- Toothache is the most common reason people seek the emergency dentist.
- Toothache can present as a sharp and stabbing pain, dull ache or a throbbing pain.
- It can be constant or intermittent, it can localise to a single tooth or it may feel like the whole jaw is involved.
Each of these symptom points to a cause, which the dentist can identify by performing a full clinical examination with special investigations, like taking an x-ray radiograph and then a treatment can be tailored to each case.
The most common causes of dental pain are:
Tooth Decay (caries)
Teeth decay when bacteria in the mouth, in the presence of acid from dietary sugars, soften and break down the outside hard surface of the tooth (enamel) forming small holes.
This is preventable and even reversible if detected early by your dentist.
If these holes in the tooth are left to progress, and reach the softer inner layer of the tooth (Dentine) an irreversible cavity forms, allowing communication between the nerve of the tooth and the outside world causing pain.
This will require treatment by your dentist, which will involve cleaning the rotten part of the tooth and restoring it to its function and form again. This is performed under local anaesthesia, so you should not feel any pain during treatment.
If a decayed tooth is left untreated, the simple tooth cavity will progress allowing the bacteria to infect the pulp of the tooth (the central portion of the tooth where the blood and nerve supply are found) causing inflammation and a periapical abscess forms.
An abscess is a collection of pus caused by bacterial infection. When the pus collects at the tip of the roots of the tooth inside the jaw it is called a periapical abscess.
Unlike some other types of infection in the body, a dental abscess will not get better on its own or by simply taking antibiotics alone, it must be treated by a dentist.
This will involve cleaning the tooth and its roots and filling the tooth and the roots, this is what is known as a Root Canal Treatment.
In these cases the tooth is usually weakened by the deep decay and the infection and will require a crown to protected the tooth and prolong its life.
Alternatively, the involved tooth will need to be extracted to rid the body of this dental infection.
This arises when the gum shrinks (gingival recession) exposing the sensitive part of the tooth (Dentine).
Gingival recession can be due to age, wrong and damaging tooth brushing technique or gum disease (periodontal disease).
The symptoms of Dentine sensitivity can vary from mild and occasional sensitivity to cold to a severe and constant pain.
Treatment will depend on the severity of the symptoms, from simple varnishes that are applied temporarily to the exposed surface, to covering the exposed surface with a permanent filling.
Periodontal Disease (periodontal abscess)
This is when bacteria infect the gum causing inflammation and pus collection between the gum and the teeth.
Periodontal disease is preventable and even reversible in its early stages (gingivitis), if left unchecked and untreated, it will progress into the irreversible and destructive (periodontist), which causes pain, bone loss and tooth loss.
Your general dentist and/or the periodontist (specialist gum dentist) will advise you on how to prevent and treat periodontal disease.
Temporo Mandibular Joint Pain (jaw pain)
Injury or stress to the joint that connects the lower jaw to the skull can cause severe pain, tooth ache and headaches.This can be caused by stress or bruxism (teeth grinding).
Simple over the counter painkillers and anti-inflammatory can help the odd episode.
Those who suffer more frequently may need their dentist to construct a removable appliance (mouth splint) to allow the jaw and its surrounding muscles to relax and recover and to protect the teeth from excessive wear.
Other causes of toothache include sinusitis, a creaked tooth and wisdom tooth eruption.