Toothaches: Causes, Complications & Treatment

What Is a Toothache?

Toothaches are a common dental condition that can cause minor, moderate, to severe tooth pain.

Typically, if you have a toothache, you’ll experience intense pain that stems from the affected tooth or jaw. The discomfort usually comes on suddenly and can be attributed to cavity formation, an infection, tooth irritation, or another condition.

In some cases, toothaches are a result of excessive teeth grinding (bruxism) or dental trauma, such as an injury.

Causes of Severe Tooth Pain

A toothache can be the result of a variety of dental problems. The pain can be a sign of an underlying dental or medical condition. Common causes of toothaches include:

Tooth Abscess

An abscessed tooth is caused by a localized infection that affects the surrounding structures of teeth. The infection is triggered by the long-term build-up of pus inside the gums or teeth and forms due to a bacterial infection.

There are three different types of dental abscesses, including gingival, periodontal, and periapical. Severe throbbing and pain near the infected tooth often accompany an abscess. In addition to a toothache, you may feel pain in the gums or root.

Tooth Decay

Tooth decay (cavities) is the most chronic oral disease that affects people of all ages. By definition, cavities are brownish or black spots on teeth that develop into tiny holes.

They form due to plaque buildup, poor oral hygiene, or dry mouth, among others. If a cavity gets large enough and closer to the nerves, tooth pain and throbbing develop.

Earache

In some cases, a toothache can be “referred pain,” which means the pain is actually coming from somewhere else in the body. Earaches commonly cause toothaches and vice versa.

Jaw or Mouth Injuries (Tooth Fractures)

Injuries to the jaw or teeth can result in toothaches.

For example, if your tooth cracks, sensitivity and severe pain will develop because the nerves within the tooth become exposed. Tooth cracks can also form due to long-term bruxism (teeth grinding).

Gingivitis

If the toothache pain stems from the gums, gingivitis may be the cause.

Gingivitis is a mild form of gum disease that causes inflammation in the gingival tissues without bone loss.

This form of gum disease is reversible and treated during professional teeth cleanings. If it is left untreated, periodontitis can form, which is a severe gum disease that results in permanent bone loss. Signs of gingivitis include red or swollen gums, bleeding gums, and bad breath.

Wisdom Teeth

Wisdom teeth can cause pain in your teeth and gums.

If they are impacted (coming in sideways), they may push against another tooth, causing toothaches. They can also form cysts, or a buildup of bacteria around the tooth when they erupt through the gum line.

Other risk factors associated with toothaches include:

• A heart attack or other heart problems
• Poorly placed or leaking restorations, such as crowns and fillings
• Obstructive sleep apnea and mouth breathing
• Temporomandibular joint disorder (TMJ)
• Tooth loss, including surgically extracted teeth
• A sinus infection
• Acid erosion
• Cold sore or canker sore
• Gum recession
• Pregnancy

Signs & Symptoms of a Toothache

Toothaches, jaw pain, and gum tenderness are common conditions.

Most people experience mild dental pain or toothaches at some point in their life. If the pain is not severe and doesn’t persist, it is typically nothing to worry about.

However, if you feel pain or pressure for longer than 15 seconds after exposure to cold or hot liquids, it may be due to a more serious underlying condition.

Common symptoms of a toothache include:

• Pain when chewing or biting down
• Sensitive teeth when drinking hot or cold liquids
• Trauma or injury to the area
• Inflammation, bleeding, and swelling around the affected tooth or gums
• Swollen jaw or cheeks

Toothache Home Remedies

If you are experiencing tooth pain, the first thing you should do is schedule a check-up with your general dentist. They will perform an oral exam and inspect the affected area. They will be able to provide you with oral health care instructions and provide additional dental care if necessary.

In the meantime, certain home remedies may provide short-term relief.

Salt Water Rinse

Salt water is a natural antibacterial agent. Rinsing with salt water can help reduce inflammation and protect your teeth from infection. Combine 8 oz warm water with ½ teaspoon of salt and swish for 30 seconds and spit.

Over-The-Counter Pain Medication

OTC pain relievers, including acetaminophen (Tylenol), Ibuprofen (Advil), or aspirin (Bayer), can provide short term pain relief. Be sure to follow the instructions found on the label.

Cold Compress

An ice pack can help if your face or jaw is swollen. Wrap the ice pack in a cloth and place it at the site of the swelling for twenty minutes. This is especially helpful before bed.

Clove Oil (Eugenol)

Eugenol is an active compound found in cloves that has anti-inflammatory properties.

According to research applying eugenol to your gums can help ease pain and swelling. Soak ground cloves in water to make a paste and apply to the painful tooth.

You should seek medical attention for the toothache if:

• It lasts longer than a few days or becomes more severe over time
• You are also experiencing an earache or fever
• There is severe inflammation or bleeding around the tooth that causes jaw, ear, or cheek pain
• There is any swelling inside your mouth or in your cheeks, jaws, or neck

Professional Toothache Treatment

Treatment for a toothache depends on how severe it is and what is causing it. For example, common treatment options include:

Cavity Fillings

If a small cavity is causing your toothache, a dentist may recommend a filling. Before the filling is placed, a portion of the cavitated tooth is removed. Then it is filled with a tooth-colored restorative material.

Fillings close the spaces in teeth where bacteria and food particles can enter, which prevents the progression of tooth decay. 

Other Dental Restorations

If the underlying cause of your toothache is due to a large cavity, dental trauma, gum disease, or an infection, a dentist may recommend an X-ray. Depending on the results, a more invasive restoration may be necessary.

Dental crowns, implants, and inlays are common options.

Root Canal Treatment

If a toothache occurs after chewing or when pressure is applied, your tooth’s dental pulp may be infected. When the dental pulp gets infected due to extreme decay, the teeth become sensitive to hot or cold substances.

Root canal treatment removes the infected dental pulp in the roots of teeth and also relieves pain associated with the infection. Then the tooth is restored with a crown.

Tooth Extractions

Tooth extractions, which is the surgical removal of teeth, is typically necessary after teeth are damaged from an injury, disease, or tooth decay. A dental implant may be placed after extraction to replace the missing tooth.

Mouthguard (Bruxism Related Toothache)

Bruxism is the habit of clenching and grinding the teeth during sleep. Over time, the enamel wears away, and the teeth become more prone to cavities, cracks, and toothaches.

To reduce bruxism-induced tooth pain, a dentist may recommend a custom-made occlusal splint that protects teeth from grinding, clenching, and gnashing.

How to Prevent Toothaches

To prevent toothaches, practice proper oral health care.

Brush your teeth using a toothpaste approved by the American Dental Association (ADA). Flossing daily will help to remove plaque, bacteria, and food particles brushing may miss. Use an ADA approved mouthwash as well.