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Dental pain, or tooth ache is one of the most common symptoms which brings individuals to meet a dentist. It also makes a large component of dental emergencies. A multitude of causes underlie toothaches and almost everyone has experienced it at some point in their lives.

Causes of toothache

  • Tooth decay: cavities and dental caries are the most common cause of tooth ache
  • Infection or abscess in the root of the tooth
  • Trauma to the teeth
  • Impacted teeth: When a tooth has trouble growing through the gums it can get stuck and cause pain
  • Gum disease or Gingivitis: infection and inflammation of the gums
  • Sensitive teeth: Exposure to heat or cold causes pain, this is generally due to disease of the roots of the teeth
  • Sinus infection: This can present with pain in the upper mouth appearing as tooth ache

Evaluation of toothache

On presenting to a dentist, the cause of your toothache would be evaluated by the following

  • Dental examination
  • Imaging: a panoramic radiograph is an X ray of the upper and lower jaw can identify impacted teeth, factures and abscesses in the roots.

Treatment of Toothache

Prior to meeting a dentist, the following measures can be taken to relieve the pain.

  • Rinse and clean the mouth with warm water.
  • Gentle flossing can be attempted to remove food debris.
  • A cold compress can be applied externally for pain following trauma.
  • An over the counter pain killer can be taken.
  • Avoid applying any medicines or creams directly over the tooth. Aspirin and other local medicines can cause burning of the gums.
  • Benzocaine, a local anaesthetic can be applied lightly, but carries a risk of getting absorbed into the blood stream to cause methemoglobinemia. This decreases the oxygen carriage of the blood.

Treatment specific to the cause will be administered by the dentist

  • Tooth decay: Filling, crowning or extraction of the tooth
  • Impacted tooth: Extraction
  • Abscess: Root canal treatment

For long term care of your teeth from preventable causes of toothache, maintenance of oral hygiene is recommended with brushing twice a day and flossing once daily by the American Dental Association

References: 

  • Dental Emergency - American Dental Association .
  • Agnihotry A, Fedorowicz Z, van Zuuren EJ, Farman AG, Al‐Langawi JH. Antibiotic use for irreversible pulpitis. In: The Cochrane Library [Internet]. John Wiley & Sons, Ltd; 2016 [cited 2018 May 23]. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004969.pub4/full
  • Research C for DE and. Drug Safety and Availability - Risk of serious and potentially fatal blood disorder prompts FDA action on oral over-the-counter benzocaine products used for teething and mouth pain and prescription local anesthetics [Internet]. [cited 2018 May 23]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm608265.htm

Dentistry, toothache


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