A toothache refers to pain felt in or around a tooth, which can range from a dull ache to sharp, intense throbbing. This discomfort arises when the innermost layer of the tooth, known as the dental pulp, becomes inflamed. The pulp houses sensitive nerves and blood vessels, making it highly responsive to irritation. While an infection is a frequent cause, tooth pain does not always indicate a bacterial invasion; various factors can trigger this uncomfortable sensation.
Common Causes of Toothaches
A dental infection can lead to an abscess, a pocket of pus at the tooth root due to bacterial invasion of the pulp, often from an untreated cavity or crack. This condition often causes severe, constant throbbing pain that might extend to the jaw, neck, or ear, with sensitivity to hot or cold temperatures and discomfort when chewing. Swelling in the face or cheek, fever, and tender lymph nodes under the jaw are common signs, along with a foul odor or taste in the mouth if the abscess ruptures.
Tooth decay, or cavities, is a frequent cause of tooth pain. As bacteria in plaque produce acids that erode tooth enamel and dentin, holes form in the tooth. This decay can lead to pain, particularly when exposed to cold, heat, or sweet foods. If left untreated, it can infect the dental pulp, causing throbbing pain or persistent sensitivity.
Gum disease, encompassing gingivitis and periodontitis, can cause toothaches. Gingivitis involves gum inflammation, while periodontitis is an advanced bacterial infection affecting the structures supporting the teeth. As bacteria accumulate, gums may become swollen, tender, and prone to bleeding, potentially leading to pain, gum recession, and abscesses.
Physical damage to a tooth, such as a crack or chip, can expose sensitive inner layers, causing pain. Minute cracks, invisible to the naked eye, allow irritants to reach the dental pulp, causing sensitivity or sharp, stabbing pain. A loose or broken dental filling can also expose the underlying tooth structure, resulting in heightened sensitivity or pain.
Bruxism, the involuntary grinding or clenching of teeth, particularly during sleep, can cause pain in the teeth and jaw. The constant pressure and friction can wear down tooth enamel, leading to sensitivity and discomfort. This habit can also strain jaw muscles and joints, contributing to broader facial pain.
Pain mimicking a toothache can originate from issues outside the mouth, such as sinusitis. The roots of the upper back teeth are often close to the maxillary sinuses, so pressure or infection in these cavities can be perceived as tooth pain. Symptoms might include pressure around the eyes and forehead, along with thick, discolored mucus.
Impacted wisdom teeth, molars that do not fully erupt through the gums, can cause discomfort. They can lead to localized pain, pressure, swelling around the affected area, and difficulty opening the jaw. This occurs as the wisdom tooth attempts to emerge but is blocked by existing teeth or insufficient space.
When to See a Dentist
Any persistent toothache, even if mild, requires evaluation by a dentist. Pain lasting more than a day or two, or not subsiding with pain relievers, suggests an underlying issue. Ignoring tooth pain can lead to complications, including infection spread, which may necessitate more involved treatments.
Certain symptoms require immediate dental attention. Severe, constant throbbing pain, especially if accompanied by swelling of the face or jaw, fever, or difficulty swallowing or breathing, indicate a serious infection requiring urgent care. A sudden rush of foul-smelling fluid in the mouth, indicating an abscess rupture, requires prompt evaluation, even if pain temporarily lessens.
A dentist will conduct a thorough examination, which may include dental X-rays, to diagnose the cause of the toothache. This diagnostic process helps determine the appropriate treatment plan. Delaying professional dental care can allow problems to worsen, potentially leading to increased pain, more complex procedures like tooth extraction or root canal therapy, and the spread of infection to other parts of the body.