toothache

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Toothache

 

Definition

A toothache is any pain or soreness within or around a tooth, indicating inflammation and possible infection.

Description

A toothache may feel like a sharp pain or a dull ache. The tooth may be sensitive to pressure, heat, cold, or sweets. In cases of severe pain, identifying the problem tooth is often difficult. Any patient with a toothache should see a dentist at once for diagnosis and treatment. Most toothaches get worse if not treated.

Causes and symptoms

Toothaches may result from any of a number of causes:
  • tooth decay (dental caries)
  • inflammation of the tooth pulp (pulpitis)
  • abscesses
  • gum disease, including periodontitis
  • loose or broken filling
  • cracked or impacted tooth
  • exposed tooth root
  • food wedged between teeth or trapped below the gum line
  • tooth nerve irritated by clenching or grinding of teeth (bruxism)
  • pressure from congested sinuses
  • traumatic injury

Diagnosis

Diagnosis includes identifying the location of the toothache, as well as the cause. The dentist begins by asking the patient specific questions about the toothache, including the types of foods that make the pain worse, whether the tooth is sensitive to temperature or biting, and whether the pain is worse at night. The dentist then examines the patient's mouth for signs of swelling, redness, and obvious tooth damage. The presence of pus indicates an abscess or gum disease. The dentist may flush the sore area with warm water to dislodge any food particles and to test for sensitivity to heat. The dentist may then dry the area with gauze to determine sensitivity to touch and pressure. The dentist may probe tooth crevices and the edges of fillings with a sharp instrument, looking for areas of tooth decay. Finally, the dentist may take x rays, looking for evidence of decay between teeth, a cracked or impacted tooth, or a disorder of the underlying bone.

Treatment

Emergency self-care

Toothaches should always be professionally treated by a dentist. Some methods of self-treatment, however, may help manage the pain until professional care is available:
  • rinsing with warm salt water
  • using dental floss to remove any food particles
  • taking aspirin or acetaminophen (Tylenol) to relieve pain; the drug should be swallowed—never placed directly on the aching tooth or gum
  • applying a cold compress against the outside of the cheek; do not use heat, because it will tend to spread infection.
  • using clove oil (Syzygium aromaticum) to numb the gums; the oil may be rubbed directly on the sore area or used to soak a small piece of cotton and applied to the sore tooth

Professional care

Treatment will depend on the underlying cause of the toothache. If the pain is due to tooth decay, the dentist will remove the decayed area and restore the tooth with a filling of silver amalgam or composite resin. Loose or broken fillings are removed, new decay cleaned out, and a new filling is placed. If the pulp of the tooth is damaged, root canal therapy is needed. The dentist or a specialist called an endodontist removes the decayed pulp, fills the space left behind with a soothing paste, and covers the tooth with a crown to protect and seal it. If the damage cannot be treated by these methods, or if the tooth is impacted, the tooth must be extracted.

Alternative treatment

Toothaches caused by infection or tooth decay must be treated by a dentist. Several alternative therapies may be helpful for pain relief until dental treatment is available. Clove oil (Syzygium aromaticum) may be rubbed on sensitive gums to numb them or added to a small cotton pellet that is then placed into or over a hole in the tooth. The herb corydalis (Corydalis yanhusuo) may also help relieve toothache pain. Pain also may be reduced using acupressure, acupuncture, or reiki. Acupuncture should be done only by a licensed practitioner.

Prognosis

Prompt dental treatment provides a positive outcome for toothache. In the absence of active infection, fillings, root canal treatments, or extractions may be performed with minimal discomfort to the patient. When a toothache is left untreated, a severe infection may develop and spread to the sinuses or jawbone, and eventually cause blood poisoning.

Prevention

Maintaining proper oral hygiene is the key to preventing toothaches. The best way to prevent tooth decay is to brush at least twice a day, preferably after every meal and snack. Flossing once a day also helps prevent gum disease by removing food particles and bacteria at and below the gum line, as well as between teeth. People should visit their dentist at least every six months for oral examinations and professional cleaning.

Resources

Organizations

Academy of General Dentistry. Suite 1200, 211 East Chicago Ave., Chicago, IL 60611. (312) 440-4300. http://www.agd.org.
American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500. http://www.ada.org.

Other

Medical Source. Medical Alliances, Inc. 2121 Eisenhower Ave., Suite 603, Alexandria, VA 22314. (800) 463-6482 http://www.medsource.com.

Key terms

Abscess — A hole in the tooth or gum tissue filled with pus as the result of infection.
Bruxism — Habitual clenching and grinding of the teeth as a result of stress. The behavior usually occurs during sleep.
Cavity — A hole or weak spot in the tooth surface caused by decay.
Dental caries — A disease of the teeth in which microorganisms convert sugar in the mouth to acid, which then erodes the tooth.
Enamel — The hard outermost surface of a tooth.
Endodontist — A dentist who specializes in diagnosing and treating diseases of the pulp and other inner parts of the tooth.
Impacted tooth — A tooth that is growing against another tooth, bone, or soft tissue.
Periodontitis — A gum disease that destroys the structures supporting the teeth, including bone.
Pulp — The soft innermost part of a tooth, containing blood vessels and nerves.
Pulpitis — Inflammation of the pulp of a tooth that involves the blood vessels and nerves.

tooth·ache

(tūth'āk),
Pain in a tooth due to the condition of the pulp or periodontal ligament resulting from caries, infection, or trauma.

toothache

/tooth·ache/ (tldbomacth´āk) pain in a tooth.

toothache

(to͞oth′āk′)
n.
An aching pain in or near a tooth.

toothache

[to̅o̅′thāk]
Etymology: AS, toth + aeca
pain in a tooth, usually caused by pulpal infection or damage. Also called dentalgia, odontalgia, odontodynia. See also pulpitis.

toothache

Dental pain, dentalgia Vox populi A potentially incapacitating pain of a tooth in the mandible Causes Caries/tooth decay, periodontal disease, pain of reference from other body regions

tooth·ache

(tūth'āk)
Pain in a tooth due to the condition of the pulp or periodontal ligament resulting from caries, infection, or trauma.
Synonym(s): dentalgia, odontalgia.

toothache

Pain in or around a tooth, usually from TOOTH DECAY or a TOOTH ABSCESS.

tooth·ache

(tūth'āk)
Pain in a tooth due to condition of pulp or periodontal ligament resulting from caries, infection, or trauma.
Synonym(s): dentalgia, odontalgia, odontodynia.

toothache,

n pain located in the tooth or its surrounding supporting tissues. Dental pain may have a halo effect, making location of the precise source or location of the pain difficult. Determining the location may require several diagnostic tests.
toothache, nonodontogenic
n pain that presents as a toothache but that is not of dental origin.

Patient discussion about toothache

Q. Can anyone suggest a method which will prevent a toothache without any medication? My mom is a great singer which has been her passion for the past 35 years. She has thousands of fans of her and I am one among them. She used to sing for us at home in our every night ‘get-togethers’ which made us relax after a strenuous work day. But for the past 4 months all her fans are very upset because my mother has been suffering from a toothache which has made it difficult for her to sing. We tried many medicines but in vain. Can anyone suggest a method which will prevent a toothache without any medication?

A. May I know her name? I may be one of her fans too... It's an old wives’ tale but does provide TEMPORARY relief...WHISKEY on the gums. This is only a TEMPORARY relief until you get to the dentist but it does help numb the gums. Clove oil works excellently well too. It is quite strong, but serves its purpose. Dentists are the best. There is no life without oxygen. So it is best to get to the root cause to cure the problem.
http://www.youtube.com/watch?v=BoluegKfvGQ&eurl=http://www.imedix.com/health_community/vBoluegKfvGQ_dental__stop_a_toothache_naturally?q=toothache&feature=player_embedded

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