Toothache: Causes, Symptoms, And Treatment

The soft material inside the tooth, known as the pulp, is filled with nerves, tissues, and blood vessels. These nerves are some of the most sensitive in the body, and when they become irritated or infected by bacteria (abscess), they can cause severe pain, referred to as toothache.

A toothache is a common symptom of an underlying dental or oral problem typically characterized by pain in or around a tooth. Minor toothaches can result from temporary gum irritation, which can be treated at home. However, more severe toothaches may require professional intervention. If left untreated, toothaches caused by tooth decay can worsen over time. Although usually not life-threatening, in some cases, toothaches can be referred from another part of the body, indicating a more serious medical condition that requires urgent medical attention.

Causes of toothache

Toothache is a common problem caused by various issues, ranging from a cavity to a sinus infection. The most common reasons for a toothache are decay, an infection, a cracked tooth, gum disease, and grinding or clenching the teeth. 

• Decay occurs when the tooth's enamel is worn away by acids produced by bacteria, leading to a hole in the tooth. 
• Infections can occur due to bacteria entering a tooth through a crack or when decay has reached the tooth's pulp. 
• A cracked tooth can be caused by hard foods, a fall, or grinding the teeth. Gum disease is caused by bacteria and plaque buildup on the teeth, which can cause the gums to become inflamed and infected. 
• Grinding or clenching the teeth can cause the teeth to be overworked and irritated, leading to toothache.

Other causative factors may include exposed nerve endings in a tooth, damaged fillings, trauma or injury, or a foreign object lodged between the teeth. Sometimes sinus infections, jaw joint problems, and even certain foods can cause toothache. It is crucial to see a dentist for a proper diagnosis and treatment.

Toothache can be a warning sign of heart and lung disease due to its connection with the vagus nerve, which runs from the brain to the heart and lungs and passes through the jaw. In addition, certain neurological conditions can cause inflammation or irritation of nerves triggering toothache.

Symptoms of toothache 

Toothaches can manifest in many forms and intensities. Pain may be transient or persistent and can worsen upon consumption of hot or cold food and beverages. The sensation may be described as sharp and abrupt in onset and often intensifies during the night or when lying down. Common symptoms of toothache include:

• sharp and throbbing pain
• tenderness in the affected area
• sensitivity to hot and cold temperatures
• pain and difficulty while chewing
• swelling in the gums
• bad taste and bad breath. 

Sometimes, a person may also experience fever, headache, earache, facial swelling, and lymph node swelling.

Treatment for toothache

Temporary relief from a toothache can be achieved by:

1. Rinsing your mouth with warm saltwater can help loosen debris between teeth, disinfect, and reduce inflammation. To prepare the salt water, add ½ teaspoon of salt to a glass of warm water, and rinse your mouth thoroughly.
2. Rinsing with a 3% solution of hydrogen peroxide can help to reduce inflammation and alleviate associated pain. To use this solution, mix it with an equal amount of water and rinse thoroughly. Take precautions not to swallow the solution.
3. For swelling and pain, apply a cold compress of ice wrapped in a towel to the affected area for 20-minute periods, repeating every few hours. It helps reduce inflammation and alleviate discomfort.
4. Herbal treatments such as the application of clove oil, vanilla extract, peppermint tea, and crushed garlic to the affected area can help treat the condition and alleviate pain. 

In case of progressive toothache, temporary remedies will not be helpful and may require professional assistance. The clinical treatment module largely depends on the toothache's causative factor. The doctor may perform diagnostic procedures such as physical examination and imaging tests to detect and examine the cause and severity of the condition and may recommend one of the following treatment procedures:

Medication – Over-the-counter drugs such as ibuprofen can be advised to reduce the pain. If the toothache is accompanied by a fever or swelling of the jaw, an antibiotic may be added as part of the treatment plan.

Filling the cavity - If a toothache is caused by tooth decay, the dentist will remove the decayed area and replace it with a filling. Alternatively, if a loose or broken filling causes toothache, the dentist will take out the filling, remove any decay present in the tooth, and replace the filling with a new one.

Root Canal - For treating infected tooth pulp, you may need root canal treatment, which entails the removal of the infected pulp and inserting a special filling to seal the tooth and prevent re-infection. 

Dental extraction - If the toothache cannot be treated using these methods, or if the tooth is impacted between another tooth and jaw, it may need to be extracted.

Tips to Prevent Toothache

Preventing toothache is essential and can be achieved by following simple steps.

1. Brush your teeth, preferably twice a day, using a soft-bristled toothbrush and fluoride toothpaste.
2. Floss daily to remove plaque and food particles between the teeth and the gum line. 
3. Use an antimicrobial mouth rinse to reduce the bacteria in the mouth.
4. Avoid sugary and acidic foods, as these can erode the enamel on the teeth and cause decay. 
5. Regularly visit your dentist for check-ups and professional cleanings to ensure your teeth and gums remain healthy. 
6. If you suffer from dry mouth, use a fluoride rinse to keep the mouth moist. 
7. Avoid smoking as it increases the risk of gum disease, tooth decay, and oral cancer and can even worsen some existing dental problems.