Toothache: Causes, symptoms, Diagnosis, Home Remedies and treatment

What is toothache?

Irritation in the nerves intervening a tooth causes tooth pain. The central cavity or the pulp of a tooth has nerves which are very sensitive to pain. Any exposure or trauma to the pulp causes inflammation resulting in severe pain.

There may be severe to moderate pain and pressure. Sometimes it’s difficult for a patient to identify the source of the stimulus. Patient may feel pain due to sensitivity towards hot and cold, pain during biting or chewing food, or aggravated pain during night. A normal appearing tooth may also pain when tapped upon. This indicates and underlying problem which needs to be clinically checked. Sometimes it’s difficult for a patient to differentiate a tooth pain from other stimuli of pain like ear or throat pain, sinusitis, or a TMD (disorder of the joint which attaches the jaw to the skull). In such cases a detailed diagnosis by a doctor is required.

Some common causes of toothache are:

• Loss of tooth structure

• Dental (tooth) infection/ Decay/ Caries

• Trauma/ Fracture

• Sensitivity

• Pain radiating due to irritation of gums, appearing to be tooth pain: If you have a discharge around a tooth, it is an important sign of an underlying infection around tooth, surrounding gums and bone. Swelling or inflammation indicates presence of abscess or pus which requires antibiotics prophylaxis and treatment.

• Pain after tooth extraction: When the clot formed in the socket after a tooth extraction gets dislodged, it exposes the underlying bone to the external environment. It is called ‘dry socket syndrome’ which is quite painful and needs to be treated as soon as possible.

• Broken/ Knocked out teeth: Any trauma of injury to the teeth resulting in knocked out or swallowed tooth should be considered as a dental emergency. Permanent and milk teeth are treated differently in such cases. Many times knocked out permanent teeth in children can be re-implanted if preserved in milk and reaching to a dentist in time.

• Radiating pain from joint (TMJ): In case of TMD, a patient may feel pain at the joint every time he opens or closes his mouth. Such symptoms are associated with an underlying disorder of the joint and needs to be treated accordingly.

• Wisdom tooth: Eruption of wisdom tooth or third molar often causes severe pain and swelling. Inflammation in the surrounding gums and overlying soft tissue and radiating pain to ears and headache is also seen in this case.

Prevention of Toothache:

Most of the dental problems can be avoided by taking regular care of the oral cavity which follows as,

1. Maintaining a balanced diet and regular brushing of teeth after every meal.

2. Learn proper technique of brushing and flossing to prevent tooth decay, using antiseptic mouthwash, fluoridated toothpaste and interdental brush to avoid sticking of food particles between the teeth.

3. Fluoride treatment in children is helpful to prevent caries.

4. Regular cleaning of teeth by a dentist and frequent check-ups for once in every 3 months is crucial for early detection of a dental or gum disease.

5. Avoid smoking or any form of tobacco.

Home remedies of a toothache:

• Over the counter painkiller medications.

• Keeping a cotton ball dipped in clove oil over a tooth helps in relieving a toothache for sometime.

No painkiller, toothpaste or any other medication can completely relieve a pain arising form dental origin, unless treated clinically. Medications can provide symptomatic relief but cannot treat a dental caries or related pain.