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What is Toothache?

By Dr Ananya Mandal, MD

Toothache refers to pain in and around the teeth and jaws and is one of the most common symptoms of dental caries or tooth decay. Toothache may also be a symptom of gingivitis, periodontitis, impacted wisdom teeth, ulcers, sinusitis or dental abscesses.

Characteristics of toothache

  • Toothache may range in severity between mild, severe and excruciating pain.
  • The onset of pain may be acute and begin suddenly or may occur gradually. Initially, pain may begin with discomfort on eating and then progress to a severe throbbing or stabbing pain that worsens at night.
  • The pain may come and go or may remain persistently intense.
  • There may be an increased sensitivity to hot, cold or sweet food and drink that cause tingling in the teeth, followed by intense toothache.
  • The pain may be confined to a decayed or affected area of the tooth or may spread to the jaws or ear of the same side of the face. Intense toothache may also cause a headache.
  • The jaw where the affected tooth is located may appear swollen and may be painful to touch.

Causes of toothache

Toothache lasting more than one or two days needs to be investigated by a dentist. Early diagnosis of the cause is important as treatment prescribed early on often prevents the more severe complications of tooth decay such as dental abscesses manifesting.

The innermost part of the tooth contains the tooth pulp and this is the part of the tooth that has become infected, inflamed or injured when toothache begins. Some causes of toothache include:

  • Tooth decay forming cavities or holes in the tooth - The hard enamel covering the tooth becomes eroded, exposing the pulp underneath which may become infected and sensitive to touch or temperature.
  • Injury to the tooth - Small cracks in the tooth enamel due to injury may expose the dental pulp and lead to toothache. Similarly, loose, displaced or broken fillings also expose the inner pulp.
  • Gum disease or receding gums expose the more sensitive, lower parts of the tooth such as the roots which are sensitive to pain and may cause toothache.
  • A painful dental abscess or collection of pus under the tooth may occur in severe cases of tooth decay.
  • Periodontal disease or periodontal abscess may also lead to severe toothache.
  • Injuries to the jaw and temporomandibular joint can result in toothache.
  • Tooth ache may occur during teething or with the eruption of wisdom teeth.
  • Other conditions such as inflamed sinuses or even an impending heart attack may lead to jaw pain or toothache.

Diagnosing the cause and treating toothache

The cause of toothache is established on clinical examination followed by a tooth X-ray and treatment varies depending on this cause. For example, if the toothache is caused by tooth decay, the decayed area is removed and the cavity is filled with a dental filling. If the dental pulp is infected, root canal treatment may be needed.

Reviewed by , BSc

Last Updated: Oct 8, 2013

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