There can be many causes for tooth pain, including dental decay from cavities, tooth injury or tooth infection. Tooth pain travels along complex nerve pathways that may make it impossible to tell which tooth is giving you pain. Endodontists are specialists at locating the source of the offending tooth. If your tooth pain is getting progressively worse, please call the office to be evaluated by our endodontic specialists.
Tooth Pain or Toothache
Tooth pain has multiple causes, both local (around the actual tooth where the pain is felt) and referred (where the cause of the pain is felt as pain at the tooth but is, in fact, coming from somewhere else).
The nerves in the pulp of the tooth, the very inner layer, conduct sensation in the teeth. These nerves can become irritated or infected, resulting in the symptom of pain. Because we cannot easily determine the cause of the pain, it is always advisable to consult your dental professional when pain occurs.
Tooth Hot and Cold Sensitivity
Sensitivity to hot or cold foods is also an indication that the pulp nerves may be irritated. If this is acute, lasting only a few moments, it is usually not a serious problem, being caused by slight decay, or, perhaps, gum recession, which exposes some of the root surface, making it very sensitive. While waiting to see your dental professional, you may try using over the counter medications, such as acetaminophen, or ibuprofen, brushing horizontally (rather than up and down) with toothpaste for sensitive teeth, or even biting down gently on a cotton ball soaked in oil of cloves (readily available in most pharmacies).
Pain Requiring a Root Canal
Prolonged sensitivity to cold or hot foods, lasting well after the stimulus is removed, is usually indicative of something more serious, usually an infection of the pulp cavity, either by tooth decay, or, quite commonly, secondary to tooth trauma, where a fine tooth crack has developed, allowing bacteria to enter the pulp cavity. This symptom may require endodontic treatment, commonly known as “root canal” treatment. A sharp pain when biting down on food, particularly if it persists after you’ve stopped biting, is, similarly, possibly indicative of damage to the pulp cavity and nerve irritation.
Bruxism (Teeth Grinding) – Tooth pain
Persistent headaches and dull pain in the upper teeth and jaw may be indicative of bruxism, or teeth grinding, often done while sleeping. This symptom can often be easily managed by behavior modification, or with the use of a simple gum guard while sleeping.
Pain from Infection of the Gums – Periodontal Disease
Obviously, if you can see swelling or redness around the base of the tooth, this may indicate an infection of the gums (known as periodontal disease) or the tooth, and consultation with your dentist as soon as possible is indicated. If tapping lightly on the tooth causes acute pain, this is usually a sign of local infection. Infections can often be treated with the simple use of antibiotics, but, in severe cases, an abscess may develop in the gums, teeth or bone of the jaw that may require surgical drainage.
Dental Referred Pain
Referred pain may come from other parts of the face or body. Quite commonly, temperomandibular joint pain can be referred to the teeth. This joint is where the jaw articulates on the skull and can become irritated with trauma, attempting to bite on overly large food, or simple wear and tear. Often tooth pain is accompanied by sensitivity over the actual joint. Similarly, inflammation of the sinuses (small bone cavities in the facial bones) can refer pain to the teeth. Your dental professional can help determine the source of this referred pain.
Heart Disease and Jaw Pain
If you experience jaw or tooth pain associated with shortness of breath, with or without chest pain, this may be indicative of ischemic heart disease (where the blood vessels supplying the heart are blocked). This could be life-threatening and you should be immediately be taken to an emergency room for diagnosis
You should probably consult your dental professional with any pain that persists for more than a few days and is not relieved with over-the-counter medication. If you experience any dental trauma, it is always advisable to consult with your dentist, even if you have no symptoms, because you may have cracked the tooth, allowing bacteria to penetrate into the pulp cavity. Early intervention may prevent greater damage later. Any facial pain associated with a high fever also merits a visit to your doctor or dentist, as this may be the first sign of a dental, gum or jaw infection.
Dental Examination and Periapical X-Ray
Following a thorough examination, periapical X-rays are done. Periapical X-rays show the entire tooth, from the exposed crown to the end of the root and the bones that support the tooth. These X-rays are used to find dental problems below the gum line or in the jaw, such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases.
Anterior Root Canal
Anterior teeth are numbers: 6, 7, 8, 9, 10, 11, 22, 23, 24, 25, 26 & 27
Bicuspid Root Canal
Bicuspid teeth are numbers: 4, 5, 12, 13, 20, 21, 28 & 29
Molar Root Canal
Molar teeth are numbers: 1, 2, 3, 14, 15, 16, 17, 18, 19, 30, 31 & 32
Treatment for Tooth Pain
Besides the treatments mentioned above, depending on the source of your tooth pain, your dentist may be able to relieve the problem with a simple filling (restoration), and with the use of antibiotics. Occasionally, the cause of the pain might need to be treated with root canal therapy (usually done after the infection is controlled). In the worst-case scenario, where the tooth infection (abscessed tooth) has overwhelmed the pulp cavity, a tooth may need to be extracted.
Prevention of Tooth Pain
Twice daily brushing and daily flossing should keep your teeth healthy. Any prevention of plaque build up with acidic sugars will help prevent tooth disease. This can be done by simply rinsing one’s mouth out with water after eating, or, better, by brushing after every meal. Frequent snacking should be discouraged.
Using a soft toothbrush with fluoridated toothpaste is highly recommended. Most municipal water supplies are fluoridated; check with your local authorities. If your water supply is not fluoridated, your dentist may prescribe fluoride supplements, particularly for younger children.
Please contact our office at 817-488-3636 if you are experiencing tooth pain.
