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Health

Toothache

, medical expert
Last reviewed: 17.10.2021
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The definition of "toothache" usually refers to pain in the teeth or jaws - primarily as a result of the condition of the teeth. In most cases, toothache is caused by problems with the teeth, such as gum disease, cracks in the tooth, an infection that affects the root of the tooth. What other causes of toothache, what diseases it causes?

What is a toothache and what is it caused by?

Disturbances of the mandibular joint (temporomandibular joint) can also cause toothaches. The severity of toothache can range from chronic pains to harsh and painful. Pain can increase with chewing or from cold or from excessive heat. A thorough examination, which includes an X-ray, can help determine what is the cause of the toothache: it develops due to diseases of the teeth or jaw or problems are completely different.

Sometimes toothache can be caused by problems that do not concern the health of the tooth or jaw. The pain around the teeth and jaws can be a symptom of heart disease (eg, angina or heart attack), ears (internal or external ear infection) and paranasal sinuses. For example, pain with stenocardia (insufficient supply of oxygen to the blood flowing to the heart muscle due to the narrowing of the heart arteries), usually gives in the chest or hands. However, in some patients with angina, toothache or pain in the jaw is the only symptom of heart problems. Infections, diseases of the ears and paranasal sinuses can also cause pain in the teeth and jaws. Thus, it is necessary to accurately determine the nature of diseases that cause "toothache".

Causes of toothache due to dental diseases

Common dental reasons for toothache include tooth decay, tooth abscess, gingival inflammation, tooth root irritation, tooth cracks, temporomandibular joint (TMJ) syndrome.

trusted-source[1], [2], [3], [4], [5]

Caries and tooth abscess

The most common cause of toothache is tooth decay. Dental caries are holes in the two outer layers of the tooth, which are called enamel and dentin. Enamel is the outer white solid surface of the tooth, and the dentin is the yellow layer directly under the enamel. Both layers serve to protect the internal tissue of the tooth, where the blood vessels and nerves are located.

Some bacteria in the oral cavity convert simple sugars into acids. The acid softens and (along with saliva) dissolves the enamel and dentin, creating problems in the cavity of the tooth. Small, shallow cavities in the tooth can not cause pain, and a person may not even notice them. The more deep cavities of the tooth are affected by bacteria, the greater the likelihood of toothache. The cavity of the tooth can irritate toxins due to the accumulation of bacteria or food residues and the intake of fluids.

Severe pulp injuries can lead to the destruction of pulp tissue, as a result of tooth infection (tooth abscess). Small swelling of the gums can also be a cause of toothache. Toothache due to these reasons is the most common reason for visiting a dentist.

trusted-source[6], [7], [8], [9]

Toothache due to seals

Treatment of shallow and small in the cavity of the tooth usually includes seals. Treatment of large cavities of the tooth includes in lining or crowns. Treatment of a cavity that is infected involves cleaning the root canal or removing the affected tooth.

The procedure for cleaning the root canal involves removing the affected tissues of the pulp (which avoids tooth extraction) and replacing it with a filling. The procedure is used in an attempt to save the affected tooth from removal. If the procedure for cleaning the root canal is not carried out, the pulp will become inflamed and the tooth will be very sick.

Toothache due to inflammation of the gums

The second most common cause of toothache is gum disease (periodontal disease). Inflammation of the gums is the inflammation of the soft tissues and the simultaneous loss of bone tissue that surrounds and keeps the teeth in place. Inflammation of the gums is caused by toxins that secrete some bacteria into "plaques," which eventually accumulate along and along the gum line. This plaque is a mixture of food, saliva and bacteria.

An early symptom of gum disease is bleeding gums without pain. Pain is a symptom of later stages of gum disease. For example, the loss of bone around the teeth leads to the formation of deep "pockets" around the gums. Bacteria that accumulate in these pockets cause gum infections, swelling, toothache and further bone destruction. Diseases of the gums can lead to the loss of healthy teeth. Inflammation of the gums is complicated by factors such as poor oral hygiene, family history of gum disease, smoking, family history of diabetes mellitus.

Treatment of gum disease

Treatment of gum disease is always associated with oral hygiene and removal of bacterial plaque, as well as tartar (cured plaque). Moderate and severe gum disease usually requires thorough cleaning of the teeth and roots of the teeth. The first task of the dentist is to remove plaque and tartar, and also to treat the surface of the inflamed layer of gums.

Both these procedures are usually performed under local anesthesia and may be accompanied by the use of antibiotics to cure gum infection or an abscess. The subsequent treatment, if necessary, can include various types of dental operations. In the late stages of gum disease, there may be significant bone destruction and loosening of the teeth, then the removal of the teeth may be necessary.

Toothache due to tooth sensitivity

Toothache can cause naked roots of the tooth. As a rule, the roots of the two lower thirds of the tooth are not visible. Bacterial toxins destroy bones around the roots and lead to the destruction of gums and bones, exposing the roots. The condition, in which the roots of the tooth are exposed, is called a "recession". Naked roots of the tooth can become extremely sensitive to cold, hot and sour food, because the gums and bones are no longer protected.

Early stages of exposing the roots of the tooth can be treated with gels with fluorine content or special toothpastes (for example, Sensodyne or Denquel) containing fluorides and other useful substances. These minerals are absorbed by the surface layer of the roots, so that the roots become stronger and less sensitive to the bacterial environment. Dentists can also use hardening gels on exposed roots to strengthen sensitive areas. If exposure to bacteria causes damage and death of the internal tissue of the tooth - the pulp, then it is necessary to clean the root canal or remove the tooth.

Cracked tooth - pain syndrome

"Cracked tooth" is also the cause of toothache, not associated with a progressive gum disease. A bite in the area of the tooth fracture can lead to severe acute pain. These tooth fractures usually result from chewing or biting hard objects, such as hard candies, pencils, nuts, etc.

A dentist can detect a fracture in the tooth area by applying a special dye to the tooth cracks or by directing a special light on the tooth. Treatment usually involves protecting the teeth with a crown made of gold and / or porcelain or cermets. However, if the crown does not relieve the pain symptoms, the root canal cleaning and sealing procedure may be necessary.

trusted-source[10], [11]

Diseases of the temporomandibular joint (TMJ)

Diseases of the temporomandibular joint can cause pain in the ear, around the ears or lower jaw. The temporomandibular joint goes to the skull and is responsible for the ability to chew and talk. Disorders of the temporomandibular joint may be provoked by various problems, such as trauma (for example, a blow to the face), arthritis, or muscle fatigue due to gnashing of teeth.

A habitual clenching or gnashing of teeth is a condition called "bruxism". It can cause pain in the joints, jaw muscles, tooth pain. Bruxism (dental scraping) is often associated with stresses, bite alignments. Sometimes the muscles around the temporomandibular joint are used for chewing. This condition can go into a spasm, resulting in a sore head and neck, and the mouth can be difficult to open.

These muscle spasms are aggravated by chewing or stress, which causes the patient to clench their teeth and continue to tighten the muscles. Temporary pain of the temporomandibular joint can also be the result of recent dental work or trauma after the extraction of wisdom teeth.

Treatment of temporomandibular joint pain usually involves oral anti-inflammatory over-the-counter drugs, for example, such as ibuprofen or naproxen. Other treatments include a warm moist compress to relax the gums, reduce stress, and / or soft foods that do not need to be chewed for long.

trusted-source[12], [13], [14], [15], [16]

Occlusion of teeth and fangs

Toothache can occur due to teeth that grow from under another tooth or are exposed to any kind of action (for example, the tooth could not come out in the correct position and remains under the bone of another tooth). Then the teeth may look like fangs.

When the tooth is cut, the surrounding gums can become inflamed and swollen. Deformed teeth cause pain when they put pressure on other teeth and become inflamed and / or infected. Dental treatment, as a rule, requires anesthesia or treatment of antibiotics (in the case of infections), as well as surgical removal. This often happens with the wisdom teeth.

Pulpitis as a cause of toothache

Reversible pulpitis is the result of inflammation of the pulp, usually resulting from caries, small lesions of the pulp as a result of previous extensive treatment or trauma. In this case, the same symptoms are observed as in caries, but unlike caries, the patient can not indicate the affected tooth. Treatment can reveal caries or other cause. Analgesics usually help, but mask the symptoms with which you can identify the causative tooth.

Irreversible pulpitis causes toothache without irritant or prolonged pain after irritation. Usually it is difficult for patients to determine the causative tooth. The doctor can determine the causative tooth by placing a piece of ice on it and removing ice immediately when pain occurs. In a healthy tooth, the pain stops immediately. Toothache lasting more than a few seconds indicates irreversible pulpitis. Analgesics are necessary until the endodontic treatment of the tooth or its removal. Patients who often experience trauma or who have not been treated by a dentist may prescribe opioids. Necrosis from pressure is usually a consequence of pulpitis, because the pulp is surrounded by dentin. Usually, the inflamed pulp is necrotic, which leads to the cessation of pain. This period of asymptomatic treatment can last from several hours to weeks. In the future, inflammation develops in the apex of the root and / or the infectious process (apical periodontitis). Infectious process, as a rule, develops under the influence of microflora of the oral cavity. With apical periodontitis, pain occurs when nibbling and chewing. Usually the patient can indicate a sick tooth. If the patient finds it difficult to indicate it, the dentist determines the causal tooth with the help of percussion of the teeth, until pain appears. Antibiotics and analgesics are prescribed if treatment is delayed.

Inflammatory Diseases of the Teeth

Periapical abscess can develop as a result of untreated caries or pulpitis. If there is a well-defined (soft) fluctuation with this abscess, it is drained through the incision, which is carried out at the most pronounced point of fluctuation with the help of a surgical scalpel No. 15. Rarely external drainage is performed. The inflammatory process, which lasts less than 3 days, can be better treated with penicillin, and the one that lasts more than 3 days can be better treated with clindamycin.

Cellulites can be observed with untreated teeth. Rarely develops thrombosis of the cavernous sinus or Ludwig's angina. With these two conditions, there is a life threat and requires immediate hospitalization, removal of the causative tooth and the administration of parenteral antibiotics, to which the microflora is sensitive.

Sinusitis can be suspected if many or all of the molars are painful on one side during percussion or if the patient has pain while tilting the head down.

Difficulty teething

Difficulty erupting of the tooth or its retention, especially 3 molars, can be painful and cause inflammation of surrounding soft tissues (pericoronaritis), which in the future can lead to more serious inflammation. Treatment consists of rinsing with chlorhexidine solution or hypertonic saline solution (one tablespoon of salt per glass of hot water - not hotter than coffee or tea that the patient drinks). Salt water keeps in the mouth on the sick side before cooling down, then spits out and immediately recruited a full mouth of a new one. During the day 3-4 glasses are used for rinsing, which allows to stop inflammation before tooth extraction. Antibiotics are prescribed if treatment is delayed.

Less frequent cases of acute inflammation in the oral cavity, including periodontal abscesses, festering cysts, allergies, blockage of the ducts of the salivary glands or their inflammation and peritonsillar infection. Tooth pain in children can be accompanied by excessive salivation and fever. Acetaminophen, based on the weight of the child, helps to stop the symptoms.

Toothache, as you now see, can arise not only because of sick teeth, but also for other reasons. To determine them, it is advisable immediately to see a doctor, so as not to bring himself to the torture.

trusted-source[17], [18], [19], [20]

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