How does toothache occur?
Any damage that occurs in the normal anatomy of the tooth can manifest itself in pain, since it is living tissue. Pain in the tooth may be internal or external pain. If there is damage to the bone tissue surrounding the tooth or tooth root, it is defined as external toothache. Toothache, defined as periodontal-induced causes, normally does not damage the enamel dentine tissue of the tooth. There might be a trauma or loss of bone tissue surrounding the root of the tooth. In this type of toothache, the pain is removed by periodontal treatment and straightening of the root surface. If there is caries or pulpal damage to the anatomical tissue of the tooth, it causes internal toothache. In such cases, it is sufficient to clean the tooth decay and fill it. But if the caries advanced to the pulp, the tooth requires a canal treatment, where the internal nerves are removed.
Is tooth tissue alive?
The dentin forming the tooth consists of hard tissue such as the enamel layer and bone tissue. The pulp tissue inside the dentin contains the vascular-nerve pack that feeds the tooth. Thus the tooth tissue is alive. It is affected by external stimuli such as cold and hot. When the tooth gets hit it reacts. When the enamel layer, which is the protective layer of the tooth, wears off with time and loses its thickness, pain occurs in the form of tingling.
What are the causes for toothache?
There are many reasons for toothache. In order to eliminate and treat pain, the source of the pain must be diagnosed correctly. In this case performing an x-ray is essential for the diagnosis of the pain. While sometimes tooth decay can be very painful, a piece of food stuck between the gums and tooth can also be the cause. Fractures or cracks on the enamel surface can also cause pain in form of tingling. The inflammation of the pulp of the tooth, called pulpitis, causes throbbing pain, especially at night and when drinking hot beverages. In such cases canal treatment is required. It is normal for the pain to persist for up to 1 week after the completion of canal treatment. This is a condition required by the healing process. Pain killers help during this healing process. Pain occurring when drinking cold beverages might be due to deep caries pain or root surface pain, which got exposed along with gingival recession. Diagnosis is very important for the correct treatment of toothache, which directly affects the social life of the patient.
What is Toothache Treatment?
After the reasons for toothache are correctly diagnosed and the cause is only small caries, it will be enough to treat it with a filling in order to get the pain under control. If the pain occurs during the night and if there is sensitivity when drinking hot beverages, a canal treatment is required. If the teeth cannot be filled or saved with a coating, it might be necessary to extract them. Gingival treatments are required for periodontal originated toothache.
Can toothache be confused with other discomforts?
Toothache might be reflected elsewhere due to the anatomical location of the teeth. This pain is defined as “referred pain”. Pain in the upper jaw might be referred to the lower teeth when closing the mouth. When the patient comes to the clinic feeling pain in the lower teeth, the problem may arise in the upper teeth. Patients with sinusitis might even feel the pain in their teeth. There might be common pain in the tooth roots in partial facial paralysis. The patient may suspect a problem with his/her teeth, but the treatment of these conditions may be neurological, not dental. In such cases the dentist will need to plan a treatment in consultation with other medical branches.