toothache

What is a toothache?

Toothache refers to pain in and around the teeth or jaws as a result of either a dental or non-dental condition. The pain can start suddenly or gradually and the severity may range from mild to really excruciating. It can either be intermittent or constant, and can be easily aggravated by chewing or drinking and by hot or cold temperature. When a toothache occurs, the jaw area that is close to the infected tooth may also be sore and the pain may sometimes refer between the jaws on that side and even go up to the ear.

Why do I have a toothache?

Toothaches happen because the dental pulp (the innermost layer of the tooth) becomes inflamed. This pulp is full of soft tissues, nerves, and blood vessels– making it very sensitive. This is called ‘Pulpitis’. Toothache can be caused by a variety of reasons, but the most common is a dental cavity (or dental caries). Dental cavities are holes found in the outer layers of the teeth, making its way through the enamel towards the dental pulp. The closer it gets, generally the more pain that is experienced. Other reasons for getting a toothache may include:

  • Gum disease
  • Abscessed tooth
  • A gum abscess
  • Tooth fracture
  • A damaged or broken filling
  • Repetitive motions, such as chewing gum or grinding teeth
  • Infected gums
  • Failed root canal
  • Dentine hypersensitivity
  • Cracked tooth syndrome
  • Temporomandibular joint (TMJ) disorders
  • Wisdom teeth problems
  • Teething
  • Ulcers
  • Bruxism (teeth grinding)
  • Abnormal bite
  • Dry socket
  • Other non-dental (ear and sinus infection)

What are the symptoms of a toothache?

If you have a toothache, you may experience sharp, throbbing pain in your gums or jaw or this may be a slow gradual ache. You may also notice swelling around the affected tooth, fever, headache, and may even notice pus coming out from the infected area. This may have a bad taste associated with it. You glands may be up if your are fighting infection and this can cause pain on swallowing. It can be hard to determine the cause of a toothache without seeing a dentist and in any case if you have a toothache you are likely to need some kind of treatment. Don’t delay, it could be the difference between a simple filling and a root canal. Even mild symptoms should be assessed and checked out. We see some patients who had pain, be it slight for many months and then present when it has spread to the jaw and has caused a swelling. Not good. Get it checked by us or someone asap.

What happens when I go to the dentist?

Before any treatment is administered, your Maroubra dentist will first obtain your medical history and conduct a complete oral examination to assess the case. During this time, your dentist will try to determine the location and cause of the toothache by checking for any sign of swelling and tooth damage. They will ask you a series of questions to give them more information and perform X-rays and other tests as part of determining the cause of your toothache. Your dentist may also prescribe antibiotics or pain medication if it is needed because of spreading infection or severe pain. If you have gone to your dentist with an already infected tooth, treatments such as extraction of the tooth or root canal procedure may be needed- if the dental pulp has been affected. However, if the cause of the toothache is a shallow or superficial dental cavity, your dentist maybe able to simply do a filling. This is like plugging a hole to stop bacteria from progressing into your tooth that may damage the nerve. If the cavity is deep and a dental filling is not sufficient, your dentist may advise that you need a root canal in order to save the tooth. At this stage the level of inflammation is so severe that a filling will not allow it to recover and it will die off. Bacteria will have worked their way through the dentine and have injured the dental pulp beyond repair. The root canal procedure involves extracting the dying pulp tissue and replace it with a filling material to save the affected tooth from being pulled out. A cracked tooth causing toothache may require a dental crown. If the toothache is caused by a loose or broken dental filling, your dentist will remove the filling first, clean out any decay on your tooth, and replace it with a new filling. In cases where a dental abscess has caused a large swelling in the mouth, this required immediate treatment. Antibiotics will be needed to stop the spread of infection and where possible, drainage of the build-up of pus will be needed to help reduce the pressure and the pain coming from it. Treatment in a hospital emergency room may be required if drainage cannot be achieved or the airway is being affected, but this is very rare. Initially treatment is aimed at simply reducing the pain and the toothache you are experiencing. Reconstructive treatments may be done at a later time when the infection has subsided- this is generally recommended. Whatever your problem, we will look after you, we have a number of specialists who we involve if it’s necessary for more complicated cases and problems- but will discuss all of this with you once you are out of pain.

What treatments should I do at home if I can’t see a dentist immediately?

If going to the dentist is not possible as of the moment, try these home remedies to help ease the pain and discomfort of a toothache:

  • Avoid chewing on the affected area
  • Avoid eating or drinking hot or cold beverages if they aggravate the pain
  • Take over-the-counter pain medications
  • Visit your doctor if you have swelling they will prescribe some antibiotics
  • Rinse your mouth with warm salt water
  • Thoroughly, but gently, brush and floss your teeth to remove food debris
  • Apply an over-the-counter antiseptic that contains benzocaine directly to the affected tooth gums to temporarily ease the pain.
  • Rub eugenol or oil of cloves directly to the gums to numb it
  • Drink plenty of water and get lots of rest
  • If you have a fever, take precautions to lower your temperature.
  • If the toothache is caused by your sinus, keep your head elevated and get some decongestants.

Do Not:

  • Put any pain medication near the gums of the affected tooth as this may cause burning gums e.g. aspirin
  • Delay seeing a dentist if you have a swelling- your doctor or the hospital can look after you if the dentist is closed to avoid further infections and problems.

How should I deal with a toothache if I’m pregnant?

With today’s modern technology, dental procedures can already be performed safely and effectively with proper precautions. During pregnancy, emergency treatment must be provided if the safety of the mother is in question. Where possible we avoid taking any x-rays and we prefer to delay longer, more complicated treatment if we can. As with other treatments, your dentist will have to try to determine the cause of your toothache by performing a complete oral examination first and doing a number of small tests. If having an X-ray is deemed absolutely necessary to determine the cause, lead shields will be used to cover and protect your abdomen.. If you have a really severe toothache, treatment must be done to prevent infection and relieve the pain. Ideally, treatments for pregnant women should be done during the second trimester. However, if your dentist decides that an emergency treatment such as a root canal procedure or tooth extraction is necessary, this will be done immediately despite the pregnancy stage. Only anesthetics and antibiotics that fall under FDA’s Category B medications should be used as these are classified safe for pregnant women (the most minimal risk). Certain drugs may pose more risk to the unborn child and these must be avoided.

What should I do after leaving the dentist’s office?

Your dentist will advise you on any specific things at your appointment. As with any other treatments, continue to follow proper aftercare, watch the numb area till the anaesthetic has worn off and take it easy with plenty of rest and fluid. Follow up appointments may be required, we will inform you if they are and any medications should be taken as per the directions given to relieve the pain and for antibiotics. It is important to finish the course even if you feel better as this creates less chance of resistance to their effectiveness developing.

How can I prevent getting a toothache?

To prevent getting a toothache, one must simply follow good oral habits by flossing (once a day in the evening) and brushing regularly (at least two times a day) with a soft- medium toothbrush and fluoride toothpaste. Eating and drinking low-sugar foods and beverages can help prevent tooth decay, too. Also, avoid chewing on hard foods such as ice and hard candies to prevent micro cracks on your enamel. Watch acidic food and drinks as these will accelerate wear. Quit smoking. If you grind- get a protective guard. If you have dentures or bridge, make sure to clean them properly to avoid unwanted dental problems. If you’re an athlete, make sure to wear protective mouth guard or helmet to avoid injury and tooth trauma from playing contact sports. toothache In addition, having a regular appointment with your dentist twice a year for professional cleaning is really important. This gives the dentist a chance to pick up things whilst they are small and fix them before they become a more major problem. You may also ask your dentist about dental sealants and fluoride applications to help protect your teeth from damage.