Published: 07/28/2023
common causes of toothaches
Photo by Engin Akyurt on Unsplash

You bite into your favorite food or down a nice ice-cold glass of water, and ouch! It hurts. When you’re in pain, you just want to know why. It’s so hard to get on with your normal life until the pain is resolved. The pain may be temporary, but it shouldn’t be ignored. A toothache is a sign that needs to be investigated further to find relief and ensure the problem doesn’t get worse. Let’s look at 9 of the most common causes of toothaches. But first, what are the symptoms?

Common Toothache Symptoms

You know you’re in pain, but how do you know it’s a toothache? Symptoms can be mild or quite severe. They can be transient or chronic. Common symptoms include:

  • Throbbing pain
  • Swelling around a tooth or the gum
  • Increased temperature (fever)
  • Sharp pain, especially to the touch or when you bite into something firm
  • Tenderness
  • Sensitivity to hot or cold foods or drinks
  • Shocking or burning pain, which is fortunately rare.

Cause of Toothaches #1: Tooth Decay

Especially when left untreated, tooth decay or a dental cavity can lead to an abscess. This is the result of an infection inside or around the affected tooth. Tooth decay can also happen if fillings are damaged or tooth enamel has worn down, and the vulnerable tooth dentin (where the nerves lie) is exposed to bacteria and sensitive to changing temperatures.

Solution: Make an appointment with your dentist right away to treat the cavity or dental abscess to prevent the spread of the infection.

If the pain results from worn-down tooth enamel, your dentist may recommend toothpaste made for sensitive teeth to help limit discomfort.

Cause of Toothaches #2: Gum Disease

Evident by dull pain, red (inflamed) or bleeding gums, and toothaches (sometimes), gum disease is a growing concern. When left untreated, gum disease can lead to not only the loss of teeth but damage to the gums and even the jaw, potentially requiring surgery. It can also increase the risk of disease.

Solution: Prevention is the best cure for gum disease. That starts with regular brushing, flossing, and visits to your dentist.

If gum disease has begun to develop, your dentist will review your medical history, examine your mouth, and see how severe the gum disease has developed (by measuring the depth of the pockets between the teeth and gums and taking x-rays). Resolving the issue may begin with scaling (to remove bacteria and tartar below the gum line), root planing (to smooth the surfaces), and perhaps a round of antibiotics.

If the gun disease is more serious, it may require surgery, soft tissue grafts, bone grafts, tissue regeneration, etc.

Cause of Toothaches #3: Orthodontic Adjustments

Another common cause of toothaches is when braces, retainers, or other alignment tools are in the process of moving teeth to improve bite and straighten your beautiful smile. While it’s common to have pain the first few days after an adjustment, fortunately, that pain typically goes away quickly.

Solution: The pain should go away on its own. However, if it is still uncomfortable several days after an adjustment, or if the pain is severe, reach out to your orthodontist to readjust.

Cause of Toothaches #4: Impacted Tooth

An impacted tooth is one that’s stuck in the gum or bone. It’s usually, but not always, a wisdom tooth.

Solution: Again, you’ll want to make an immediate appointment with your dentist to safely remove the affected tooth. If the tooth is removed before it breaks through the gumline or pushes against other teeth, it should be less painful.

Cause of Toothaches #5: Sinusitis

If you have a viral, bacterial, or fungal infection, it can lead to inflammation in the sinuses along with a stuffy nose and ears, as well as excess mucus. Allergies can also lead to a sinus infection. Because of the proximity of the upper teeth, the pressure can cause pain in the upper mouth, making your teeth ache.

Solutions: Depending on the cause of the infection, the treatment may vary. For a minor infection, an over-the-counter anti-inflammatory (e.g., ibuprofen, acetaminophen, or aspirin), antihistamine (for allergies), or nasal spray (e.g., oxymetazoline) may provide relief. You may also try a decongestant (e.g., pseudoephedrine or phenylephrine) to help reduce the swelling.

In addition, it can be helpful to stay hydrated by drinking plenty of water or hot tea along with using a warm compress on the affected area. A humidifier or hot, steamy shower may also help loosen secretions to lessen some of the pressure and relieve the toothache.

Cause of Toothaches #6: Too Much Pressure

If you get overly enthusiastic or use a hard-bristled toothbrush to brush or floss, you can press into the teeth, leading to inflamed, irritated, and even bleeding gums.

Solution: While you want to clean your teeth well, you don’t need to apply much pressure. And you’ll want to use a softer toothbrush that doesn’t cause pain and potentially receding gums. Discuss your toothbrush options with your dentist and ask for some lessons on proper brushing techniques to care for the teeth without irritating your mouth.

Cause of Toothaches #7: Grinding Teeth (aka Bruxism)

One common reason for toothaches, as well as pain in the jaw and neck, headaches, and chipped or cracked teeth, is teeth grinding during sleep. Teeth grinding often gets worse during stressful times. The violent jaw clenching and teeth grinding against each other can also wear down and damage teeth.

Solution: Talk with your dentist about fitting you with a custom mouthguard or splint that you can wear to help prevent you from gnashing and possibly damaging your teeth as you sleep. Kids may outgrow teeth grinding as they grow. And helping correct your bite can also help prevent grinding and the pain and damage it causes.

It may also help to learn relaxation techniques (e.g., meditation, listening to music, warm baths, and regular exercise) to relieve the stress that leads to grinding behavior. You may also want to avoid caffeinated or alcoholic beverages before bed, as these may heighten the behavior.

Mediation for stress, anxiety, and tight muscles may also be recommended. Some people have also found Botox injections may help, especially for people who have not responded to other treatments.

Cause of Toothaches #8: Disease States

While it’s less common, toothaches can also indicate that something more serious is occurring. For example, a toothache can be a warning sign of a heart attack. It can also be a sign of heart or lung disease. Why? Because of the location of the vagus nerve, which goes from the brain to various organs like the heart and lungs via the jaw.

Solutions: If you have unexplained jaw pain, it’s time to visit your doctor to ensure it isn’t a sign of something serious. As well, during your regular doctor appointment, let your doctor know if you’ve been experiencing toothaches, especially if they’re increasing in pain or frequency.

Cause of Toothaches #9: Neurological Conditions

Another rare cause of toothache is the painful neurological conditions trigeminal neuralgia and occipital neuralgia. These conditions cause the nerves in the face and teeth to become inflamed and can lead to toothache.

Solution: Again, if you have unexplained pain in the mouth, make an appointment with your healthcare team to review your symptoms and help you discover the problem.

Taking care of your teeth is vital to a healthy, happy smile. While toothaches sometimes go away on their own (especially when due to allergies or a sinus infection), they do sometimes require a trip to the dentist or doctor. Make an appointment if you find the pain increases in severity or frequency, if you have any swelling or bleeding, or if you have a cracked or loose tooth.

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