We all will agree about having experienced tooth pain at some point of time in life. Toothache surely is one of the most dreaded aches. The reason being, that all other body pain will relieve with medication but not the tooth ache. Toothache can be either due to disease of the tooth or the disorder of the surrounding structures.

The most common causes of include:

1. Pain due to decayed tooth:-

Cause: The most common cause of tooth pain is the pain arising due to decay. Infection of tooth when deep can cause inflammation & death of tooth pulp (part of tooth which has nerves & blood vessels). Pain arising from pulpal infection can cause tooth sensitivity, night pain, facial swelling, repeated gum boils, bone loss, difficulty in chewing & speaking etc.

Management: Visiting your dentist & getting your tooth filled if carious at an early stage, root canal treatment if the cavity is deep.

2. Wisdom tooth pain:-

Cause: Wisdom tooth or third molars are the most difficult tooth to erupt (appear in oral Cavity) if wrongly placed- [a condition which is called as impaction]. The newly erupting tooth might cause frequent rubbing on the cheek & hence the discomfort., Sometimes, even if the tooth emerges out fine, incorrect brushing can cause collection of food and debris around it, causing infection of gums & adjacent teeth (pericoronitis) It might also be associated with difficulty in opening or chewing or swelling of the face

Management: Impacted tooth needs removal. Pericoronitis can be relieved by gum surgery & local debridment

3. Pain due to Periodontal/ gum problem:-

Cause: The gingiva and bone supporting the tooth contribute to what is known as the periodontium of the tooth. The periodontal problems may arise from either due to bone loss, infections of gums, excessive force from chewing and accumulation of heavy debris around teeth(Known as tarter or calculus) It can manifest as:

  • Infection and pus in the gums (periodontal abscess)
  • Loosening of the teeth (periodontitis)
  • Formation of small space around tooth in which food gets lodged and cause infection (pocket formation)
  • Receding of gums ( Gingival recession) causing tooth sensitivity
  • Bad breath
  • Bleeding from gums

Management: Periodontal problems are treated by thorough professional cleaning of teeth known as scaling & root planning where the deposits over teeth are removed. Thereby promoting gum health. In advanced cases periodontal surgeries may be required under local anesthesia.

4. Pain due to loss of enamel:-

Cause: Enamel is the hardest substance in human body and it protects the extremely soft pulp which lies on the inside of tooth. Aging, incorrect habits (grinding teeth, acidic food in diet) & forceful brushing can cause loss of this protective layer of tooth When this happens the pulp is exposed to the environment, giving rise to sensitivity or severe toothache. This is known as wasting disease of teeth (attrition, abrasion or erosion ).

Management: Although the enamel cannot be brought back, wasting disease of teeth can be treated either by filling or root canal.

5. Oral cancer:-

Cause: Tumors or oral cancers are the growths in oral cavity. Tumors generally do not cause any pain, but if there is some nerve involvement associated with tumors, they cause excruciating pain. Other features might be associated with tumors- swelling, loosening of teeth to, loss of facial symmetry, name a few.

Management: removing the cysts or tumors. This is followed by further treatment which might include radiotherapy or chemotherapy if the tumor is malignant.

6. Fractured tooth and trauma:-

Cause: Sometimes, a sudden blow to the tooth might induce changes in the inner components to tooth. This makes the tooth painful, tender, mobile & discolored.

Management: Depending on the severity the tooth is treated using various measures. If the tooth is severely mobile, it has to be removed in entirety. It might be replaced by bridges or dentures or implants. If only a part of the tooth is lost and pulp is damaged, root canal may be required.

7. Bruxism or night grinding:-

Cause: Usually associated with stress or mental trauma it’s a condition where a patient grinds teeth involuntarily during sleep. This typically results in pain in the jaws, tenderness of facial muscles on either or one side. Bruxism also causes premature loss of enamel causing results in pain due to exposure of dentin and pulp.

Management: Management includes therapy to eliminate mental stress. This would be followed by using night guard (an appliance given by dentist), to be worn at night. This prevents the teeth to grind and provide relief to muscle

8. Other causes:-

Above list enumerated the most common causes of pain in tooth. There are other causes which are as follows:

  • Old damaged dental filling
  • Alteration in oral mucosa due to use of tobacco or supari
  • Foreign Body Material
  • Sinusitis
  • Infection in ear
  • Joint disorders (TMJ)
  • Cardiac disorders can also cause referred pain to jaws

So, all those who have been neglecting the tooth pain are earnestly advised to visit a dentist as soon as possible because the cause of this ache might be more serious than you can ever imagine.