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Toothache

 

Toothache is pain in the area of your jaw and face.

It usually happens when the inside of a tooth becomes irritated and inflamed.

Inside the tooth

In the middle of every tooth, there is space containing dental pulp. Dental pulp is a soft, spongy tissue containing sensitive nerves and blood vessels.

The pulp cavity is surrounded by layers of hard tissue to protect it. The outermost layer is called enamel and is harder than bone.

Toothache occurs when the pulp inside your tooth gets inflamed (known as pulpitis). This is often caused by dental decay that results from poor oral hygiene, or it is sometimes caused by infection (see Causes).

Dental decay

Dental decay is when bacteria in your mouth form plaque and break down the enamel of your tooth. This can lead to holes (cavities) developing in the tooth, which expose the nerves underneath and cause toothache.

Outlook

If you have toothache, it is important that you see your dentist as soon as possible to have it treated. Treatment depends on what is causing the problem.

For example, if toothache is caused by dental decay, your dentist will take out the decayed area and replace it with a filling.

If toothache is left untreated, the pulp inside your tooth will die and become infected. This will lead to a dental abscess (a lump containing pus) forming, causing severe and continuous throbbing pain. In serious cases a dental abcess can lead to blood poisoning.

 

Toothache often starts suddenly and the pain can vary from mild discomfort to severe. You may have a throbbing pain in your head, jaw and ear that is constant or that comes and goes.

The pain can be worse when you are eating or drinking, particularly if the food or drink is hot or cold.

The jaw in the area of the tooth may be sore and tender to the touch. The pain can also get worse when you lie down, because more pressure is put on the tooth.

Typical symptoms of toothache include:

  • increased pain when chewing
  • sensitivity to hot or cold food
  • bleeding around the tooth or gums
  • swelling around the tooth
  • swelling of the jaw

Glossary

Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

You get toothache when the pulp (containing nerves) in the middle of your tooth becomes inflamed. This may be caused by:

  • dental decay (caries), which can lead to cavities (holes) in the hard surface of the tooth
  • a fracture(crack) in the tooth, which is often so small that it cannot be seen with the naked eye
  • some types of dental treatment, such as a filling that has become loose or broken
  • receding gums (gums that have moved back), which leaves softer, more sensitive parts of the teeth exposed and may expose a tooth root

Teething in babies and young children can also cause toothache. This starts at around six months of age and can continue as the adult teeth start to come through.

Glossary

Acute
Acute means occuring suddenly or over a short period of time.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Abscess
An abscess is a lump containing pus, which is made by the body during infection.
Ulcers
A disintegration of the surface of the skin or a mucous membrane resulting in an open sore that heals very slowly.
Joint
Joints are the connection point between two bones that allow movement.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Similar conditions

Some other conditions can cause pain similar to toothache, even though the teeth are not affected, such as:

  • an abscess in the gum (lateral periodontal abscess)
  • ulcers on the gums (acute ulcerative gingivitis)
  • sore or swollen gums around a tooth that is breaking through, such as when your wisdom teeth start to come through
  • sinusitis (inflammation of the sinuses), which sometimes causes pain around the upper jaw
  • an injury to the joint that attaches the jaw to the skull, known as the temporomandibular joint

If you have toothache it is usually treatable, but first your dentist needs to find out what the problem is.

You may think you know which tooth is affected, but the nerves in the teeth sometimes give the brain the wrong message. This means the problem could actually be in another tooth or even the other jaw.

Your dentist will examine your teeth and gums to look for signs of swelling, redness and tooth damage. They may rinse the area with warm water to dislodge any food particles and to test whether you are sensitive to heat or cold.

Your dentist may carry out an X-ray to identify tooth decay, cracks in your teeth or problems with your jaw bone.

Glossary

Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Brain
The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
X-ray
An X-ray is a painless way of producing pictures of inside the body using radiation.
Painkillers
Analgesics are medicines that relieve pain. For example paracetamol, aspirin and ibuprofen.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

If you have toothache, it is important you see your dentist as soon as possible.

Treatment for toothache depends on what is causing the problem. Some of the possible treatment options are outlined below.

  • if your toothache is caused by tooth decay, the dentist will take out the decayed area and replace it with a filling
  • if your toothache is caused by a loose or broken filling, the filling is taken out, any decay is cleaned out and a new filling is put in
  • if the pulp of your tooth is infected, you may need to have root canal treatment, where your dentist (or a specialist called an endodontist) takes out the decayed pulp, fills the space with a paste and covers the tooth with a crown to protect and seal it

If toothache cannot be treated by these methods, or if the tooth is impacted (wedged between another tooth and the jaw), it may need to be taken out altogether.

Painkillers

While you are waiting for an appointment with your dentist, to ease the pain you can take over-the-counter painkillers such as Paracetamol or Ibuprofen

Children under 16 years of age should not be given aspirin. If you are unsure, speak to your dentist or pharmacist.

Try to avoid very hot or cold foods as they can make the pain worse.

Glossary

Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Antibiotics
Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.
Painkillers
Analgesics are medicines that relieve pain. For example paracetamol, aspirin and ibuprofen.

Keep your teeth and gums as healthy as possible to avoid toothache.

  • Limit the amount of sugary foods and drinks you have. Have them as an occasional treat, and only at mealtimes.
  • Brush your teeth twice a day using a toothpaste containing fluoride. Gently brush your gums and tongue as well.
  • Clean between your teeth using dental floss. If necessary, use a mouthwash.
  • Do not smoke, as it can make some dental problems worse.
  • Visit your dentist at least once a year. Consider having your teeth cleaned occasionally by a hygienist. Children should have dental check-ups every six months so that any decay can be spotted and treated early.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.