Reasons for Toothache
Pain in the tooth is one of the most common dental problems that you rush to your dentist. Common perception is that tooth ache is caused by caries or tooth decay. But besides decay there could be several reasons for the pain. To know the right cause, it’s recommended that you take an expert opinion.
- Tooth decay is the most common (but not only) reason for a toothache.Cavity causing species of bacteria convert the sugar from the food we eat into acids which de-mineralise and destruct the enamel of the tooth to create cavities in them (called tooth decay). These small cavities affect only the outer coating of the tooth (called enamel) and are usually painless. But when the decay penetrates through the enamel and affects the inner layer of the tooth (dentin) the tooth becomes extremely sensitive. In advanced stages the decay progresses deeper into the innermost layer (pulp) resulting in intense, sharp pain. Infection from a decayed tooth can cause death of the pulp tissue and cause an abscess (filled with pus) below the root of the tooth.Advanced tooth decay or gum disease may also cause pus formation or tooth abscess. The infection and the inflammation associated with an abscess causes throbbing and pulsating type of pain which may make it difficult for you to identify the tooth that causes your distress.
- Advanced gum disease can cause toothache even in an otherwise healthy tooth too. Gum infection causes inflammation of the gum and bone tissues leading to swelling, loss of bone around the teeth and pain. In many cases of advanced gum disease or periodontitis, gum abscess may occur causing pain.
- Accidents could cause fractured or broken teeth, which sometimes gets unnoticed at that time. However, they are almost certain to cause severe toothache when the fracture line runs through the pulp (nerves) of the teeth. Even if the fracture line is not very deep, plaque and bacteria can get accumulated in the crack and cause tooth decay.
- Cracked tooth syndrome occurs due to bad chewing habits, teeth grinding, tooth injury, weakening of tooth due to large fillings, etc. Tooth pain may occur due to a concealed crack/fracture of the tooth that is too small to be even seen on X-rays.
- Bruxism or Tooth grinding can wear down or chip your teeth and put excess force on the tissues supporting them causing pain not only in the teeth but also in the jaw joints and muscles.
- Improper tooth brushing and gum disease cause the gums around the tooth to detach or recede. This causes the roots of the tooth to be exposed and can cause extreme sensitivity to cold, hot, and sour foods. Acidic drinks can also further erode the roots and aggravate the sensitivity.
- Misaligned or impacted wisdom teeth fail to erupt partially/completely through the gum line. This may cause pain if there is not enough space for it to erupt. Bacteria grow on the food that accumulates under the soft tissue flap around it, leading to a pericoronitis (infection) which causes swelling and redness of the gum with diffuse pain. If untreated, it can lead to serious infections and severe pain.
- Crooked toothor misaligned teeth causes uneven distribution of forces on the teeth and thus inflammation of the nerves in the teeth causing pain.
- Orthodontic treatment(or correcting the alignment of the teeth with braces) could often cause pain for brief periods of time when the braces are adjusted or tightened.A toothache may also be caused by a problem that is not related to a tooth or the jaw. There are some conditions elsewhere in the body that can cause pain that is referred to a tooth. TMJ/TMD (Temporomandibular Joint Disorder), sinus or ear infections, and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache.
Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician.
Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take x-rays to look for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone.
Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If by the time you see your dentist your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth. If pain is due to misalignment, he might also refer you to an orthodontist . An orthodontist might further suggest you braces.