Toothache or tooth pain is caused by inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain, which are most often caused by dental cavities (tooth decay), infection, tooth injury or the loss of a tooth.
Bacteria that live in the mouth thrive on the sugars and starches in food. These bacteria form a sticky plaque that clings to the surface of your teeth.
Acids produced by the bacteria in plaque can eat through the enamel that covers the teeth, thereby creating a cavity. Oftentimes, the first sign of decay may be a sharp pain caused by pain and sensitivity to sweet foods, as well as very cold or very hot foods and drinks.
In addition, tooth pain may actually be radiating pain from other parts of the body. For instance, an earache may sometimes cause tooth pain.
Another common area from which tooth pain originates is the jaw joint. Toothache and jaw pain are relatively common complaints, which may range from pressure to severe pain, and/or extreme sensitivity to hot or cold stimuli.
The pain may persist for longer than 15 to 30 seconds after the stimulus is removed. As the area of inflammation increases, the pain tends to become more severe.
Important signals to seek medical treatment include: pain when chewing, hot or cold sensitivity, bleeding or discharge around a tooth or gums, swelling around a tooth or of your jaw and injury or trauma to the area. Dental decay or an area of redness around the tooth's gum line may also point to the source of pain.
In addition, patients who experience severe pain after a tooth is pulled may experience pain as a result of the tooth socket being exposed to air. The condition is known as "dry socket syndrome."
Wisdom teeth can also cause pain. As wisdom teeth (molars) start growing out, they cause inflammation of the gum around the erupted crown. The gum overlying the crown may become infected and cause pain to the jaw and ear.
There may be swelling in the affected area, which will prevent the jaw from closing properly. In severe cases, pain in the throat and in the bottom of the mouth may make it hard to swallow.
Pain accompanied by swelling of the gums or face, discharge around a tooth, pain when opening the mouth very wide and/or fever (an important sign of infection) warrant a call to the doctor or dentist. Fever and swelling may indicate the presence of an abscess.
Dental abscesses may require antibiotics and surgical opening (drainage) of the abscess. In addition, depending upon the circumstances, the dentist may also recommend a root canal.
Sources:
Acute sinusitis. Web. www.mayoclinic.com. Accessed 3 Dec. 2011
http://www.mayoclinic.com/health/toothache/AN01433
Toothache: First Aid. Web. www.mayoclinic.com. Accessed 3 Dec. 2011
http://www.mayoclinic.com/health/first-aid-toothache/FA00013
Toothache. Web. www.emedicinehealth.com. Accessed 3 Dec. 2011
http://www.emedicinehealth.com/toothache/article_em.htm
Reviewed December 5, 2011
by Michele Blacksberg RN
Edited by Malu Banuelos