Toothache is the most obvious symptom of various dental diseases and should never be ignored. Once toothache occurs, it should be treated in time to better protect dental health.
There are many causes of toothache, and the only cure for toothache is to treat the cause of toothache. The 6 major culprits causing toothache are
Tooth decay
Commonly known as “worm tooth” or “tooth decay”, the real cause is still not very clear.
Both the milk teeth and the permanent teeth can occur caries. Tooth decay can cause loss of chewing ability, and when serious, complications such as pulpitis, periodontal abscess, jaw bone osteomyelitis can occur, which endangers the whole body health.
Patients don’t feel pain at the early stage of tooth decay, but when the cavity develops to the dentin, the pain occurs when encountering cold, hot, sour, salty and sweet food (usually sour pain). If the cavity is deeper, close to the pulp (dental nerve) or penetrated to the pulp, the above stimulation can cause unbearable pain, which can be called “small cavity is not filled, big cavity eats pain”. As the cavity continues to expand, the crown will collapse piece by piece, and finally only the residual root will be left. Therefore, it is necessary to check regularly and fill the cavities in time.
Acute pulpitis
Pulpitis, commonly known as dental neuralgia, is mostly caused by the infection of tooth decay developing into the pulp cavity and is the main cause of severe toothache.
The pain is spontaneous and intensifies when it is stimulated by heat or cold, and it can be more severe at night when sleeping. Initially, the pain is paroxysmal, i.e. the pain is intermittent for a while, but later it becomes continuous. The pain can also be reflected to the head, ears and neck. When the pulp becomes abscessed at a later stage, the pain can be relieved by holding cold water in the mouth or inhaling cold air. Acute pulpitis cannot be relieved by taking analgesics. The most effective way to relieve the pain is to open the pulp cavity so that the products of inflammation and or exudate can flow out and reduce the pressure in the pulp cavity.
Teeth with pulpitis must also be filled by an oral surgeon after the symptoms have cleared in order to preserve the affected tooth. If not treated properly, pulpitis can develop into apical abscesses or even osteomyelitis of the jaw bone, making it more difficult to preserve the affected tooth.
Acute periodontitis
The pain is very intense, with a continuous throbbing pain, the tooth cannot bite and chew, the painful tooth seems to grow out a little more than the other teeth, and there is a feeling of floating of the tooth.
Acute pericoronitis of the wisdom tooth (root-less tooth)
This is mainly due to the malposition of the third molar, which is partially covered by gums on the crown surface and often has food embedding, which easily causes bacterial infection and inflammation, resulting in red and swollen gums and constant pain, sometimes accompanied by a sore throat and an inability to open the mouth. The inflammation around the crown of the wisdom tooth is known as pericoronitis.
Pericoronitis occurs in cases of poor oral hygiene and reduced body resistance, and is more likely to occur in mandibular wisdom teeth than in maxillary wisdom teeth. When the disease starts, the gums are painful and the mandibular wisdom teeth are close to the pharynx, so there can be sore throat and difficulty in opening the mouth, which affects speaking and eating. In severe cases, it may be accompanied by high fever, facial swelling, and swollen submandibular lymph nodes.
At the age of eruption, if wisdom teeth are found to be malpositioned or not erupting, with frequent inflammation, they should be examined by a dentist and extracted early.
Heavy wear of tooth enamel
The outermost layer of enamel is gradually worn away due to the long term function of chewing food, so that the second layer of dentin is exposed, and because of the distribution of nerve endings in dentin, it can feel sore when there is hot, cold or mechanical stimulation.
Cervical wedge-shaped defect
Due to gingival atrophy and toothbrush bristles are too hard, in the part of the tooth surface near the gum, the enamel is very thin, often due to the friction of bristles when brushing, the enamel is worn away, the exposed dentin is softer, and is worn into deeper depression by the bristles, so it will feel sore.
There are also some uncommon causes of toothache, such as teeth that have not erupted and are pressing on nearby teeth; pulp with calculus crowns cracked, etc. In addition, certain special groups of people may also experience toothache, such as pulp congestion in patients with high blood pressure and inflammation and necrosis of the blood vessels in the pulp in diabetic patients. Although whatever the cause of the toothache, it must be treated early for the cause under the guidance of a doctor.