Medically Reviewed by Greg Grillo, D.D.S.
Many people frequently associate a toothache with the need for tooth extraction, making the thought of visiting the dentist too much to handle. However, toothaches should not be ignored, since they could be related to a more serious health issue. For example, studies have revealed that heart attacks could be triggered by pain on the left side of the jaw. A sore and painful sensation in the jaw and cheekbones, or difficulty chewing, also could be a sign of temporomandibular disorder (TMD or TMJ disorder).
Fortunately, dentists now have more advanced techniques for determining the sources of the painful sensations in your teeth. What’s more, they also have more soothing and effective solutions to preserve teeth when treating toothache pain.
Types of Toothaches
There are several types of toothaches, each of which indicates a specific oral health problem. Your dentist is the best person to identify your type of toothache and its cause by performing an evaluation and making a diagnosis.
A sharp, intermittent tooth sensitivity or pain may be triggered by sensitivity to cold and hot foods or beverages. Sensitivity to cold could be an indication of gum recession, enamel loss from over-brushing or aging, wear and tear or a cavity. Sensitivity to heat also might be a sign of a cavity, but an abscess, fracture or severe decay also could be the culprit. Sensitivity in upper teeth may also be related to sinus congestion, up to 6 weeks after it’s cleared.
A chronic toothache affecting one or more teeth may be caused by nerve damage. Severe tooth decay, teeth grinding or trauma to the teeth through injury could also play a role in damage to the nerves. An intense, throbbing pain, sometimes with a swollen face, can often be a sign of an infection or abscess. Eating may become painful if there is decay or a slight fracture present in a tooth. A painful sensation located in the back area of the jaw could be linked to impacted wisdom teeth, a sign of TMD or teeth grinding, all of which lead to soreness in the jaw and other facial areas. Joint and muscle pain often mimics a toothache and should be considered a possible cause in many cases.
The treatment options for toothaches are based on the severity of the pain and the cause.
Dentists can treat gum recession using different approaches of gum grafting to replace the missing tissue. To help alleviate tooth sensitivity, dentists can apply a professional desensitizer, which requires periodic reapplication. Desensitizers also can be used at home to relieve sensitivity, including toothpastes containing a desensitizer.
Over-brushing, an acidic diet, or natural wear and tear all can contribute to enamel loss and tooth pain. When enamel is lost, dentin is exposed, and sensitivity and pain develops. Desensitizers can help provide relief in this instance, also.
Loss of enamel, uneven teeth and tiny cracks/chips are typically signs of tooth destruction, which causes sensitivity or pain. In some of these cases, dentists may apply composite materials to fill in the uneven surfaces of the teeth to prevent pain and sensitivity. However, in many wear and tear cases a crown is required.
Poor dental hygiene habits and an improper diet can contribute to the formation of cavities, which also can cause toothaches. Treatment for cavities depends on the amount of tooth decay present. In some cases, treatment may require dental fillings (composite or amalgam). If there is significant nerve damage or exposure of the root pulp, a root canal may be considered. For more severe cases when multiple tooth surfaces are affected, a dental crown or veneer may be a good option.
Deep tooth decay or trauma from an injury could potentially lead to a painful infection or abscess. Treating an infection or abscess may start with antibiotics and pain medication prescribed by your dentist. In other cases, the tooth may be opened to relieve the pressure inside and allow pus drainage. The next step is an appointment for a root canal. A crown or veneer then can be used to strengthen the weakened tooth. Almost all back teeth that have a root canal should be protected by the strength of a crown to keep them from breaking.
Painful cracks or fractures in your teeth could be caused by teeth grinding, trauma, or wear and tear. A protective covering, such as a dental crown or veneer, may be required to repair cracked teeth. If you experience a sharp, shooting pain when you bite on hard food, your teeth is probably cracked. Your dentist can confirm a cracked tooth with a few quick tests.
Additionally, teeth grinding might also be responsible for toothaches caused by unevenness and a possible shift in the bite. In order to prevent teeth grinding and other complications, mouth guards may be prescribed by your dentist for you to wear while asleep to protect your teeth. Orthodontic appliances (such as braces, Invisalign, ClearCorrect, etc.) may be used to improve the position of the bite.
Impacted wisdom teeth can crowd and move surrounding teeth. In this case, oral surgery often is suggested to extract the offending wisdom teeth to alleviate the pain.
Toothaches vary significantly in terms of sensitivity and pain levels. For a permanent cure, seeing your dentist is of paramount importance. However, there are a few at-home remedies to help lessen the degree of pain you experience. Pain relievers such as ibuprofen or acetaminophen can help ease the pain. In addition, medications that contain benzocaine also may lessen your toothache pain.
It is important to note that dentists do not recommend applying aspirin directly to the affected area, since it can burn gums or cheeks. Swishing warm saltwater throughout the day and applying an ice pack to the swollen region could help reduce swelling and the pain it causes.
Swelling in the head and neck area can quickly become life-threatening. If you have swelling in your neck, under the chin or around the eye, difficulty breathing, or a temperature, seek emergency care immediately. If you’re unable to find a dentist, go to the ER for evaluation.