Pain or discomfort in one or more teeth or in the gums
Pain in one or more teeth is usually a symptom of an underlying problem with the teeth or gums. Depending on the cause, the pain may range from a dull ache to a severe throbbing sensation. Toothache may last only a few minutes or it may be continuous.
A sharp pain triggered by biting or consuming hot, cold, or sweet foods and drinks may be a symptom of the early stages of tooth decay (see Dental caries). A fractured tooth, receding gums, or advanced gum disease (see Periodontitis) may also result in toothache. A dull pain in the teeth while chewing may be due to inflammation of the gums (see Gingivitis) following a build-up of plaque (a deposit of food particles, saliva, and bacteria). Pain may also be caused by food trapped between the teeth.
A continuous, severe, throbbing pain is usually the result of advanced tooth decay (see Pulpitis), in which the pulp, the central part of the tooth containing the nerves and blood vessels, becomes inflamed. If the pain changes so that the tooth becomes tender to touch, it may be a sign that pulpitis has developed into a dental abscess at the root, with infection and death of the pulp tissues. The infection may spread to surrounding tissues and be accompanied by facial swelling and, occasionally, fever. The lymph nodes in the neck may also become enlarged and tender.
Pain and tenderness at the back of the mouth may be due to emerging wisdom teeth. If the wisdom teeth only partially emerge (see Impacted teeth), the gum around the teeth can become inflamed or infected, which can be particularly painful.
In some cases, toothache occurs as a result of a disorder elsewhere in the body, such as sinusitis, an ear infection (see Otitis media), or a problem in the joint between the jaw and the skull (see Temporomandibular joint disorder).
If you have toothache, you should consult your dentist as soon as possible. If you have a fever and/or a swollen face in addition to toothache, you should see a dentist immediately.
Painkillers, such as paracetamol, can help to relieve toothache while you are waiting for an appointment. Rinsing out your mouth with warm salt water may also help. However, the only permanent remedy for toothache is for the affected tooth to be treated by a dentist.
Your dentist will ask you about your symptoms and examine your teeth and gums.He or she may also take X-rays of your mouth to look for decay.
If toothache is caused by decay, your dentist will remove the decayed areas and may put in an ordinary filling to stop the pain and prevent further decay (see Tooth filling). If tooth decay is advanced and you have pulpitis or a dental abscess, you may need root canal treatment, in which the soft pulp tissues within the tooth are taken out. The cavity is sterilized to clear up the infection, and the root canals and decayed area are filled permanently. If you have gingivitis or periodontitis, your dentist will probably remove the plaque and tartar that is causing the inflammation by scaling your teeth. A tooth that is very badly damaged or decayed may need to be extracted. Likewise, painful, impacted wisdom teeth may need to be extracted. Your dentist may pre-scribe antibiotics if there is an infection. If your toothache is due to a condition such as sinusitis or an ear infection, you may need to consult a doctor for the necessary treatment.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.