A toothache or tooth pain is a pain in or around a tooth and jaws. The pain can come and go or be constant. It can also be worsened by eating or drinking, particularly if the food or drink is hot or cold. The pain can also be mild or severe. It can be described as sharp, intense, throbbing, miserable, or unbearable and can be worse at night. Generally, a toothache can be in several forms and patterns all with a common theme of ‘pain’. Toothache can affect a person’s ability to perform normal activities, such as their job, housework, social activities, sleeping, talking, and eating, as well as making them depressed and affecting their social interactions.
Toothache has been confirmed as a public health problem. A recent investigation of children and adolescents revealed that overall, about one-tenth of patients complaining of pain suffered from toothache. A wide range of toothache occurrence has also been reported from 5% of the population to 88% of the patients in dental clinics round the world.
What are the causes of tooth pain?
Most of the pain of toothache comes from a part of the inner tooth called the pulp. The pulp contains several blood vessels and nerve endings. These pulp nerves are among the most sensitive in the human body. When these nerves are irritated or infected, they can cause severe pain. Toothache can be from the tooth (odontogenic causes) and from surrounding structures (non-odontogenic causes). They are:
- Dental caries or tooth decay. This is the commonest cause of tooth pain. It occurs when bacteria destroy the tooth structure by forming a cavity from acidic byproducts of bacterial carbohydrate metabolism that erode through the enamel and dentin and then into the pulp. The bacteria that causes tooth decay is as a result of the degradation of remnants of sugary food in the tooth, especially overnight due to poor dental hygiene. According to the WHO, caries of permanent teeth is the most common cause of toothache and it is estimated that 2 billion people globally suffer from caries of permanent teeth and 520 million children suffer from caries of primary teeth. The CDC also estimates that 13.2% of children aged 5-19 years and 25.9% of adults have untreated dental caries in the U.S.
- Receding gums where the gums shrink (contract) to expose softer, more sensitive parts of the tooth root
- Periapical abscess, which is a collection of pus at the end of the tooth caused by a bacterial infection.
- Cracked tooth.
- Loose or broken fillings
- Fracture of the tooth or tooth root
Tooth pain not from direct injury to the pulp are:
- Periodontal abscess, which is a collection of pus in the gums caused by a bacterial infection
- Ulcers on the gums
- Sore or swollen gums around an erupting tooth for example during teething in children or wisdom tooth eruption or impaction.
- Repetitive motions, such as chewing gum or grinding or clenching teeth which can wear down the teeth resulting in pain.
Non- odontogenic causes of tooth pain include:
- Sinus infections
- Temporomandibular (jaw) joint problems
What are the other symptoms of tooth pain?
Apart from pain, other associated features a person with toothache can have include:
Swelling around the tooth.
Fever or headache.
Foul-tasting drainage from the infected tooth.
A bad odor from the mouth.
Can tooth pain go away on its own?
Depending on the cause of a toothache, it may go away on its own without a trip to the dentist. If it is due to a temporary gum irritation, or self-resolving sore, it may go away on its own after some days. Non- odontogenic causes of tooth pain can also resolve on their own sometimes depending on the cause. However, most cases of odontogenic tooth ache require a visit to the dentist. The pain may be on and off, giving the impression that it has resolved on its own, however, this may be a false reassurance and the pain may recur again, sometimes in a much worse condition. Pain due to tooth decay is notorious for this, especially in the early stages. It may keep on fluctuating until the damage or the resultant cavity becomes extensive, resulting in severe pain that may become an emergency.
How to treat a tooth ache?
It is usually advisable to book an appointment with the dentist once a person begin to experience toothache. However, the following home remedies may be effective while waiting for the appointment with the dentist.
Cold compress. A cold pack or bag of frozen vegetables applied to the side of the face for 20 minutes at a time can help alleviate discomfort by blunting pain and reducing swelling.
Rinsing with warm, salt water. This can clean infections and promote temporary pain relief. Treating a toothache with salt water can also help heal any oral wounds and reduce inflammation.
Using a hot pack. The heat from this can also reduce discomfort by interrupting pain signals from the mouth to the brain.
Use of clove oil. This old method is used to treat dental pain throughout human history. A small amount of clove oil applied onto a clean cotton ball and dabbed to the affected area can reduce inflammation and numb oral pain. It also contains eugenol, a natural antiseptic that can sterilize oral wounds.
Use of peppermint tea bags. Peppermint tea bags have mild numbing properties that can ease oral pain for a short time. Most people prefer to cool their tea bags in the freezer for a couple of minutes before use. It can also be applied while it’s still warm and then wait for it to cool. This can create a pleasing sensation and a distraction from the tooth pain.
Analgesics. This (the NSAIDS) can also reduce the pain and swelling associated with tooth ache. Over the counter analgesics are usually taken according to the right dosing intervals written on the medications.
Visit to the dentist. the ultimate cure for tooth pain is when a visit has been made to the dentist. The dentist examines the person and determines the cause of the tooth ache. Based on the identified cause, they can offer treatment. This treatment ranges from antibiotics, tooth extraction, to dental surgery.