What is toothache?
Toothache is an uncomfortable feeling produced by the excitation of nerve endings in the tooth region. It can be the sign of some serious oral condition, just as it can be the result of injuries and accidents.
So if you have toothaches, it’s a good idea to look for a dentist and find out the cause!
Anatomy of the tooth
To understand about tooth pain, it is important to understand what are the parts that make up the teeth. All of these parts work together to keep oral health on the high side, helping to preserve the ability to chew food.
Understand what they are:
It is the largest part of the tooth, reaching ⅔ (two thirds) of its size! It is the part that is inserted inside the maxillary bones and the mandible, conferring stability to the tooth.
The tooth enamel is the outermost and hardest part. When you see a smile, you are looking directly at the enamel of all those teeth!
It is the most mineralized and hard part of the human body – more so than the bones! – but can suffer damage such as corrosion by acids released by bacteria (cavities).
Here is the “middle” part of the tooth: it lies between the enamel and the pulp. It is still highly mineralized and hard, but less than enamel.
This layer has the function of absorbing external impacts caused by food, preventing wear. However, it can be very sensitive, since it is directly attached to the pulp, where the nerve part of the tooth is.
Right in the middle of the tooth, there is a structure called pulp, which is what keeps the tooth alive. It is full of blood vessels, which keeps the dental tissues well-nourished and alive, and nerve endings, which tell you when something is wrong with your teeth (i.e., causing pain).
Types of Toothache
Incredible as it may seem, there may be more than one type of toothache. It is because the causes of pain are so diverse that they affect the nerves in different ways. Understand:
Momentary sensitivity to hot or cold foods
It is one of the most common types of dental pain and does not last for long. It is usually just uncomfortable and does not cause more serious problems.
It is associated with mild corrosion of the tooth enamel or a small termination of the gum, which exposes the nerve root of the tooth.
Sensitivity to hot or cold foods after dental treatment
Dental treatments have a downside: they often end up causing the dreaded sensitivity to extreme temperatures. It is because of the swelling of the pulp inside the tooth.
The good thing is that this symptom is temporary and should pass in a few weeks.
Acute pain upon biting
This type of pain is not as common as sensitivity and usually indicates a structural problem in the tooth. It is caused by mild corrosion in the enamel, slightly “loose” teeth or even a crack in the tooth.
The pulp, if damaged, may also be involved in the painful sensation.
Lasting pain (more than 30 seconds) after eating hot or cold foods
While sensitivity to extreme temperatures is common in some cases, it does not last for long.
When it lasts longer than 30 seconds, it may be a sign that some corrosion or physical trauma have irreversibly damaged the pulp. In this case, channel treatment may be necessary.
Constant pain and pressure, swollen gums and touch sensitivity
This type of pain is, in fact, a set of symptoms that indicate an infection. Sometimes it may even be an abscess. It can happen due to untreated gingivitis or periodontitis.
Dull pain and pressure in the upper dental arch
Usually, this type of pain is also accompanied by a headache, and is the result of an involuntary creaking of the teeth, a condition called bruxism.
As mentioned earlier, the origins of a toothache can be diverse. The most common are:
Caries is a condition in which orifices are formed on the surface of the teeth. It is because bacteria that live naturally in the mouth release organic acids that destroy the dental tissues, causing lesions in the enamel.
One of the primary bacteria responsible for caries is Streptococcus mutans, which can be easily combated with proper oral hygiene.
The problem is that a lot of people do not brush their teeth and do not floss at the frequency needed to avoid that kind of problem. Over time, the bacteria accumulate and form a bacterial “plaque” that can only be removed at the dentist.
As these bacteria release acids, the corrosion of dental tissues increases and eventually generates easily visible holes in the tooth enamel.
These holes go deeper and deeper into the dentin, reaching into the dental pulp, making nerve stimulation frequent. Generally, those who have cavities often experience toothaches when eating, especially when eating sweet foods.
It is worth remembering that there are 3 types of caries: coronary, radicular and recurrent. The difference between them is where they appear and persistence. Understand:
- Coronary: Appears on the chewing surface of the teeth, in a region called “crown”;
- Radicular: It is the type of caries that appears in the root of the teeth, generally in cases where there are a gingival retraction and the bacterium has more facility to access this area, since it does not enamel for protection;
- Recurrent: Persistent caries, which reappears even after crown restorations, are called repetitive. They usually appear in regions that tend to accumulate plaque, such as the crown (or chewing surface).
Enamel wear is one of the main reasons for tooth injury since the main protection of the tooth against external agents is impaired. In general, wear leads to pain-type tenderness, but it can cause other types of pain as well.
However, such wear does not happen out of anywhere. Some reasons for this are:
Many foods possess abrasive properties that wear away the enamel of the teeth. A good example is soft drinks, widely consumed by people.
In addition to assisting the wear itself, these beverages also contain many sugars, which helps in the proliferation of bacteria that cause caries.
Although brushing is one of the best ways to prevent oral problems, the habit may become inadequate when overdone or with the wrong toothpaste.
Brushing your teeth many times a day or too hard can damage the gums and the enamel. Also, the use of abrasive toothpaste, such as whitening creams, only makes the problem worse.
Dental whitening processes can cause abrasion on the enamel.
Bruxism is characterized by the grinding or clenching of teeth for prolonged periods. It usually happens unconsciously during sleep, but it can also occur in waking states such as reading a book or watching television.
Its occurrence is linked to factors such as stress, anxiety, frustration, anger, and even incorrect feeding. It can be a side effect of certain medications and is related to episodes of sleep apnea.
Another problem that causes bruxism is malocclusion, a condition in which there are facial changes that affect the mechanism of contact between the upper and lower teeth.
The gum is a great protector of the root of the teeth and, when retracted, can leave this part of the tooth exposed for the bacteria to celebrate. In this case, diseases such as gingivitis and periodontitis are the major culprits.
These two conditions are part of the so-called “periodontal disease,” which does not directly attack the teeth, but their support mechanisms: the gingiva and the bones that support the teeth.
They are caused by the presence of bacterial plaques that produce acid that erodes tooth enamel and irritates the gums, causing an inflammatory reaction called gingivitis.
When these plaques are not removed for a long time, they form pockets of bacteria where the gums meet the teeth, giving rise to periodontitis.
Gradually, gingival retraction occurs and the bone, which exposes the root and leaves the teeth “loose”. Over time, they may even fall.
Accidental cracks and breaks are not rare and maybe the reason behind that pain that bothers you when you bite and chew something. Sometimes the lesion is so tiny that the patient may not even know that his or her tooth is damaged.
This kind of damage ends up exposing the dentin or even the pulp, making the excitation of the nerve roots of the teeth very frequent.
Pulpitis is the name given to inflammation of the pulp, the innermost part of the tooth. This structure is full of nerve endings and it is no wonder that the condition is very painful.
Pulpitis may appear after restorations and placement of prosthetic crowns, due to the inadequacy of the material used. It can also manifest when microorganisms reach it, as it is in the case of deep caries.
Wisdom tooth birth
There is no denying that the wisdom tooth’s birth is an extremely painful ritual of passage. It is because it needs to “tear” the gingiva to open its space in the dental arch, which, in fact, dramatically stimulates the local nerve endings.
And the problem does not stop there since the pain is so strong that it radiates to the other teeth. What looks like a pain in the first molars is actually a pain in the gum due to the birth of the last molar!
Anyone who has had to use knows that orthodontic appliances can cause a lot of pain! This is because their task is precisely to realign the teeth, which implies pushing a little there, another little there … And all this hurts, obviously.
There are also many other causes that can be responsible for the pains felt in the teeth. Did you know that during a heart attack, is it possible for the pain to radiate into the lower dental arch?
However, there is no need to worry: hardly a toothache is a sign of a heart attack.
The sinusitis is a disease that causes a lot of pain in various parts of the face due to inflammation caused by the accumulation of mucus in the sinuses. Calm down, you did not read wrong: it’s in the same breasts that it happens!
Anatomically speaking, breasts are air-filled cavities, so we are talking about the air-filled spaces found in the pneumatic bones of the face.
These spaces are on the forehead, behind the nose and eyes, below the eyes and at the jaw. In some cases, the pain of this inflammation is so intense that it ends up reflecting in the teeth, especially when the accumulation is in the maxilla.
Do you know those bumps that appear on the neck when someone is sick? They are called the gills and can be a cause of tooth pain.
Ingas are commonly associated with infections, but they appear as an immune response to anything the body finds suspicious, whether infectious or not.
Sometimes, a simple inflammation in the throat is enough for the appearance of gums, which, in turn, also hurt. This pain radiates to the jaw, being mistaken for a toothache.
Anyone can have toothaches at any time, but children are one of the biggest risk groups because of the number of sugars they ingest daily. Also, at this stage of life, it is common that they are not yet familiar with the oral care routine.
People without access to basic sanitation are also a large group at risk, as this impediment makes it difficult to clean the teeth properly.
Toothache in pregnancy
Toothaches are common to feel during pregnancy and many moms become frightened, wondering if that can do any harm to their child.
These pains are a result of an increase in progesterone, a hormone in abundance during pregnancy. Although it is indispensable for pregnancy to occur well, one problem is that it increases the sensitivity of the woman, making her feel more pain easily.
It is also common episodes of gingivitis during pregnancy, which helps to make pains felt. So many moms wonder if there is a problem in getting dental treatment during pregnancy because it was once believed that one should not go to the dentist when expecting a child.
Nowadays, however, it is already proven that treating dental problems only brings benefits to the mother and the baby. Depending on the case, the mother can even extract a tooth, without having to wait for the baby to be born, because several local anesthetics do not cause any problem to the fetus.
So if you are pregnant and have toothaches, be sure to visit the dentist! You have to win.
Pain in milk teeth
Unfortunately, the problems that affect the teeth of adults are also capable of affecting the teeth of children. They are especially susceptible to tooth decay because of the number of sugars they ingest daily.
In children, caries can also reach the tooth pulp and cause massive damage. Therefore, parents must stay alert and take the child to the dentist as soon as they show signs of toothache.
Otherwise, a tooth infection can even harm the permanent teeth that are to come!
Toothache is, in itself, a symptom. However, several others can come together and give a greater sense of what is happening. Are they:
- Sensitivity to drinking or eating hot or cold foods – may be related to enamel wear;
- Pain when biting and chewing food – a sign that the enamel is worn, cracked tooth or even deep caries;
- Pulsating and constant pain in the tooth – may be a pulpitis signal;
- Gums swollen and painful – a sign of gingivitis;
- Bad breath – associated with symptoms of gingivitis, may indicate periodontitis.
Toothache: What to do?
When you feel toothache, the first thing to do is contact your dentist, especially if you have had dental treatment recently.
While you can not schedule an appointment, some medications can be taken to relieve pain, such as anti-inflammatories or painkillers. However, they need to be taken under the supervision of a physician.
An alternative is to try some homemade methods for pain relief. Several of them are described in the topic “Home Remedies”.
How is the diagnosis of toothache diagnosed?
The only qualified professional who can tell you the reason for your toothache is the dentist. This professional is a specialist in oral health and dental diseases. To assist with the exam, you can:
Perform a physical exam
At this examination, the patient sits in the reclining chair, and the dentist asks him to open his mouth. It may or may not use a tool to keep the patient’s mouth wide open, as well as a bib to avoid wetting the clothes.
Using some specialized equipment such as small mirrors and lights, the dentist will look for signs of tooth injuries, cavities or gingivitis.
He is often able to determine the cause of the problem only with this observation. However, that alone may not be enough.
Request an Imaging Exam
The imaging exams are quite useful in dentistry too! However, do not worry, it’s nothing too complicated: the dentist is most likely to ask for a panoramic x-ray of the jaw and jaw.
To perform this examination, the patient should support the head and forehead in some structures while a radiologist takes the images. No need to open your mouth.
It is recommended that any jewelry is taken, from mouth piercings to earrings, to prevent the metal from interfering with the visualization of the radiograph.
With this examination, the dentist can see if there is any problem in the root of the tooth, the depth of some cavities, if there is any inflammation in the pulp, etc.
Does toothache have a cure?
In most cases, toothache has a cure, yes. If it is the case of cavities, for example, just do the restoration treatment that will be fine!
However, sometimes the problem demands more radical treatments, such as the complete removal of a tooth. In these cases, the pain may stop, but the tooth will not be there either.
What is the treatment?
The treatment for toothache varies according to its cause. People suffering from cavities will have no benefit if they receive treatment for bruxism, for example.
Therefore, it is always recommended to seek a dentist so that he can indicate which treatment is most appropriate for each case. However, here are some alternatives the dentist may suggest:
Treatment of obturation
When there are more superficial caries, the dentist can perform a filling treatment, which consists of using a drill bit to drill, further opening the cavity hole, and getting rid of all contaminated and damaged tissue. It’s the much-feared “dentist drill”!
Then this “hole” is cleaned, and the dentist puts a “mass” to fill the space and restore the tooth enamel, restoring the integrity of the tooth.
It is not a very time-consuming treatment and does not require anesthesia.
In the case of deeper cavities, the treatment is a bit more complicated. Most of the time, the use of anesthesia is necessary, because in these cases, the drill reaches the pulp.
In the canal, the dentist “opens” the tooth to be able to remove the infected toothpaste. Then the place is cleaned, disinfected and then filled with a material to protect the tooth.
It is worth remembering that channel treatment is much more complex and may require more sessions to reach its end. It all depends on the extent of caries and the involvement of the roots.
Treatments for gingivitis and periodontitis
If these periodontal diseases cause pain, the treatment is much more complicated. It may involve surgical solutions or not, depending on the case.
The patient should undergo cleaning and scraping the root of the tooth to remove and prevent the accumulation of bacteria in the region.
Among the surgical treatments, is the reduction of the periodontal pocket, which consists of exposing the roots to make deep cleaning of the affected area. Then a suture of the gingiva is performed in its proper place.
If there is a bone retraction in the gum region, a bone graft may be performed to fill the site and prevent tooth loss.
These are just a few of the procedures that can be done to solve the problem in the case of periodontal disease, but there are many others.
Often mistaken for obturation, the restoration seeks to correct the tooth in cases of breaks and cracks. In these cases, a larger part of the tooth is replaced with synthetic materials, restoring its original shape.
In the latter case, when the problem is very deep, it is possible that the dentist suggests a dental extraction. The tooth is surgically removed and may or may not be replaced by a prosthesis.
In the case of the birth of the wisdom teeth, this treatment is very common because, often, these last molars only cause pain and do not bring any advantage. In addition, cleaning these teeth is so difficult that they often suffer from periodontal problems.
Since they are not teeth that affect the smile, they are not usually replaced by prostheses.
While it is not possible to do any of these procedures, non-steroidal anti-inflammatory drugs may be used to relieve pain.
Medications for toothache
The most commonly prescribed medications to relieve toothache are non-steroidal anti-inflammatories, but they should only be used after a dentist’s evaluation.
This is because one of the side effects of anti-inflammatories is the suppression of the immune system, i.e., its ability to fight infections is reduced. If the problem is an infection, it tends to get worse with the use of these medications.
The toothache can be easily relieved with some home remedies. However, there is no evidence that these remedies work or that they are safe, so all care is short!
Do not try any of the following recipes without first talking to your dentist because the results can be unpleasant without the necessary guidance.
It is important to remember that these treatments are also not effective for the complete eradication of the problem, that is, they do not cure toothache! However, they can be used to alleviate the problem until the correct treatment is given.
Warm water with salt
A home remedy commonly indicated in cases of gingivitis or periodontitis is the mouthwash with warm water and salt. This is because the salt has antimicrobial properties and can help to alleviate the infection.
To do this, merely dilute 1 teaspoon of salt in 1 cup of warm water, mix well and make a 30-second mouthful, being careful not to swallow the water. Spit all the water out and repeat the mouthwash every 1 hour.
India clove oil
The oil produced by India’s carnation has analgesic and antimicrobial properties, which can help in relieving infections and pain.
Simply put, with or without the help of a cotton swab, 2 drops of the oil directly on the sore tooth. This procedure can be done up to 3 times per day.
Macaque tea and propolis
While propolis has antimicrobial action, the tea of macula has calming and anti-inflammatory properties and can aid in the aching tooth.
One tip is to make a 30-second mouthwash with the mixture, 2 times a day. The preparation of the mix is done as follows:
- Boil 1 tablespoon of dried macula flowers in a 1-quart pot;
- Separate one cup of this tea and store the rest for other mouthwashes;
- Add 5 drops of propolis to the bowl of tea, and you’re ready for the toothpaste!
The good old ice on the wound works excellently here too! The cold temperature contracts local blood vessels, relieving inflammation, and may even slow down the infectious process, depending on the bacteria.
Always remember to cover the ice with a cloth not to burn the skin! It is also important to be aware of the weather: 15 to 20 minutes is already more than enough since contact with cold temperatures for an extended time can bring unpleasant consequences.
The process can be repeated every 3 hours.
Another alternative is to suck the ice, but this technique may not work very well in case of sensitivity to temperatures.
Vinegar with salt
An alternative to the mouthwash with warm water and salt is the mouthwash with vinegar and salt. Although the taste may not be the best, it is worth remembering that vinegar has antimicrobial properties and can potentiate the effect of salt.
Mix 1 tablespoon of salt with 3 tablespoons of vinegar in 1 glass of water. Boil the mixture and make the mouthwash when it is warm.
Pepper and ginger
Did you know that pepper has analgesic effects? Well, to use this beauty in the relief of toothache, take 1 pinch of cayenne pepper and 1 pinch of ginger powder and mix in a small container.
Add water gradually until it forms a paste. Use a small piece of cotton to apply some of this paste to the inflamed gum. Leave it for a few minutes. Avoid touching the glue while you have the mixture there.
Lemon balm tea
With soothing properties, the mouthwash with lemon balm can help in cases of inflammation in the gums. Just make a mouthful of tea while it’s still warm.
In most cases, the prediction of a toothache is favorable. Some of the causes are curable, while others can only be treated and kept under control.
In the latter case, extraction of the tooth may be necessary, but the placement of a prosthesis restores aesthetics and dental function.
The toothache itself does not cause any difficulty in the problem bearer. However, the conditions that cause it can have several consequences.
Untreated caries can lead to even heart problems such as infective endocarditis, an infection of the internal wall of the heart (endocardium) or valves.
Periodontitis can also lead to this infection in the heart, in addition to a loss of teeth due to gingival retraction and bone.
However, the cases of hypersensitivity do not present dire consequences if they are not treated. However, just the hassle every day should be enough to take the patient to the dentist’s office to resolve the situation.
How to prevent toothache?
The easiest way to prevent any oral problem is to have good hygiene. However, this is not always enough – some people suffer from these diseases, even taking care of their teeth assiduously.
In these cases, it is only possible to try to mitigate the situation and prevent relapses with the following tips:
Brush the surface of the teeth toward the cheek, both upper and lower, in circular motions.
On the chewing surface, make back and forth movements, and then make a broom-like movement on the inner surface – sweeping the teeth from the inside out.
Always start from the dental arch above, as food remains may fall into the lower arch. If the brushing begins from the bottom, the food remains can be trapped there.
Do not forget to brush your tongue. It is recommended to use fluoride toothpaste to strengthen the enamel.
It is essential to brush your teeth at least 2 times a day – when you wake up and go to sleep – but it is also recommended, if possible, to touch them every time after meals.
Floss every day
A good tip to prevent periodontitis is to floss every day since many bacteria that attack the gums accumulate between the teeth, where the brush does not reach.
To floss, pick up about 30 centimeters of yarn and curl on the index fingers. Snap the wire between your teeth and make back and forth movements. Do this with all your teeth.
Prefer to begin with the dental arch above for the same reason as in brushing.
Speaking of brushing, there is no right order for cleaning. There are those who prefer to use floss before brushing, have to choose later, but there is no consensus among dentists on which is the best order.
Avoid foods that promote cavities
There are some foods that we eat every day that can aid in the development of holes. It fooles those who think it’s just candies and candy that do it: even acidic juices and fruits or carbohydrate-rich foods can be transformed into the corrosive acid responsible for caries.
Alcoholic beverages, coffee, and teas are rich in pigments and dyes that can stain the teeth.
Consume foods that are good for teeth
Just as there are enemy teeth foods, there are others who are good friends. This is the case of apple and carrot, two foods high in fiber that require a lot of chewing, which stimulates the production of saliva and promotes the natural cleaning of the teeth.
Cheese is a food rich in calcium and protein, which help strengthen the enamel of teeth, in addition to increasing the pH of the mouth, which reduces the risk of developing cavities.
Yogurt is rich in bacteria good for gums and, like cheese, rich in calcium and protein.
Lastly, celery is a food that helps to scrape the food particles and bacteria that remain in the teeth, in addition to being the source of vitamins beneficial to your body in general, such as A and C.
Use personal protective equipment whenever necessary
When riding a bicycle, skateboarding, or performing any sport that allows great impacts, it is important to use protective gear. In the case of teeth, mouth guards can help ensure the physical integrity of teeth, preventing trauma, and breakage.
Visiting the dentist regularly
Lastly, one of the best ways to prevent oral problems is to visit the dentist every six months. It takes about six months for caries to form a deep hole, and with this frequency of visits, you can protect yourself from this problem before it even becomes bigger!