having tooth pain. What are the likely causes, and what can be done?

Dear Brad,
Generally speaking, pain is a protective response that ranges from minor sensitivity to severe pain and informs the body that something is wrong. As for tooth pain, it is caused by a reaction of the nerves inside a tooth’s pulp chamber with the severity dependent upon the type and degree of the stimulus. What follows are some examples of symptoms you may be feeling and their possible causes.

Symptom: Sensitivity to hot or cold foods and liquids.

Possible problem: If discomfort lasts only moments, sensitivity generally does not signal a serious problem. It may be caused by; a small area of decay in a tooth, a loose filling or an exposed root surface resulting from gum recession and possibly toothbrush abrasion.

What to do: If a root surface is sensitive, keep it clean and free of dental bacterial plaque. Use a soft toothbrush, cleaning very gently at the gum line, and brush no more than twice daily. Try using fluoride-containing toothpaste made for sensitive teeth. You can even try using toothpaste like an ointment, rubbing it into the root surface for ten minutes or so at a time. If the sensitivity continues, see your dentist.

Symptom: Sensitivity to hot or cold foods after dental treatment.

Possible problem: Dental work may result in tooth sensitivity due to inflammation of the pulp tissues inside a tooth.

What to do: This sensitivity should last no longer then a few days; however, if decay has recently been removed or a filling or crown recently has been placed, a tooth may take a week or two to settle. Mild pain relievers like acetaminophen, aspirin or ibuprofen should help. If the pain persists or worsens, see your dentist.

Symptom: Sharp pain when biting down on food.

Possible problem: Decay, a loose filling and/or a cracked tooth are possible causes.

What to do: See a dentist to diagnose the problem before the pain worsens. Decay will need to be removed, and a loose filling replaced by your dentist. If the pain is caused by pulp tissue damage, your dentist may send you to an endodontist (“endo” – inside; “dont” – tooth), a specialist who will perform a root canal treatment to clean out the damaged pulp, disinfect the root canal and fill and seal the remaining space to save the tooth. A cracked tooth may be difficult to treat not only if it involves the pulp, but also depending on the location and depth of the crack. (See the Dear Doctor magazine article on “Cracked Tooth Syndrome”)

Symptom: Lingering pain after eating hot or cold foods and liquids.

Possible problem: This probably means the pulp is inflamed and/or dying, and may be irreversibly damaged usually as a result of deep decay or physical trauma.

What to do: See your dentist or endodontist to diagnose the problem before the pain becomes severe due to the development of an abscess. The tooth will likely need root canal treatment to remove the dying or dead pulp tissue to save the tooth.

Symptom: Dull ache and pressure in the upper teeth and sinus area of one or both sides.

Possible problem: Pain felt in the sinus area of the face is often associated with the upper back teeth because they share the same nerves. The origin of this “referred” pain consequently may be difficult to determine. Therefore, sinus pain can feel like tooth pain and vice versa. That’s why sinus congestion from a cold or flu can cause pain in the upper teeth. Additionally it’s also important to determine if clenching or grinding is a factor, as they too cause similar symptoms.

What to do: See your dentist or endodontist to find out if the symptoms are dentally related; otherwise, you may need to see your family physician. However, don’t wait until the pain worsens.

Symptom: Acute and constant pain from an area, but difficult to say exactly which tooth is causing the problem.

Possible problem: The pulp tissue inside a tooth is acutely infected, inflamed and dying. This is generally in response to decay coming very close to or entering the nerve.

What to do: See your dentist or endodontist immediately for a thorough examination. Once the problematic tooth is isolated, a root canal treatment to remove the infected pulp tissue will bring relief while saving the tooth. Untreated, the pain could become worse.

Symptom: Constant severe pain and pressure, swelling of the gum and sensitivity to touch.

Possible problem: A tooth may have an infection/abscess that has spread from the pulp into the surrounding periodontal tissues (“peri” – around; “odont” – tooth) and bone.

What to do: See your dentist or endodontist immediately. A root canal will probably be required. Over-the-counter medications like acetaminophen and ibuprofen will help minimize symptoms until you are treated.

Don’t wait for the pain to get worse.

Note in the above examples, possible problems and solutions are suggested — but they only provide possible guidelines. In all cases of tooth or jaw pain or discomfort in and around the teeth and jaws, see your dentist as soon as possible for a proper evaluation and treatment. Your dentist may refer you to an endodontist for diagnosis and treatment, especially if the issue is related to a root canal problem. And if your pain has a medical component, your dentist or endodontist will refer you to a physician.

10 Reasons Why All My Teeth Hurt Suddenly

Teeth pain can occur with certain health conditions, including tooth sensitivity and conditions affecting the gums. It may feel worse when consuming foods and drinks at extreme temperatures.

If you feel a flash of pain in your gums or a sudden toothache, you’re not alone. A survey by the American Family Physician revealed that 22 percent of adults have experienced pain in their teeth, gums, or jaw within the last six months.

Two of the most likely explanations are that you’ve developed tooth sensitivity or that one of your teeth is cracked or infected. The good news is most causes of sudden tooth discomfort are easily treatable by your dentist.

Here are 10 possible reasons why your teeth might be giving you pain, and when to see a doctor.

Tooth sensitivity is caused by worn tooth enamel or exposed nerves in your teeth. When you eat or drink something with an extremely low or high temperature, you may feel a sudden, sharp flash of pain.

Gums are the layer of pink tissue that cover bone and surround the root of the tooth to help protect the nerve endings of your teeth. As you age, gum tissue often begins to wear , causing gum recession.

This recession leaves the roots of your teeth exposed, as well as leaving you more vulnerable to gum disease and tooth infections. If your teeth are suddenly more sensitive than they used to be, gum recession could be the culprit.

It’s estimated that at least 12 percent of people have some form of “dentin hypersensitivity” that causes them discomfort when they eat. This kind of sensitivity can be caused by eating a highly acidic diet, brushing your teeth too hard, and other factors.

As a result, the enamel that coats and protects your teeth begins to wear away and is not replaced. This can lead to sharp, stabbing pain that sends shivers up your spine when you bite into certain foods.

Tooth decay, also referred to as a cavity, might be the reason why your teeth have suddenly started bothering you. Tooth decay can linger on the sides or tops of your tooth enamel without being noticed for some time.

Once the decay begins to progress toward an infection, you may startexperiencing pain in your tooth.

Gum disease, also called periodontal disease, affects more than 47 percent of adults over the age of 30. Gum disease is called gingivitis in its early stages, and some people don’t even know that they have it. Sensitive teeth and gums can be a sign of escalating gum disease.

You may not be surprised to learn that a cracked tooth or crown can cause tooth pain and sensitivity. But there are cases when you may have a tooth cracked ever so slightly, so that it causes pain but is nearly impossible to see.

One symptom of a sinus infection is pain in your teeth and in your jaw. As your sinuses become inflamed and filled with pressure from the infection, they can compress the nerve endings of your teeth.

Grinding your teeth and clenching your jaws can lead to chronic tooth sensitivity, as you wear away at the enamel on your teeth.

While many people clench or grind their teeth from time to time, high-stress circumstances or poor sleep can lead to you increasing this habit without you realizing it, resulting in tooth pain that seems mysterious.

Recent fillings or tooth work involving drilling can temporarily make the nerve endings of your teeth more sensitive. Sensitivity from a tooth filling procedure may last up to two weeks.

Using whitening strips, bleaching gels, or having an in-office teeth-whitening procedure can put you at a higher risk of tooth sensitivity. Pain in your teeth that’s caused by teeth bleaching is often temporary and will usually subside if you stop using whitening products.

If your teeth have become sensitive when they never were before, make an appointment with your dentist. They may be able to recommend a simple treatment, such as a sensitivity-reducing toothpaste.

Your dentist will also be able to tell if you need a corrective procedure, such as a filling or a tooth extraction, to relieve your pain.

Some symptoms should never be ignored. See your dentist right away, or contact another health professional, if you experience the following:

• toothache that lasts for more than 48 hours
• throbbing or sharp, aching pain that doesn’t subside
• migraine or thunderclap headache that extends to your teeth
• fever that seems to coincide with your toothache

The Healthline FindCare tool can provide options in your area if you need help finding a dentist.

There are myriad reasons why you might feel a sudden pain in your teeth. Most of them are connected to the natural erosion of your gums or tooth enamel.

If you’ve developed hypersensitive teeth seemingly overnight, you should speak with your dentist. While it’s not usually considered a dental emergency, teeth that are causing you pain should be examined by a dentist to rule out some of the more serious causes.

Tooth hurts when biting and pressing

19 March 2020

Toothache on pressure can occur in both healthy and already treated teeth. Causes of pain associated with pressure or touch include: secondary latent caries, periodontal disease, or inflammation of the pulp. Most often, patients complain of toothache when biting after filling or root canal treatment. How to treat toothache when biting and pressing?

Dentist will check for toothache on tapping. Depending on the characteristics of the clinical picture and pain manifestations, additional diagnostic tools, such as x-rays, may be required. Based on the examination, the cause of the pain syndrome is determined. It can be:

• Pulpitis

Toothache on pressure often indicates diffuse inflammation of the pulp.

• Hidden caries

Patients are often surprised that they have a toothache that does not contain caries and fillings. But it can be hidden caries, that is, a defect that is invisible during visual inspection. This process develops in the spaces between the teeth. At the initial stage, it is not clinically noticeable. With a more detailed diagnosis, a slight discoloration of the tooth over the defect may be noticeable. Such caries is clearly visible on x-rays.

• Secondary caries

Patients often complain that the filled tooth hurts when they bite. If the pain occurs immediately after the filling is placed, when the effect of anesthesia wears off, it is most often temporary and disappears on its own within 1-2 days. If there is pain in a long-filled tooth, this may mean secondary caries. In this case, caries develops under or around the filling. Such a filling should be removed, the defect cleaned and refilled.

• Filling too high

A filling placed too high puts pressure on the apical periodontium. To avoid pathological changes, it should be corrected as soon as possible. After the intervention of the dentist, the toothache should disappear.

• Periodontitis

Toothache when eating can be caused by periodontitis (inflammation of the tissues surrounding the tooth). Bacterial plaque and tartar attack the gums and periosteum, causing them to become inflamed. The pressure on the tooth during chewing causes pressure on the inflamed tissues, resulting in pain.

• Complications after endodontic treatment

Toothache after root canal treatment may be caused by periapical changes, ie inflammation at the top of the root of the tooth. These may be abscesses, granulomas, or cysts. For their diagnosis, an x-ray or panoramic image is needed. Re-sealing the canals in a timely manner will save the tooth. It is better if the treatment is performed with optical magnification.

• ENT diseases

Separately, it is worth mentioning the pain during biting in the upper molars. If the dentist did not find any abnormalities in the clinical examination and the x-ray did not show any changes, it is worth contacting an ENT specialist for a consultation. Additional symptoms that indicate the need to visit an otolaryngologist with a toothache are a recent or persistent runny nose, nasal discharge, increased pain when tilting the head.

Whatever causes toothache when biting or pressing, you should see a dentist as soon as possible.

Why does the tooth hurt if the nerve is removed

Home \ Articles \ There is a question: why does the tooth hurt if the nerve is removed?

My name is Gogiya Tea Zurabovna, I am a dentist-therapist of the NOVOSTOM STsNT. Many patients asked me the same question, so I decided to talk about it in detail.

Most people believe that if a nerve is removed from a tooth, it will never hurt again. What can hurt if the nerve is removed?

As soon as the patient catches a cold or just freezes, such teeth begin to make themselves felt. Patients are surprised to learn at the dentist’s office that the anxiety is caused by inflammation at the root of the tooth, and they need to re-treat the root canals.

“They have already treated me!” they say: “What can hurt there if the nerve has been removed? Without a nerve, a tooth is dead! This is the most common misconception of patients, which leads to forced re-treatment.

It is important to know that if a tooth has been depulped, or, as we used to say, a nerve has been removed from it, this does not mean that this tooth will never hurt.

Pulpless teeth must also be observed. There is such a situation when, several years after the removal of the nerve and treatment, inflammation may occur at the top of the tooth and periodontitis treatment is necessary. It may not bother the patient, and he will not suspect about it until a picture is taken at the dentist’s office.

Or until, due to a decrease in immunity caused by a simple seasonal viral disease, the root inflammation worsens and the tooth becomes painful, causing trouble for the patient.

There can be several reasons for periodontitis:

• Poor root canal treatment may be the main cause of development: all root canals must be well processed and tightly sealed to the full length. If the dentist missed the canal, did not remove the remnants of the instrument, allowed the perforation of the canal, then this may subsequently cause an inflammatory process and root canal treatment will be required.
• However, periodontitis often develops with well-treated canals due to a large load, the so-called overload, on the tooth caused by the anatomical features of the patient’s bite, when, due to trauma, cracks, an allergic reaction to medications and toxins, the integrity of the tooth is broken and infection occurs. .

Most often, microorganisms begin to multiply in the region of the root apex at the junction of bone and soft tissue. They release toxins, which leads to bone defect surrounding the tooth. Just such a case is depicted in the picture (Fig. 1 and Fig. 2).

It is for this reason that dentists recommend examining the teeth six months after treatment, and then at least once a year taking an x-ray for diagnostic purposes. It is important to know that with a certain frequency, which depends on the individual characteristics of the patient, and which should be clarified with the attending dentist, it is necessary to take not only an aiming picture and a panoramic picture of the tooth of a previously treated tooth.

For OPTG Lower 3.6 teeth

Spot X-ray 3.6 tooth

For a more accurate diagnosis, it is also necessary to periodically do a cone beam computed tomography (CBCT), which is usually abbreviated as CT. This technique improves the quality of diagnosis, often allowing you to avoid many mistakes in the process of treatment and diagnosis, and will not let you miss the moment of the necessary treatment.

When conducting a CT scan, we get a 3D image that allows you to better understand the condition of the patient’s jaws, viewing them on the screen in different projections. Thanks to CT of the teeth, you can see each tooth not only from the front, but also from below, from above, from the side, while turning it at any angle.

Often, the inflammatory focus may not be visible on the x-ray or panoramic images of the tooth: these are two-dimensional images, and the inflammatory focus may be covered by the root of the tooth or other structures.

CT shows the same tooth as in the x-ray and OPTG.

Retreatment of a tooth is particularly difficult. No one can guarantee a 100% positive result during retreatment, since even with strict adherence to all the rules of treatment, the canal cannot be completely rid of the microbes that have entered it. A lot depends on the patient’s body, his immunity.

The treatment methods used in modern dentistry help us significantly reduce the likelihood of periodontitis: tooth isolation using a rubber dam, dental treatment under a microscope for processing and studying the anatomy of the tooth, good and high-quality medical and mechanical treatment of root canals.