The symptoms and signs of toothache are wide and varied. Toothache symptoms and toothache treatment depend on the cause of the toothache, which can also be one of many things.
Dental decay is the most common cause of a toothache. If the decay reaches the pulp of the tooth, the nerves inside can become inflamed and can cause a response. In the early stages of dental decay, toothache symptoms may be sensitivity to cold stimuli – most likely be felt as short, sharp discomfort. This usually denotes a reversible inflammation, and the treatment may be removal of the decay and placement of a filling. If the lesion is allowed to progress, the inflammation can worsen and infection may occur. This can cause toothache symptoms such as a dull throb, sensitivity to hot stimuli, tenderness to biting, and spontaneous pain. Treatment for such toothaches usually requires a root canal treatment, or even removal of the tooth, with possible immediate or future replacement.
Toothache may also be due to a crack in the tooth. Teeth usually crack when they have large filings in them, when the patient has a heavy bite force, after a root canal treatment that has left the tooth fragile, or after chewing on hard foods. This is why crowns / caps on teeth are recommended in some instances as they add extra strength and provide support to the remaining structure of a previously treated tooth. Toothache symptoms from a crack can be varied, however ‘rebound pain’ (i.e. when biting on the tooth and releasing) may be the cause of discomfort. Your dentist will perform a number of tests to determine the toothache treatment in this instance.
A toothache may also be caused by gum problems. Sometimes our gums can become infected, causing pain. Gum recession can also cause a toothache. In these instances, the dentine of the tooth is exposed, and when cold air, foods or drinks enter the mouth, a short, sharp, cold sensation can be experienced. Using sensitive toothpastes and/or fluoride varnish, or even having gum surgery, may be necessary to treat this type of toothache.
Wisdom teeth may also cause a toothache. Sometimes, our mouths do not have enough room for our wisdom teeth to erupt, and they become impacted. These teeth can easily become infected and cause toothaches. The toothache symptoms from wisdom teeth are usually discomfort of the gum, sore jaws and / or a dull throb in the area.
Sometimes, a toothache may not be associated with the tooth itself but is referred from surrounding structures. In such cases, a general dentist may choose to refer the patients to a medical doctor.
If you have any pain or discomfort in your mouth, you are advised to visit your dentist. They will examine the area and perform appropriate tests and investigations to diagnose your problem and provide you with the appropriate treatment.
Dr Lucy Burchall
BHSc (Dent), MDent (La Trobe)