Toothaches: Causes, Complications & Treatment

What Causes a Toothache?

Toothaches are a common dental condition that can cause minor, moderate, to severe tooth pain. Normally, if you have a toothache, you’ll experience intense pain that stems from the affected tooth or jaw. The discomfort typically 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.


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A toothache can develop for a variety of reasons. The pain can be a sign of an underlying dental or medical condition. In particular, the most common causes of severe tooth pain include the following:

receding gums
Tooth Abscess

A tooth abscess forms due to 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 oral abscesses, including gingival, periodontal, and periapical. Severe throbbing and pain near the affected tooth often accompany an abscess. In addition to a toothache, you may feel pain in the gums or root.

cavity
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 commonly develop.

stress
Earache

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

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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 are common symptoms because the nerves within the tooth may become exposed. Tooth cracks can also form due to long-term bruxism (teeth grinding).

gingivitis gum disease
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 loss of bone or attachment. This form of gum disease is reversible and treated during professional teeth cleanings. If it is left untreated, periodontitis can form, which is a serious gum disease that results in permanent bone loss.

Other risk factors associated with toothaches include:

Signs & Symptoms of a Toothache

Toothaches, jaw pain, and gum tenderness are common conditions. In fact, 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. Although, 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
  • Tooth sensitivity when drinking hot or cold liquids
  • Trauma or injury to the area
  • Inflammation, bleeding, and swelling around the affected tooth and/or gums
  • Swollen jaw or cheeks

Toothache Relief Tips

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 filling
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.

dental crown
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 a more invasive restoration. For example, dental crowns, implants, and inlays are common options.

root canal
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
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
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.

Resources

“Abscessed Teeth.” American Association of Endodontists, https://www.aae.org/patients/dental-symptoms/abscessed-teeth/.

Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.

“The Truth Behind a Toothache.” Https://Www.deltadental.com, https://www.deltadental.com/us/en/protect-my-smile/oral-health-conditions/toothaches/the-truth-behind-a-toothache.html.

“Toothaches: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, https://medlineplus.gov/ency/article/003067.htm.

Updated on: June 29, 2020
Author
Alyssa Hill
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Medically Reviewed: November 21, 2019
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Lara Coseo
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