Teeth are the only part of the human body that cannot repair or heal on its own. Research on the effect of oral health on people in the United Kingdom reported that 51% of adult individuals were affected negatively by dental problems.¹

Have you ever experienced toothache? A famous quote says, “Some tortures are physical, some tortures are mental, the one that is both is dental”.

What is toothache?

Toothache medically termed-odontogenic pain refers to pain originating from the teeth or their associated structures, including the gums, maxillary (upper jaw) and mandibular bone (lower jaw) or periodontal tissues.²

Causes of toothache³

Toothache can be because of any of the following-

• Tooth decay or Dental caries
• Gum diseases
• Fractured tooth
• Dental abscess or infection
• Broken filling or restorations
• Wisdom tooth impaction
• Pericoronitis
• Bruxism or teeth-grinding
• Dry socket

Toothache is caused by inflammation of the dental pulp, most commonly because of dental caries (tooth decay).² Around the world, tooth decay is one of the most common human diseases affecting 60-90% of school children.²

Types of toothache

Toothaches can be differentiated based on their duration and severity.

Acute sharp throbbing pain

Acute sharp pain is most often associated with dental pulpitis, inflammation of dental pulp tissues because of dental caries or any chemicals used in dental treatment. This pain may be reversible or non-reversible. If the reversible infection is left untreated, it leads to irreversible pulpitis.³

Chronic dull aching pain

The constant severe pain is commonly associated with dental abscesses. If the pain is dull and continuous, it may be because of underlying gum diseases or night teeth grinding.

Sensitivity to hot and cold food

Minor tooth decay, a broken filling or exposure of root surfaces due to mild gum recession may lead to tooth sensitivity. Sensitivity may persist for a few seconds to minutes after eating hot or cold foods. ^{3, 5}

Distinguishing tooth pain

Most of the Orofacial pain may often mimic toothache, so it is important to distinguish between different types of pain. Toothache is the most common type of Orofacial pain but several other conditions such as nerve pain, maxillary sinusitis, trigeminal neuralgia and myofascial pain may present themselves as tooth pain.⁴ Time of occurrence, severity and pain associated with triggering factors may help to differentiate nerve and tooth pain. Seeking medical or dental professional consultation is highly recommended when any of the symptoms or facial pain arises.

Maxillary sinusitis is another condition often mistaken as toothache. Recurrent maxillary sinus infection often leads to widespread pain in the upper back tooth region, and it is associated with fullness on the affected part of the face. The sinusitis pain is usually unilateral, dull, throbbing, continuous and associated with fever.² An important distinguishing feature to differentiate from toothache is, that pain due to maxillary sinusitis increases on lying down or bending down.

Treatment

There are several treatments available for toothache, but it depends on the severity of the condition. Dentists after an initial examination and diagnosis can give the appropriate treatment plan. Some of the treatment options are listed below-

Over-the-counter pills

When you are waiting for your dental appointment, over-the-counter painkillers or analgesics may be helpful to ease your dental pain.

Dental fillings

For early dental caries, small cavities, or small fractures of the tooth that don’t involve dental pulp, your dentist may advise dental fillings or restorations.

Root canal treatment

In case of severe dental caries, severely fractured tooth, or pulpitis (pulpal inflammation) root canal treatments are advised.

Tooth extractions

If the tooth is severely damaged or a loose tooth because of an underlying abscess or periodontal disease, and if it cannot be repaired, the dentist may remove or extract your tooth.

Dental crowns

After restoration or root canal treatments of carious tooth, dental crowns are recommended to protect the existing tooth structure. It is also helpful in cases of sensitivity due to tooth attrition in older patients.

Night guards

For patients suffering from teeth grinding, night guards made of silicone are provided to prevent damage to tooth structures and alleviate pain.

Ignoring tooth pain

Prevention is better than cure fits well even for dental problems. Visiting your dentist every six months can be highly helpful to detect and treat any early cavities. Cleaning your teeth at six-month intervals also helps you to prevent gum disease.

If the toothache is ignored for longer term it may progress to irreversible condition that can require root canal treatments or sometimes tooth extraction. At extreme conditions, a dental abscess can progress to other deadly conditions such as cellulitis of the face.

If you have any dental pain that lasts longer or any facial swelling, immediate medical intervention is recommended.

Interesting facts

Phantom Tooth Pain (PTP) is manifested as persistent pain and burning sensation in the face, teeth, and supporting oral structures. It usually occurs because of nerve injury to the face during dental or surgical procedures.

Summary

Toothache, often caused by tooth decay, gum disease, or infections, can manifest in various forms, including acute sharp pain, chronic dull ache, or sensitivity to hot and cold foods. It's crucial to distinguish between tooth pain and other Orofacial pains like nerve pain or sinusitis. Treatment options range from over-the-counter painkillers to dental fillings, root canal treatments, extractions, dental crowns, and night guards for teeth grinding. Ignoring tooth pain can lead to irreversible conditions, necessitating root canal treatments or extractions and, in extreme cases, potentially life-threatening complications like cellulitis. Regular dental check-ups and prompt medical attention for persistent pain or swelling are emphasized for maintaining oral health and preventing severe complications.

FAQ’s

What is toothache?

Toothache, medically known as odontogenic pain, refers to pain originating from the teeth or their associated structures, including the gums, maxilla, mandible, or periodontal tissues.

What are the common causes of toothache?

Toothache can be caused by various factors, including tooth decay (dental caries), gum diseases, fractured teeth, dental abscesses or infections, broken fillings, impacted wisdom teeth, bruxism (teeth grinding), or dry sockets.

How can toothache be differentiated?

Toothache can be differentiated based on its duration and severity. It may manifest as acute sharp throbbing pain (often associated with dental pulpitis), chronic dull aching pain (commonly associated with dental abscess), or sensitivity to hot and cold foods.

How can I distinguish tooth pain from other types of Orofacial pain?

Distinguishing tooth pain from other types of Orofacial pain, such as nerve pain or maxillary sinusitis, can be done by observing factors like time of occurrence, severity, and pain associated with triggering factors. Consulting a medical or dental professional is recommended for accurate diagnosis and treatment.

What are the treatment options for toothache?

Treatment options for toothache vary depending on the severity of the condition and may include over-the-counter painkillers, dental fillings, root canal treatments, tooth extractions, dental crowns, or night guards for teeth grinding.

What happens if toothache is ignored?

Ignoring tooth pain can lead to the progression of dental conditions, potentially requiring more extensive treatments like root canal treatments or extractions. In severe cases, untreated dental abscesses can lead to life-threatening complications such as cellulitis.

How can I prevent toothache?

Preventive measures for toothache include maintaining good oral hygiene, visiting your dentist regularly for check-ups, cleaning your teeth at recommended intervals, and seeking immediate medical attention for persistent pain or swelling.

When should I seek immediate medical intervention for toothache?

Immediate medical intervention is recommended if toothache persists for an extended period or is accompanied by facial swelling, as these may indicate serious underlying conditions that require prompt treatment.