Toothache: Symptoms, Treatment, Causes

Toothache, characterised by pain in or around a tooth, arises from various dental and medical conditions, including tooth problems or gum inflammation. The pain ranges from mild to severe and is continuous or intermittent. A comprehensive grasp of the symptoms, treatment, and causes is vital for successful prevention and recovery. Research studies on toothache highlight the prevalence and impacts of toothache across different demographics, underscoring significant effects on daily activities and the necessity for timely dental care.

Toothache symptoms include jaw or tooth pain during mastication, headaches, bleeding or gum discharge, foul-smelling breath, unpleasant taste in the mouth, and swollen gums and glands. Pain during mastication indicates underlying dental problems such as cavities, fractures, or infections. Headaches in the jaw or temples arise from stress or anxiety due to dental pain. Bleeding or discharge from the gums suggests gum disease, infection, swelling, and chronic bad breath. Foul-smelling breath, known as halitosis, results from decay or infection trapping food particles or bacteria in decaying areas. An unwanted or metallic taste in the mouth means an abscess or dental infection, persisting despite regular brushing and flossing.

Treatments for toothache range from professional care to home remedies. Dental treatments like fillings, crowns, inlays, onlays, root canal therapy, and extractions address structural damage and infections, alleviating pain by restoring and protecting teeth. Home remedies include applying a cold compress to reduce swelling and numbing pain, rinsing with salt water to promote healing, and using over-the-counter painkillers for temporary relief. Natural remedies such as peppermint, thyme, aloe vera, hydrogen peroxide rinse, and cloves offer antibacterial, soothing, and numbing effects.

Toothache occurs due to various factors, such as the formation of cavities caused by consuming sugary snacks and inadequate dental hygiene, leading to holes in the tooth’s enamel. An abscessed tooth is a condition characterised by the formation of a pocket of pus due to a bacterial infection in the tooth’s pulp or surrounding tissue. It leads to severe pain produced by the accumulation of pus and inflammation that affects the nerves.

Cracked or broken teeth, which occur due to tooth grinding, accident, or ageing, expose the inner nerves and tissues of the tooth, leading to pain, sensitivity, and edema. Dental restorations, such as crowns or fillings, cause pain and must be replaced or repaired by a dentist. Bruxism, known as teeth grinding or clenching, exerts additional pressure on the teeth and jaws, resulting in dental harm, headaches, and jaw pain.

Impacts of Toothache on Daily Activities of Children Aged 5 to 9 Years in Kerman, Iran by Kalantary, et al. is one of several studies on the effects of toothache on children. Cohen, et al. wrote Coping with Toothache Pain: A Qualitative Study of Low-Income Persons and Minorities to investigate the behavioural influence of toothache and the strategies to alleviate it among poor and minority groups.

Prevalence of Toothache in Chinese Adults Aged 65 and Above by Wan, et al. aimed at checking how common toothache is in the older Chinese groups. Global and Regional Estimates of Dental Pain Among Children and Adolescents—Systematic Review and Meta-Analysis were formulated by Pentapati, Yeturu, and Siddiq to assess if toothache is a usual occurrence in children and teenagers.

What are the Types of Toothache?

The types of toothache are listed below.

Sharp Pain: Sharp pain arises abruptly and intensely due to severe tooth decay, a fractured tooth, or a loose filling. It occurs when masticating or when the tooth encounters extreme temperatures.
Dull Pain: Dull pain tends to linger and is less intense. It results from dental caries or periodontal disease. The discomfort signifies inflammation or infection in the tooth pulp or adjacent gingival tissues.
Severe Throbbing: Severe throbbing, rhythmic, and pulsating pain is linked to an abscessed tooth or significant decay. The pain indicates a serious infection requiring urgent dental intervention.
Irregular Pain: Irregular pain comes and goes without a clear pattern and is associated with bruxism (teeth grinding or minor tooth fractures). It sometimes suggests the beginning stages of tooth decay or gum disease.
Dental Abscesses: Dental abscesses cause intense, constant pain due to infections at the tooth root or between the gum and the tooth. Symptoms include swelling, fever, and a foul taste in the mouth.
Hot or Cold Sensitivity: Sensitivity to hot or cold foods and beverages is due to exposed dentin or receding gums. The pain indicates tooth decay, worn enamel, or a cracked tooth.

What are the Symptoms of Toothache?

The symptoms of toothache are listed below.

Jaw or Tooth Pain during Mastication: Jaw or tooth pain is a sign of underlying dental problems such as cavities, fractures, or infections. The pain makes eating and speaking difficult.
Headaches: A toothache causes headaches in the jaw or the temples. Headaches arise from stress or anxiety brought on by oral aches.
Bleeding or Gum Discharge: Gum disease or infection is indicated by bleeding or gum discharge. Bleeding or gum discharge accompanies other signs of dental concerns, such as swelling and pain. Chronic foul breath and an unpleasant aftertaste result from the bodily fluid discharges.
Foul-Smelling Breath: Halitosis (foul-smelling breath) is a sign of a toothache brought on by infection or decay. Food particles or germs trapped in decaying areas are the underlying cause besides the discharges.
Unwanted Taste in the Mouth: A metallic or unwanted taste in the mouth indicates an abscess or dental infection. The metallic or unpleasant taste remains even after regular brushing and flossing.
Swollen Gums or Jawline: A common toothache symptom, swollen gums or jawline indicates infection or inflammation. The swelling results in apparent asymmetry and discomfort in the face.
Swelling of the glands: A dental infection causes swelling of the glands in the neck or beneath the jaw. The body attempts to fight off the disease, which causes soreness and discomfort.

What are the Causes of Toothache?

The causes of toothache are listed below.

Cavities: A cavity is a dental condition characterised by the formation of a hole in a tooth due to tooth decay. Cavities develop due to acid erosion on the enamel, the tough outer coating of the tooth. Cavities, or areas of dental decay, grow on tooth surfaces due to plaque buildup, sugary snack consumption, and poor oral hygiene.
Abscessed Tooth: An abscessed tooth is a pocket of pus caused by a bacterial infection in the tooth's pulp or surrounding tissue. The infection leads to intense pain due to pressure from the pus buildup and inflammation affecting the nerves.
Cracked Tooth: Cracked or fractured teeth result from tooth grinding, injury, or ageing. The crack exposes the tooth's inner nerves and tissues, resulting in pain, sensitivity, and swelling when chewing or exposed to temperature changes.
Damaged Dental Restoration: A broken filling or crown causes pain and necessitates repair or replacement by a dentist. Restoring damaged dental work reduces pain and protects the tooth.
Teeth Grinding or Clenching (Bruxism): Bruxism is the subconscious clenching, grinding, or gnashing of teeth that occurs during waking hours or sleep. Frequent grinding during stressful periods puts extra strain on the teeth and jaws, leading to dental damage, headaches, and jaw pain. The excessive force causes toothache by wearing down tooth surfaces, causing fractures, and inflaming the supportive structures around the teeth.
Gum Disease: Gingivitis, the first stage of gum disease, arises when plaque and bacteria accumulate on teeth, resulting in infection. The symptoms include red, swollen, and bleeding gums.
Tooth Trauma: Tooth trauma refers to physical injury to a tooth, such as from an accident or sports injury. Trauma generates toothache by damaging the tooth's structure or exposing the inner nerves, leading to pain and sensitivity.
Sinus Infection: Sinus infections cause tooth discomfort in the upper teeth due to pressure and inflammation in the sinus cavities. Treating the sinus infection usually alleviates the toothache.

What are the Treatments of Toothache?

The treatments of toothache are listed below.

Dental Fillings: Dental fillings address small cavities or minor fractures in teeth. They involve removing the damaged part of the tooth and filling the resulting space with a resilient substance. The treatment alleviates dental pain by eradicating decay and repairing the tooth's structure, preventing additional harm.
Dental Crowns: Dental crowns address extensive cavities or fractures by encasing the complete tooth with a cap that resembles a natural tooth. The treatment relieves dental pain by safeguarding the compromised tooth, reinstating its form, durability, and functionality, and impeding any additional decay.
Inlays or Onlays: Inlays or onlays are personalised ceramic restorations used when the tooth damage is too substantial to be repaired with a filling but not significant enough to require a crown. Toothaches are alleviated by carefully fitting dental restorations into the affected location, which restores the tooth's structural integrity and functionality.
Root Canal Therapy: Root canal therapy is a procedure that entails removing inflammatory or infected pulp tissue from the interior of the tooth, followed by cleaning and filling the resulting space. The treatment aims to soothe pain by eradicating the cause of infection and inflammation. A crown is installed to safeguard the tooth that has undergone the treatment.
Tooth Extraction: Tooth extraction is performed when teeth are severely damaged beyond repair and are unable to be preserved. Tooth extraction involves extracting the affected tooth and eliminating any accompanying infection to alleviate pain.
Cold Compress or Ice Pack: Applying a cold compress or an ice pack to the affected area helps ease dental pain, mainly if the toothache is due to injury or swollen gums. The method constricts blood vessels, slows blood flow to the area, numbs the pain, and reduces swelling and inflammation.
Saltwater Mouthwash: Rinsing the mouth with warm salt water helps loosen debris lodged in cavities or between teeth, reduce swelling, boost healing, and relieve a sore throat. The simple remedy involves dissolving 1 teaspoon of salt in a glass of warm water and swishing it around the mouth for about 30 seconds before spitting it out.
Painkillers: Over-the-counter medications, such as acetaminophen and ibuprofen, temporarily relieve toothache. These painkillers help reduce inflammation and alleviate pain but must be used as directed and are not suitable for children under 16 years old in the case of aspirin.
Peppermint: Peppermint has numbing properties that soothe toothache due to menthol, which is antibacterial. People with toothache use peppermint tea, slightly warm wet tea bags, or peppermint oil with a cotton ball to relieve pain.
Thyme: Thyme has antiseptic and antifungal properties due to its main component, thymol, making it practical for dental pain relief. People with toothache use thyme essential oil mixed with water as a mouthwash or apply it directly to the affected tooth with a cotton ball.
Aloe Vera: Aloe vera gel is known for its antibacterial qualities and cleans and soothes gums. Applying the gel directly to the painful area in the mouth provides relief and helps destroy germs that cause tooth decay.
Hydrogen Peroxide Rinse: A hydrogen peroxide rinse is an effective antibacterial mouthwash beneficial if an infection causes toothache. A mixture of equal parts 3% hydrogen peroxide and water is swished in the mouth for about 30 seconds, followed by thorough rinsing with plain water, but it must not be swallowed.
Cloves: Cloves contain eugenol, a natural anaesthetic that helps numb pain and has anti-inflammatory and antibacterial properties. Applying clove oil with a cotton ball or gently chewing whole cloves to release their oil helps relieve toothache and fight infections.

Can Toothache Be Treated At Home?

Yes, toothache can be treated at home. Toothache is temporarily alleviated at home using various pharmacological agents and natural remedies. Over-the-counter analgesics, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), are highly effective in managing dental pain. These medications mitigate inflammation and diminish pain perception, rendering them among the optimal methods for relieving toothache. Home or natural remedies provide an alternative when medications are unavailable or contraindicated. For example, rinsing with saline solution decreases inflammation and cleanses the affected area. Clove oil, recognised for its natural analgesic properties, is applied directly to the afflicted area using a cotton swab to numb the discomfort.

What are the Researches about Toothache?

The research about toothache focuses on its prevalence, its impact on the different age groups, and how people with toothache cope with pain. Impacts of Toothache on Daily Activities of Children Aged 5 to 9 Years in Kerman, Iran by Kalantary, et al., conducted in Kerman, Iran, involved 465 children between the ages of 5 and 9. The study utilised the Child Dental Pain Questionnaire to evaluate the effects of toothache on their everyday activities.

The findings revealed that toothache had a substantial impact, leading to the cessation of eating in 73.3% of children, sleep disruptions in 63.8%, and more than 40% of children requesting dental appointments owing to pain. 55.9% of youngsters were absent from school due to toothache.

Cohen, et al. were the author of Coping with Toothache Pain: A Qualitative Study of Low-Income Persons and Minorities. The qualitative analysis investigates the strategies employed by low-income and minority individuals in managing toothache pain using self-care techniques and non-dental treatments. Participants experienced severe and incapacitating pain that impacted their daily activities and emotional well-being. The participants tried several over-the-counter medications and home remedies, but they experienced very little relief. The study emphasised that financial obstacles significantly cause delayed access to professional dental care, even when individuals are experiencing severe pain.

The research, Prevalence of Toothache in Chinese Adults Aged 65 Years and Above, is a national survey of 25,048 Chinese adults aged 65 and above-analysed toothache prevalence and risk factors. The study by Wan, et al. found a prevalence rate of around 16% in different survey years, with higher rates associated with being female, younger age within the elderly cohort, urban residency, and certain lifestyle factors like smoking and sugar intake. Results underscored the need for targeted interventions to reduce toothache among the elderly.

Global and Regional Estimates of Dental Pain Among Children and Adolescents—Systematic Review and Meta-Analysis authored by Pentapati, Yeturu, and Siddiq is a meta-analysis that reviewed studies on dental pain prevalence among children and adolescents up to 18. The pooled prevalence was 32.7%, with significant variation across regions, highest in Africa (50.1%) and lowest in Australia (20.7%). The study revealed that dental pain is a common issue affecting nearly one-third of children and adolescents globally, with no significant gender differences.

What is the Differences between Toothache and Sensitive to Cold Teeth?

The differences between toothache and sensitivity to cold teeth lie primarily in their symptoms, causes, and treatments. Toothache is a persistent or throbbing discomfort localised in a tooth or adjacent tissues. Toothache indicates underlying dental conditions, such as caries, infection, or trauma. Pressure fluctuations or temperature fluctuations exacerbate the discomfort, ranging from mild to severe. The treatment of toothache is contingent upon the underlying cause. It involves interventions such as dental fillings to address cavities, root canal therapy to manage infections, or extraction for irreparable harm.

Sensitive to cold teeth is characterised by acute, transient pain when teeth are exposed to cold stimuli. It suggests that the enamel has been compromised, allowing external triggers to reach the tooth's nerves. The sensitivity is caused by enamel erosion, which is attributed to acidic dietary behaviours, mechanical abrasion from improper brushing, or untreated surface-level decay. Remedial measures for sensitive to cold teeth involve desensitising toothpaste fortified with fluoride or potassium nitrate, obstructing pain transmission and strengthening enamel resilience.

Toothache and sensitive to cold teeth exhibit similarities in preventive strategies despite their distinct presentations. A cornerstone in preventing these conditions is the consistent adherence to meticulous oral hygiene practices, which include regular brushing with fluoride toothpaste and thorough flossing. Dietary changes must be made, such as reducing the consumption of sugary and acidic foods known to accelerate enamel erosion to prevent sensitivity and dental discomfort.

Routine dental examinations are essential milestones that facilitate the early detection of emerging dental issues, allowing for timely intervention to prevent progression and preserve oral health.

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).