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TOOTHACHES

Toothaches are a pain! There are many possible causes listed below. Be aware that referred pain from the jaw may cause you to have symptoms of toothache. Pain sometimes originates from other areas and radiates to the jaw, thus appearing to be tooth pain. The most common areas include the jaw joint (temporomandibular joint or TMJ), ear pain, and even occasional heart problems.

Important Note

A toothache needs to be differentiated from other sources of pain in the face. Sinusitis, ear or throat pain, or an injury to the temporomandibular joint(TMJ) that attaches the jaw to the skull may be confused with toothache. Pain from a deeper structure (called referred pain) may be passed along the nerve and be felt in the jaw or tooth. In order to pinpoint the source of the pain and get relief, call your dentist or doctor for guidance.

The following symptoms should lead you to seek advice from your dentist:

  • Severe pain to pressure
  • Hot or cold sensitivity: pain may persist for longer than 15 seconds after the stimulus is removed
  • As the area of inflammation increases, the pain becomes more severe.
  • Pain may radiate to the cheek, the ear, or the jaw.
  • Pain with chewing
  • Bleeding or discharge from around a tooth or gums
  • Swelling around a tooth or swelling of your jaw
  • Injury or trauma to the area
  • Dental decay or an area of redness around the tooth’s gum line may point to the source of pain
  • If you tap an infected tooth, it may make the pain more intense, even if the tooth appears normal.

What causes a toothache?

  • Tooth infection, decay, injury, or loss of a tooth are the most common causes of dental pain.
  • Toothache or tooth pain is caused when the nerve root of a tooth is irritated.
    • Toothache occurs from inflammation of the central portion of the tooth called pulp. The pulp contains nerve endings that are very sensitive to pain. Inflammation to the pulp may be caused by dental cavities, trauma, and infection.
  • Pain may also occur after an extraction (tooth is pulled out).
    • You may experience severe pain after a tooth is pulled. This may occur on the second or third day after tooth extraction.This is a result of the tooth socket being exposed to air. The condition is known as “dry socket syndrome.” If you develop this condition, you should see a dentist within 24 hours.
  • Wisdom teeth can cause pain.
    • As wisdom teeth (molars) are coming out, they cause inflammation of the gum around the erupted crown. The gum overlying the crown may become infected. The pain may extend to the jaw and ear. There may be swelling in the affected area so that the jaw cannot be closed properly. In severe cases, pain in the throat and the floor of the mouth may make it difficult to swallow.

You should call your doctor or dentist for help with the following concerns:

  • Dental pain not relieved by over-the-counter medications.
  • Pain associated with swelling of the gums or face or discharge around a tooth.
  • Fever is an important sign of infection in dental disease.
    • Simple dental decay does not cause fever.
  • Fever and swelling may indicate the presence of an abscess.
    • Dental abscesses may require antibiotics and surgical opening (drainage) of the abscess.
    • When this procedure is recommended to be done inside the tooth, a “root canal” is performed, or the tooth is pulled.
  • Broken or knocked-out teeth from an injury
  • Swallowed teeth and permanent tooth loss are considered dental emergencies.
  • Tooth loss due to injury is cared for differently in children who have lost their primary teeth as opposed to older children and adults with injury to their secondary teeth.
  • Pain at the angle of your jaw.
    • If every time you open your mouth widely you have pain, it is likely that the temporomandibular (TMJ) joint has been injured or inflamed.
    • This can occur from an injury or just by trying to eat something that is too big.

Prevention

  • You can prevent the majority of dental pain problems through flossing, brushing with fluoride toothpaste, and having your teeth professionally cleaned twice a year. The dentist may apply sealants and fluoride.

    Please read the Dental Emergencies for more important information.

  • Remember, any history of trauma, chest pain or history of heart disease, or rashes may suggest causes of pain other than of purely dental origin. These symptoms with toothache or jaw pain indicate that you should visit your doctor or your nearest emergency room.

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