What causes toothache? 5 possible conditions
A toothache is pain that you feel in or around your tooth. Most often, toothache pain is a sign that there is something wrong with your tooth or gums. Sometimes, however, toothache pain is referred pain, meaning that the pain is caused by a problem elsewhere in your body.
You should never ignore toothaches. Toothaches caused by tooth decay can get worse if left untreated. Toothaches are usually not life threatening, but in some cases, they can be signs of serious conditions that require immediate medical treatment.
Toothache pain can range from mild to severe, and may be constant or intermittent. You may feel:
- throbbing pain in or around your tooth
- sharp pain when you touch your tooth or bite down
- tenderness and achiness in or around your tooth
- painful sensitivity in your tooth in response to hot or cold foods and drinks
- burning or shock-like pain (uncommon)
Common Causes of Toothaches
Tooth decay is the most common reason for toothaches. If tooth decay goes untreated, an abscess (an infection near your tooth or in the pulp inside your tooth) can develop. See your dentist right away if you think you have a dental abscess. In rare cases, the infection can spread to your brain, which can be life threatening.
A toothache can also be caused by an impacted tooth, which is when a tooth—usually a wisdom tooth—is stuck in your gum tissue or bone and cannot erupt (grow in).
Common Causes of Referred Pain Toothaches
Sinusitis is a condition in which your sinuses become inflamed due to a viral, bacterial, or fungal infection in the sinus cavity. Because the roots of your upper teeth are close to your sinuses, sinusitis can cause pain in your upper teeth.
Less Common Causes of Referred Pain Toothaches
Heart disease and lung cancer can cause toothaches, according to a 2010 entry in the journal General Dentistry (Myers DE, General Dentistry, 2010), and may be a warning sign of a heart attack. The vagus nerve is the reason heart and lung disease can cause toothache pain. This nerve runs from your brain to the different organs in your body, including your heart and lungs, passing through the jaw.
Rare Causes of Referred Pain Toothaches
Trigeminal neuralgia and occipital neuralgia are painful neurological conditions that cause the trigeminal and occipital nerves to become irritated or inflamed. These nerves service your skull, face, and teeth. When they become inflamed, pain can appear to be coming from the teeth.
Seek emergency treatment if you have a toothache as well as:
- swelling in your jaw or face (your tooth infection may be spreading)
- chest pain, shortness of breath, lightheadedness, or other signs of a heart attack
- a cough that won’t go away, wheezing, or coughing up blood (may be signs of lung cancer)
Toothaches usually require medical treatment. Home treatment may temporarily relieve your pain while you wait for your dentist or doctor’s appointment.
Most people go to a dentist for a toothache, since most toothaches are caused by problems with the teeth. Your dentist will do X-rays and a physical exam of your teeth to detect tooth decay and other dental problems.
Your dentist may give you painkillers and antibiotics to treat an infection, if necessary. If your toothache is due to tooth decay, your dentist will remove the decay with a drill and fill the space with dental materials. An impacted tooth may require surgical removal. If your dentist cannot find the cause of your toothache, he or she may refer you to a doctor for further diagnosis and treatment.
Your doctor may treat sinusitis with antibiotics or decongestant medications, and in rare cases with surgery to open your nasal passages.
Treatment for Trigeminal Neuralgia and Occipital Neuralgia
There is no cure for these conditions. Treatment usually consists of relieving your pain with medications.
Treatment for Heart Attack, Heart Disease, and Lung Cancer
If your dentist suspects that you are having a heart attack, he or she will send you to the emergency room. If your dentist suspects that you have heart or lung disease, he will refer you to a doctor for further testing.
Things that may help temporarily relieve your tooth pain include:
- over-the-counter pain relievers, such as aspirin
- clove oil applied to the aching tooth
- Anbesol, Orajel, or other over-the-counter topical dental pain relievers
- over-the-counter decongestants, such as Sudafed, if the pain is due to sinus congestion
To help prevent toothaches, brush and floss your teeth at least twice a day and get dental checkups and cleanings twice a year, or as often as recommended by your dentist.
You can help keep your heart and lungs healthy by not smoking, eating a low-fat and high-fiber diet, and exercising at least 30 minutes a day, three times a week. Get your doctor’s permission before starting an exercise routine.
- Myers, D. (2010). Toothache referred from heart disease and lung cancer via the vagus nerve. General Dentistry, 58(1), 2-5.
- Okeson, J. (2000). Non-odontogenic toothache. Northwest Dentistry, 79(5), 37-44.
- Sinusitis. (2011, Aug. 31). National Institutes of Health. Retrieved July 2, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/000647.htm
- Toothaches. (2012, Feb. 22). National Institutes of Health. Retrieved July 2, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/003067.htm
- Trigeminal neuralgia. (n.d.). University of California Los Angeles Neurosurgery. Retrieved July 2, 2012, from http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=105&action=detail
See a list of possible causes in order from the most common to the least.
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