It may happen only occasionally: a sharp twinge when you’re eating a “challenging” food like steak or drinking a cold beverage. Or, it may start off as a mild pain that grows into a throbbing you can’t ignore. But no matter when or where it happens, tooth pain is an issue that needs your attention. Because whether it’s minor sensitivity or an unrelenting ache, the pain indicates a potential problem in your mouth that should be addressed.
By far the most common cause of tooth pain is tooth decay, a chronic disease caused by harmful bacteria in the mouth. When the protective enamel layer is eroded by an untreated cavity, bacteria can make their way deeper into the tooth. They may eventually reach the nerve cells in the tooth’s pulp, where they cause inflammation and pain. Preventing cavities from forming, and treating them promptly if they do, is a major goal of general dentistry.
But many other things can also cause tooth pain. Worse, it’s sometimes difficult to pinpoint the precise source of the pain, describe the exact sensation you are feeling, or determine what’s causing it. In fact, the only sure way to diagnose the cause of tooth pain is to have a dentist perform a thorough examination. This may include a series of questions about what you’re experiencing, and one or more diagnostic tests, such as x-rays.
However, there are some general categories we can use to describe tooth pain. The following sections list a few of the most common symptoms, the potential causes of tooth pain, and possible treatments for the underlying conditions.
Many people experience tooth sensitivity from time to time—particularly after having dental or orthodontic treatment, or in an area of the mouth with old dental work (such as large fillings). If the pain is momentary and relatively minor, it’s probably not a serious issue. Try using a toothpaste specially formulated for sensitive teeth for a few weeks, and always brush gently; you can also use over-the-counter pain relievers if needed. If the pain doesn’t go away or worsens, see your dentist.
If tooth pain remains long after a stimulus (like touch or temperature) is gone, it may mean that damage has occurred in the pulp—the soft material deep inside the tooth, containing nerves, blood vessels and connective tissue. This damage is generally caused by untreated decay or physical trauma (injury). If the pulp is inflamed, the tooth will probably need root canal treatment. This involves cleaning out the infected pulp material, disinfecting the canals (tiny spaces) inside the tooth, filling them with inert material and sealing them off from the outside. If you’re experiencing lingering tooth pain, you should schedule an examination right away.
Sharp, stinging pain may be caused by untreated decay, a loose filling, or a cracked tooth. All of these issues need prompt treatment to prevent them from getting worse. Usually, decay can be removed and fillings placed during an office visit at your general dentist. However, a cracked tooth may require a root canal procedure in order to save it; for this treatment, you may be referred to a dental specialist called an endodontist.
Severe pain may come from a particular location, or may be spread out and hard to pinpoint. If pain seems to come from the general area of a few teeth, it probably indicates acute infection in a tooth’s pulp. When gums become swollen and sensitive to touch, it may mean that a pulp infection has spread into the surrounding periodontal tissues, forming a gum abscess. In either case, you should see a dentist immediately. A root canal will generally be needed—but the good news is, it will quickly relieve the pain. In the mean time, you can take over-the-counter anti-inflammatory medication such as ibuprofen.
This could be a dental problem—for example, the result of teeth grinding and clenching, or possibly an inflammation or infection of the gums. Or, it could result from a cold, flu, or sinus infection. If accompanied by flu-like symptoms, consult your family physician if necessary; remarkably, sinus pain sometimes feels very much like tooth pain. But if the condition doesn’t improve, or seems to be related to your teeth, consider seeing your dentist.