Toothache, could it be more then just a little pain?

A "Toothache" can usually be referred to as pain that is felt around the teeth and or jaw. The cause of a toothache in most cases is by either problems with your jaw and or tooth. In most cases you (and I am talking from experience here) you would just leave it and wait for the pain to subside, but this isn’t the correct thing to do. Toothaches are a sign that there may be more to worry about then just a little pain. The causes of toothache are several but the major causes are, dental cavity, a cracked tooth, exposed tooth root, gum disease, disease of the jaw joint or spasms of the muscles used for chewing. It is possible for the cause of a toothache to originate from an entirely different problem such as heart attack or angina but this is quite rare. It can be noted however that some patients suffering angina will show toothache or jaw pain as the only symptoms so it is always best to let your dentist or doctor evaluate you. What are the most common dental causes for a toothache? 

Dental Cavities

The most common cause of a toothache is a dental cavity. Dental cavities (caries) are holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath the enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Certain bacteria in the mouth convert simple sugars into acid. The acid softens and (along with saliva) dissolves the enamel and dentin, creating cavities. Small shallow cavities may not cause pain and may be unnoticed by the patient. The larger deeper cavities can collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods that are cold, hot, sour, or sweet-causing toothache. Toothache from these larger cavities is the most common reason for visits to dentists. Treatment of a small and shallow cavity usually involves a dental filling. Treatment of a larger cavity involves an onlay or crown. Treatment of a cavity that has penetrated and injured the pulp requires either a root canal procedure or extraction of the affected tooth. Injury to the pulp can lead to death of pulp tissue, resulting in tooth infection (dental abscess). The treatment of an infected tooth is either removal of the tooth or a root canal procedure. The root canal procedure involves removing the dying pulp tissue (thus avoiding or removing tooth infection) and replacing it with an inert material. The procedure is used in an attempt to save the dying tooth from extraction. 

Gum Disease

The second most common cause of toothache is gum disease. Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. Gum disease is caused by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria. Early symptoms of gum disease include gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth. Treatment of early gum disease involves oral hygiene and removal of bacterial plaque. Moderate to advanced gum disease usually requires a thorough cleaning of the teeth and teeth roots called "root planing" and "subgingival curettage." Root planing is the removal of plaque and tartar (hardened plaque) from exposed teeth roots while subgingival curettage refers to the removal of the surface of the inflamed layer of gum tissue. Both of these procedures are usually performed under local anesthesia and may be accompanied by the use of oral antibiotics to overcome gum infection or abscess. Follow-up treatment may include various types of gum surgeries. In advanced gum disease with significant bone destruction and loosening of teeth, teeth splinting or teeth extractions may be necessary. 

Tooth Root Sensitivities

Chronic gum disease also contributes to toothache due to root sensitivities. The roots are the lower 2/3 of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The exposed roots can become sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone. The sensitivities may be so severe that the patient avoids any cold or sour foods. Early stages of root exposure can be treated with topical fluoride gels applied by the dentist or with special toothpastes (such as Sensodyne or Denquel) which contain fluorides and other minerals. These minerals are absorbed by the surface layer of the roots to make the roots stronger and less sensitive to the oral environment. If the root exposure causes injury and death of the inner living pulp tissue of the tooth, then a root canal procedure or tooth extraction may be necessary. 

Cracked Tooth Syndrome

"Cracked Tooth Syndrome" refers to toothache caused by a broken tooth (tooth fracture) without associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc. Sometimes, the fracture can be seen by painting a special dye on the cracked tooth. Treatment usually involves protecting the tooth with a full-coverage gold or porcelain-fused-to-metal crown. However, if placing a crown does not relieve pain symptoms, a root canal procedure may be necessary. What should I do about my toothache?

A toothache should always be professionally treated by a dentist. However there are some self methods that will help with the pain until a dentist appointment can be made.

1.Apply a cold compress (e.g bag of frozen beans from the freezer) against the outside of the cheek. 2.Rinsing your mouth out with warm salt water
3.Use dental floss to remove any food particles from the area 4.Taking an aspirin

Please not none of these remedies should be used instead of seeing a dentist but only for temporary pain relief. Toothaches are usually a mask for an underlying problem which may be worse.

Toothache Prevention

These are the standard prevention methods, but you know what. THEY WORK….

1.Brush in between meals or twice a day 2.Use a toothpaste that contains fluoride (most do these days) 3.Ask your dentist about using a tongue cleaner (this is important specifically for people who smoke or whose tongues are coated or deeply grooved)

4.Ask your dentist which mouthwash he or she recommends using. 

5.Schedule regular trips to your dentist (the dentist will recommend every 6 months) 

6.Do not smoke or use tobacco products 

7.Do not use illegal drugs, such as methamphetamines which cause tooth and gum problems

By following the majority of these you should have healthy, clean and pain free teeth for the majority of your life.

In conclusion a toothache should always be treated by a dentist as it could lead to something more serious. Following the tooth prevention method’s above will in most cases keep your teeth nice and health and keep you away from the dentist.