3 Causes of Toothache
Hi, I’m Dr Billy Choi, the principal dentist at Precision Dental here at Fortitude Valley in Brisbane.
Last week, a new patient, Ella, from Spring Hill, visited our practice for an emergency appointment. Her left back tooth had been constantly aching for the past three days. During our consultation, she asked me about the causes of toothache.
I get asked this question quite often. So I decided to record this short video and share with you the three most common causes of toothache and what you can do about them.
The most common one is dental decay. Bacteria in our mouth feed on the sugar we eat and produce the acid, it is this acid that weakens and creates cavities or holes in the tooth. Over time, if left untreated, the cavity will get bigger and the bacteria will get closer to the nerve that sits in the middle of the tooth.
As the toxins and the bacteria penetrate towards the nerve, the nerve becomes inflamed, this is when the pain starts. Initially, you’ll start to feel hot and cold sensitivity, but no lingering pain. It’s just a sensitive tooth. At that stage, we can still restore the tooth with a filling.
However, once the decay gets deeper and the bacteria is actually starting to infect the nerve inside the tooth, you may start to get some lingering pain, not just short, sharp sensitivity, but sensitivity that lingers for a minute or two, or even longer. You might even experience a constant ache. This is what happened to Ella at which stage, the nerve has been infected.
If that progresses, the nerve will eventually die. And when the nerve dies, the tooth loses the immunity, and the bacteria will travel down the tooth’s canal or in the middle of the tooth, reaching the tip of the root and can subsequently cause an abscess.
That’s the second cause of toothache, which can be very painful. When there is an acute abscess at the tip of the root, the pus builds up and that increases pressure in a confined space and it will create a constant throbbing pain. It can also be painful when you touch or bite the tooth.
The third one could be an acute gum infection. The gum is very delicate, so if the teeth are clean and there are no obstructions, the gum’s generally happy. But if the gum has something caught in it or if the teeth have a lot of plaque and tartar deposits, the gum can get acutely infected, and that can cause a lot of pain. In this case, it is the pain originating from the gum, not the actual tooth.
A good example is a wisdom tooth. When the wisdom tooth erupts, especially the lower wisdom teeth, the gum can cover a part of the tooth which creates a pocket where food particles and debris get caught underneath.
This can cause acute infection of the gum around the wisdom tooth. That’s actually the number one reason for pain from wisdom teeth. Not the wisdom tooth causing pain, but the gum around it is getting inflamed, swollen, and infected.
As you know, pain is a sign that you should seek medical or dental attention. When you feel any sensitivity or toothache, you should definitely get it checked out before it gets any worse. The longer you leave it, the worse the problem gets, and you may end up needing a more extensive treatment, which could have been prevented if it had been dealt with earlier.
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