Have a toothache?  Read on to learn about some of the most common causes.

Tooth Decay

The number one cause of tooth pain is tooth decay, meaning an untreated cavity.  Tooth decay can affect the outer coating of the tooth (the enamel) or the inner layer (the dentin).

Toothaches occur in advanced stages of tooth decay where the cavity has progressed deep into the tooth.  This pain may be constant, or you may feel pain when eating or drinking something hot or cold.   Sometimes you might only feel pain only when you bite down.

It is important to remember that cavities begin long before a toothache occurs.  So make sure to visit your dentist regularly for check-ups to help identify tooth decay early, and take steps to treat any issues before they become painful.

Gingivitis and Gum Disease

Gingivitis is an inflammation of your gums due to a build-up of bacteria in plaque along your gum line.  If left untreated, the disease can progress to periodontitis (gum disease).  Gum disease creates pockets in the gums that reveal the root, exposing the nerve and leading to a toothache.

The first signs of gingivitis and gum disease are bleeding while brushing, or red and swollen gums.  If you experience any of these symptoms be sure to visit your dentist even if you don’t have any tooth pain.  While plaque is the primary culprit, gum disease can also be caused by hormonal changes, medications, certain types of illnesses and smoking – things you can’t control with brushing and flossing alone.

Tooth Sensitivity

Tooth sensitivity is caused by exposure of the inner layer of the teeth (the dentin).  It can be exposed by weakened enamel or a receding gum line.  A telltale sign is pain triggered by eating or drinking something hot, cold, sweet or sour.  Sometimes even breathing cold air can cause discomfort.

Enamel damage can be caused by acidic foods, tooth grinding or clenching, and use of tooth whitening products.  Gum lines can recede due to age or another oral health condition.  Because sensitivity can be caused by a number of things including tooth decay, gingivitis, plaque build-up, periodontal disease, or a cracked tooth or filling, be sure to talk to your dentist for proper treatment.

Tooth Grinding

Grinding or clenching the teeth on a regular basis can wear down the enamel or break the teeth.  Many people are unaware of grinding unless a partner hears it while they sleep, but grinding often causes dull headaches and jaw pain.

If your tooth pain is more intense in the mornings or is accompanied by an overall soreness in the jaw or a headache, talk to your dentist.  Continued grinding can cause severe damage including wearing down of the teeth, jaw problems, and tooth breakage or loss.

Abscessed Tooth

An abscessed tooth is a painful infection either at the tooth’s root or between the gums and the tooth.  These infections are generally caused by untreated tooth decay that has progressed to a severe stage, but they can also be caused by trauma to the tooth (i.e. a chip or break) or oral health issues like gingivitis and gum disease.

If left untreated the abscessed tooth may die and the pain may subside.  However the infection will continue to spread and destroy surrounding tissue, so it is important to see your dentist as soon as possible.  An abscessed tooth is distinctive in that it is often accompanied by other symptoms like fever, swollen glands, a bitter taste, an open sore, and swelling.

Sinus Infection

Sinus infections commonly cause generalized pain in the upper teeth in the back of your mouth, which are close to the sinuses.  If the pain persists beyond a few days or is not located near your sinuses, be sure to talk to your dentist to rule out a cavity or more serious condition.

Have a Toothache?

Only your dentist can determine if your tooth pain is the result of a cavity, gum line changes, or something more serious.  In most cases tooth pain indicates a dental condition that needs proper dental treatment.  Home remedies should only be used to help with pain while you wait to see the dentist.

Depending on the cause of the pain you may need to get a filling, try a desensitizing toothpaste, use a special mouthwash, or wear a mouth guard to prevent further damage from grinding.  But the best way to avoid tooth pain in the first place is to visit your dentist regularly so that he or she can spot cavities and other oral health problems before they cause pain.

Written by: Dr. Yahya Mansour