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Toothache Guide: How Serious Are They?


The treatment for a toothache may involve a somewhat invasive dental procedure such as a dental filling, root canal, dental bridge, dental crown or ultimately, a tooth extraction. But treatment today can be comfortable, and in fact, often helps you avoid tooth extraction. In addition, today's cosmetic dentistry options, like dental veneers and dental implants, offer alternatives to traditional treatment, and provide a greater esthetic and functional benefit.

Toothache Types and What They May Mean

Evaluation and diagnosis by a dental professional can determine the type of toothache you are suffering from, and its source.

Sharp, Intermittent Tooth Sensitivity or Pain: Sensitivity to cold may denote gum recession, enamel loss from over-brushing or aging, wear and tear or a small dental cavity. Sensitivity to heat may also signify a small cavity, but it could be the result of an abscess, crack or severe decay.

Chronic Toothache: If one or more of your teeth is affected by chronic pain, nerve damage could be the cause. Nerve damage may result from teeth grinding, severe tooth decay or trauma to the teeth through injury.

Intense, Throbbing Pain: Intense, throbbing pain, sometimes accompanied by a swollen face, is often a sign of an infection or abscess.

Painful Eating: If it is painful for you to eat, the culprit could be tooth decay, or a slight fracture (crack) in a tooth.

Back-of-the-Jaw Pain: Pain in the back of the jaw may be associated with impacted wisdom teeth (back molars). But it could also be a sign of TMD or teeth grinding, both of which can cause jaw pain, and pain throughout other facial bone areas.

Toothaches range in severity, particularly in terms of tooth sensitivity and pain levels. An intermittent pain may seem little more than an occasional bother, while a chronic pain may prompt you to take immediate action.

Regardless of the type, your toothache should be evaluated by a dental professional through an oral health examination.

Causes and Solutions

Treatment for toothaches varies significantly depending on the severity of the pain and its cause. Options include:

Gum Recession: Gum recession can be reversed through a gum graft procedure whereby the gums are rejuvenated and maintained at their healthiest level. There are three approaches to the gum graft procedure:

  • The first approach involves removing tissue from the palate and grafting it to the root area.
  • The second approach involves an allograft (synthetic gum tissue) that is placed over a root.
  • The third approach is called a sliding graft whereby gum tissue is moved from adjacent areas over the root.

Tooth Sensitivity: Professional grade desensitizers are applied at the dental office, and require a reapplication every so often. Desensitizers can also be used during times of sensitivity at home. Finally, over-the-counter desensitizers such as those offered in select toothpastes may also provide relief.

Enamel Loss: An acidic diet, brushing too hard or natural wear and tear can result in enamel loss. When enamel is lost, the dentin (inner surface of the tooth) is exposed, causing sensitivity or pain. Desensitizers can help.

Wear and Tear: Enamel loss, uneven teeth, tiny chips and cracks can cause sensitivity or pain, and is usually indicative of tooth destruction. Uneven surfaces of the teeth may be filled with composite materials. Many cases involving wear and tear require tooth restoration with a crown or veneer.

Tooth Decay: Tooth decay is caused by an improper diet and poor dental hygiene. Depending on the amount of tooth decay you have, treatment may require a composite or amalgam filling, or, when accompanied by nerve damage or exposure of the root pulp, a root canal. When multiple tooth surfaces are affected, (making a dental filling an impractical solution) a dental crown or veneer is indicated.

Infection or Abscessed Tooth: An infection or abscess is the result of tooth decay or trauma. The treatment plan for an infection or abscess often begins with antibiotics and pain treatment, with a follow-up visit for root canal treatment. For the final restoration, the weakened tooth can be strengthened with a crown or veneer.

Crack or Fracture in Tooth: Cracks or fractures in teeth can occur from teeth grinding, trauma to the tooth or simply years of wear and tear. Usually, a cracked tooth is treated with a protective covering such as a dental crown or veneer.

Teeth Grinding: Teeth grinding can result in tooth fractures, unevenness and even a shift in the bite. Mouth guards used during sleep can help protect teeth from self-imposed injury caused by teeth grinding.

Impacted Wisdom Teeth: Impacted wisdom teeth are back molars that fail to surface. Impacted wisdom teeth can crowd and shift other teeth. Oftentimes, oral surgery is required to remove impacted wisdom teeth and relieve pain.

Is Your Toothache Indicative of a More Serious Problem?

Because some toothaches signify more serious health issues, you should not ignore them. For instance, studies have demonstrated that heart attacks may be signaled by the sensation of pain on the left side of the jaw. Soreness in the jaw and cheekbones or difficulty in chewing may also be the first sign of temporomandibular joint disorder (TMJ), a serious maxillofacial condition. In addition, sinus infections may produce pain in the upper molar teeth, wrongly leading you to believe that your pain is the result of a dental problem. It is for these reasons that you should consult your dentist if you have a chronic or extremely painful toothache.

The good news is that dentists now have more advanced methods for identifying the sources of toothache pain, and have developed more comforting and effective solutions to preserve teeth.

First Aid Relief for Toothache

Until you are able to reach the dental office, there are a few ways to find relief from dental pain.

Your dentist may advise you to take ibuprofen, acetaminophen or aspirin to dull the pain. Over-the-counter medications containing benzocaine may reduce pain in the affected tooth, or surrounding gum area. However, aspirin applied directly to the tooth is not recommended, because it can burn the gums or cheek.

To reduce discomfort from swelling, you may be advised to swish warm saltwater in your mouth periodically throughout the day, and apply an ice pack to the swollen area.





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    Kenneth A. Ingber, DMD

    Washington, DC 20006
    (202) 331-7474

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    Gordon M. Bell, DDS

    Hallam, PA 17406
    (717) 757-4878

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    Dr. Scott Shalit

    Garnet Valley, PA 19060
    (610) 459-5859

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    Dr. Dan David

    Phoenixville, PA 19460
    (610) 935-1015

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    Dr. Lon Kessler

    Phoenixville, PA 19460
    (610) 933-3342