There are few of us who have never experienced that sinking feeling when a tooth starts to hurt. As we poke around in our jaws, the thoughts begin to poke around in our heads. Is it going to develop into something worse? Is it a minor problem or a serious one? How am I going to find the time and the money for dental treatment? It is time to take a deep breath and to consider what is going on, beginning with what might be causing the pain in the first place.
Our first thought, when faced with a painful tooth, is that it is probably a cavity. Cavities are caused by the action of acid and bacteria breaking down the defensive enamel and finding a way into the softer dentin layer. Gradually they eat away and can eventually begin to affect the nerve-bearing pulp of the tooth, producing pain.
Regular inspections of the teeth by a dentist will normally spot cavities before they reach the stage of causing pain. The treatment is either the familiar amalgam filling or a white filling, which are both capable of protecting the tooth for many years.
A crack in a tooth may be microscopic and may not be apparent to a dentist on a routine inspection. Even X-rays may not show it unless they happen to be taken from exactly the right angle. It can be months or years after the initial trauma before painful symptoms emerge. Cracks can also develop between an old filling and the tooth itself.
The symptoms are similar to a cavity—a specific pain when you bite down on a tooth. If you can remember an occasion when you accidentally bit on something hard, it might be because of a crack in the enamel.
A pain which you feel when you eat or drink something hot or cold, or when you draw in cold air through your mouth, may be the result of a developing sensitivity. This can be caused by the enamel on the teeth wearing very thin, often because of a dietary factor such as a lot of acidic drinks. The thin enamel exposes the more sensitive dentin, which reacts more to the heat stimuli.
Another cause of sensitivity could be gum disease, causing the gums to withdraw and to expose more of the tooth near the roots. These parts of the tooth will also react more to hot and cold.
Infections can strike in many ways, and any of the above problems can lead to infection. The most painful version is an abscess, which is a severe infection in or around the root of the tooth, where the nerves are most vulnerable. Untreated, an abscess can lead to infection of the bone as well. A persistent throbbing pain is quite likely to be a symptom of an infection.
Pressure on the teeth can cause temporary pain. If you have had a new crown, bridge, or implant, then the neighboring teeth may have to adjust slightly to accommodate it for a few days.
Growing wisdom teeth can also cause problems, as the pressure for space and their late arrival on the scene can cause them to grow out badly, and the symptoms can come back years later. Steadily increasing pain at the back of the jaw may be caused by wisdom teeth needing extraction.
Only Your Dentist Can Tell
Whatever the cause of your toothache, only a dentist can give a definite diagnosis and effective treatment. Many people are afraid of dentists and will do anything to avoid a visit. Sometimes previous encounters have caused that, but advances in both treatment and pain relief now mean you can look forward to what might be called the Dentistry with TLC experience.
If your pain lasts more than a day or so, it is only sensible to make an appointment. If the pain gets significantly worse, you can ask for an emergency appointment; if it goes away, you can always cancel—though it would probably be sensible to have an investigation, as it will probably come back sometime.
Many Causes, One Decision
There are many possible reasons for a toothache, including rarer ones not mentioned above. There are ways to minimize your risk of being affected, mainly by a healthy diet and good dental hygiene. But when a toothache strikes, there is very little possibility of dealing with it by yourself. A visit to your dentist will need to happen sooner or later.
Patrick Foster works at a dental practice and has started to write articles to help better inform patients, as well as a wider online audience about dental health and what can be expected for various procedures.