What causes acute toothache and how to deal with it?

What is a toothache?

A toothache can have an obvious cause: for example, when a person starts eating, the pain comes, and when it stops, it ends, or it can occur spontaneously, regardless of what a person is doing (walking, sleeping, eating). Such types of toothache are also distinguished as short-term (from a few seconds to 15 minutes) and long-term (several hours).

Why can teeth hurt?

There are many causes of toothache, and in any case, a dentist should diagnose and treat. Let’s consider the main causes of toothache:

• caries – penetrating deeper into the tooth, caries destroys it more and more. Therefore, the use of food and drinks causes irritation of tooth tissues and pain;
• pulpitis – caries reaches the nerve, and when it is irritated and disintegrated, sudden, causeless and long-lasting pain begins, usually in the evening or at night;
• periodontitis — pulpitis, moving closer to the roots, causes inflammation of the tissues around them. Periodontitis is accompanied by pain when biting, touching, a feeling that the tooth has increased in size, throbbing pains;
• eruption of wisdom teeth – can be quite painful and accompanied by an increase in temperature and the inability to chew food. This is the case when a toothache causes a headache: the pain spreads throughout the jaw, radiates to the ear, temple, and back of the head;
• tooth injury (fracture or crack of the root, crown, dislocation, chipped enamel) when falling, hitting, trying to chew something hard;
• gingivitis is inflammation of the gums or mucous membrane of the mouth, which also causes pain. It can be local (a focus of inflammation in one area) or spread to one or both jaws;
• other diseases of the gums, mucous membrane of the oral cavity or tongue (stomatitis, herpetic lesions of the lips, corner of the mouth, larynx, mucous membrane) — are accompanied by pain, temperature, malaise and inability to eat.

Toothache after dental treatment and nerve removal is also possible, and we will consider these cases in the following sections.

Causes of toothache after filling

If a tooth hurts after a filling, most likely the fact is that the carious cavity was so deep that only a thin layer of the tooth’s own hard tissues separates the filling from the nerve. Then, during the next two to three months, a replacement dentin must be formed from the soft tissues of the pulp, which will protect the nerve and increase the gap between it and the filling. The hardening of the tissues can cause pain, but it is a natural process that must be endured with the help of painkillers. If after several months the treated tooth still hurts, you should go to the dentist for an examination.

Can a tooth hurt after nerve removal?

A slight aching toothache or pain when biting after nerve removal is considered normal, because it is actually a minor operation. The dentist penetrates deep into the root of the tooth with tools to seal the canals, and this is quite a traumatic process for the patient. The same applies to pain after the removal of a wisdom tooth.

Another reason why a tooth without a nerve suddenly began to hurt may be inflammation of the periodontium. This happens if the root canals are flawed or poorly sealed (for example, when the canals are so thin and branched that it is physically impossible to reach everywhere with instruments). Currently, most cases of moderate periodontitis are successfully treated with medication, and tooth extraction is carried out exclusively according to indications.

Why does a tooth hurt when pressed?

Toothache when pressed may indicate a fracture of the tooth root. At the same time, the tooth looks intact from the outside, but begins to move, pain and discomfort are felt when trying to chew.

Acute toothache when biting

The tooth hurts when pressed, biting, and feels higher than others when the periodontium (periodontitis) is inflamed – the tissues that surround the roots of the tooth. The diagnosis is made based on the results of the examination and X-ray examination. Therapeutic treatment lasts about a year, and in many cases the tooth can be saved. If periodontitis has developed into a cyst at the apex of the root, the tooth is removed together with the cyst. After the dentist is sure that there is no inflammatory process, he can offer options for restoring the tooth.

What symptoms accompany a toothache?

The symptoms accompanying a toothache depend on what exactly caused it to appear. If we are talking about the disease of the tooth itself (caries, pulpitis), then a concomitant symptom is increased sensitivity to the temperature of food or drink. With diseases of the gums and oral mucosa, as well as the eruption of wisdom teeth, the following complaints most often occur:

• general malaise;
• subfebrile temperature (37.2-38 degrees);
• inability to eat and drink;
• toothache radiates to ear, temple, head.

If the toothache is so severe that painkillers do not help, it can become incapacitating, where the person is unable to concentrate on anything else.

How is a toothache diagnosed?

Pain is a subjective feeling, and if the patient thinks that he has a toothache, or if he understands that something is wrong with the tooth, he should seek help from a doctor. A more difficult situation is when a child has a toothache, because he can manipulate his parents and the doctor. In this case, the task with an asterisk appears: to bring the child to the line of honesty and explain that if he sabotages the treatment, it will only prolong its duration.

The dentist will examine the tooth and the oral cavity: conduct palpation and percussion (tapping), determine whether this tooth has been treated before, what is the condition of the filling, whether the tooth hurts under the crown, what is happening with the mucous membrane of the cheek and the gums nearby. If necessary, he will refer to additional studies (CT or X-ray if there is suspicion of periodontitis or tooth trauma) and will eventually make a diagnosis and offer a treatment plan.

Drug treatment of toothache

It is important to understand that drug treatment of toothache only helps to temporarily eliminate the symptoms, but does not get rid of the cause. Therefore, analgesics and nonsteroidal anti-inflammatory drugs in the form of pills or rinses are only a way to tolerate a dentist’s examination. Sometimes we even advise you to take toothache remedies before the visit, because local analgesics may not be enough for acute pain.

How is a toothache treated in a dent medical center?

Treatment of toothache depends on the diagnosis. In each specific case, the actions of the doctor will differ. For example, if the problem is pulpitis or caries, after treatment the pain will go away immediately. If the cause of the toothache is periodontitis, the therapy will take longer, and the pain will continue for the next few days. But this will already be a controlled process, and the doctor will not allow the inflammation to spread and develop into a phlegmon (spill of pus into the surrounding tissues). And if the pain occurred due to the eruption of the “eight”, then the problematic wisdom tooth will be removed, and after the operation, the patient will be given painkillers that will help get rid of postoperative pain.