Toothache

What do you mean by Toothache?

Toothache is the pain in and around the teeth and jaws. Toothache can be felt in many ways. It can be sharp shooting pain on eating or drinking something hot/cold, pain that may come and go or pain that is constant. It can be mild or severe. The major and common cause of toothache is tooth decay.

Factors Triggering Toothache

A range of factors can stimulate or trigger tooth pain for people with sensitive teeth.

• Eating cold food or drinking cold drinks
• Eating hot food or drinking hot drinks
• Eating sugary or sour foods
• Breathing in cold air
• Brushing teeth

Causes

• Tooth decay
• Inflammation of the pulp
• Dental trauma,
• Dentin hypersensitivity 
• Apical periodontitis
• Dental abscesses
• Alveolar osteitis 
• Acute ulcerative gingivitis 
• Temporomandibular disorder

Tooth Decay

Tooth decay is the major cause of toothache. It usually occurs when the sugars from foods and drinks react with the bacteria in the plaque of teeth to form some acids. This acid gradually softens and dissolves the teeth enamel and dentine. Tooth Decay goes unnoticed, as one might not feel any pain until it gets advanced. It can be treated in the early stages with regular Dental checkups. Brushing twice a day with toothpaste containing fluoride will help to strengthen the teeth.

Symptoms

Some of the symptoms of Toothache are:

• Localization of the pain,
• Thermal sensitivity,
• Pain on biting/chewing,
• Spontaneity of the pain,
• Periodontal pain is more localized to a particular tooth, which may get worse by biting on the tooth, sudden in onset, and often associated with bleeding and pain when brushing.
• Non-dental pain often causes multiple teeth to hurt and have an epicenter that is either above or below the jaws. For example, cardiac pain (which can make the bottom teeth hurt), sinusitis, migraine etc.,  

Treatment
Since many cases of toothache are inflammatory in nature and for the dentist, the primary goal of treatment is to relieve the pain with non-steroidal anti-inflammatory drugs (NSAIDs). Secondly, he takes remedies to preserve or restore the normal functioning,

The treatment depends on the cause of the toothache, and most often a clinical decision regarding the current state and long-term prognosis of the affected tooth, along with the individual's interest and ability to cope with dental treatment, will influence the treatment choice. Often, administration of an intra-oral local anesthetic such as lidocaine and epinephrine is indicated to carry out pain-free treatment.

The dentist might give remove the dental decay with a dental drill and subsequent filling, or a root canal treatment, or tooth extraction, or debridement.

Prevention

Since most toothache is the result of tooth decay and periodontal disease, the majority could be prevented by avoiding a sugary diet and by maintaining good oral hygiene. Brushing the teeth twice a day with fluoride toothpaste and flossing.

A regular visit to a dentist decreases problems by early detection of tooth decay.

Authored By Dr Sanjay N - Orthodontics & Dentofacial Orthopaedics, Bangalore