Dealing with a Chronic Toothache

By Premier Dental of Ohio

What causes a toothache

A toothache can be a major interruption in your everyday life.  Many express to us that a toothache is the worst pain they have ever experienced, even worse than childbirth!  This article will explain everything you need to know about toothaches so that you are prepared in the event that you or a loved one develops one.

Why Does a Toothache Hurt So Badly?

A toothache has the potential to be one of the worst pains you ever experience.  This is due to the unique anatomy of the tooth.  Many people do not realize that teeth are hollow, and the internal chamber of each tooth contains nerves and blood vessels that provide sensation and nutrition to the tooth.  The nerve tissue within a tooth connects to the nerves that supply sensation to a distinct region of the jawbone, which in turn connect to the central nervous system.  This is what allows a tooth to feel sensations of hot, cold, and pain.

The blood vessels within each tooth connect to the greater network of blood supply.  This allows the blood to bring an inflammatory response into the internal chamber of a tooth when it detects an injury.  We call this tissue inside each tooth, containing both nerves and blood vessels, the pulp.  The problem is that the pulp is completely surrounded by hard tissue.

When there is an injury to an area of the body, our body’s response is to send acute inflammation to fight this injury and alert us to the problem.  Inflammation leads to an increase in blood supply to the injured region in order to bring important defense cells to the site.  Normally, this increase in blood supply would result in swelling.

In a tooth, however, the pulp tissue cannot swell because of its hard encasement of tooth structure.  That means that instead of swelling, it develops an extreme increase in pressure within that internal chamber.  The pressure signals the nerves inside the tooth to tell the brain there is pain!

Patients who have a toothache that persists long enough to spread outside the tooth into the surrounding jawbone actually experience a relief of pain because the pressure is released.  Often, we see dangerous dental infections with large facial swellings that do not hurt.  It is extremely important that you understand this fact: A decrease in pain does not mean you are no longer in danger!

The stage where a tooth hurts the most is that stage in which all of the infection and inflammation remains inside the tooth.

What Causes Toothaches?

The general cause of a toothache as described in the previous section is acute inflammation inside the tooth’s pulp, typically referred to as pulpitis.  There are several specific causes of pulpitis, including both infection and injury.

Dental Infection

A dental infection can reach the pulp inside the tooth in two different ways.  An infection can begin in the hard structure of the tooth (enamel and underlying dentin) as a cavity and work its way toward the hollow center.  When bacteria from dental plaque penetrate into enamel, they gradually dissolve the hard enamel and dentin and make their way to the pulp.  In these infections, there is often a large, visible cavity in the tooth.

The second way infection can reach the pulp is through an exterior route.  Bacteria in severe gum disease travel down the root through deep pockets between the teeth and surrounding tissues.  If they reach the end of the tooth’s root, they can enter the hollow chamber through a small pore in the tip of each tooth root. In cases like this, the tooth itself is perfectly intact.  The destruction is in the surrounding bone and gums.

Regardless of how the bacteria reach the pulp, once they are there, they stimulate the inflammatory response by releasing toxic substances.  Then the toothache starts.

Dental Injury

In the case of a dental injury, it is trauma to the pulp tissue that stimulates the inflammatory response.  Usually, the trauma is a heavy force to the tooth or surrounding jawbone.  This can happen during sports injuries, car accidents, a physical fight, or a fall.  The trauma can break or sever tiny blood vessels or nerve tissue entering the tooth.  When cut off from the rest of the body, this pulp tissue goes through the process of necrosis, or dying.  This process includes various phases of inflammation, which . . . you guessed it . . . causes the toothache.

Are Toothaches Dangerous?

They can be, yes!

A toothache is an indication of some type of problem with the nerve tissue inside the tooth.  When that problem is due to a dental infection, the situation is very dangerous.  The bacteria from a dental infection can spread to other areas of the body.  As the bacteria multiplies and extends outside the tooth into the surrounding jawbone and gums, it does not stop there.  Without treatment or any type of intervention, the infection could spread to the bloodstream, brain, or airway, which can lead to serious if not fatal results.

As we mentioned earlier, often the infection spreading actually relieves some of the pain of the toothache.  Don’t let this lull you into a false sense of security.  It simply means that the change in location has allowed the pressure to release.

What Can I Do About a Toothache?

The first, and most important, step to take is calling your dentist.  If you do not currently have a dentist, find one –  quickly.  Many dentists, including our team at Premier Dental of Ohio offer emergency services.  You should have a plan of whom to call if a toothache develops in your own mouth or a loved one’s.

Obviously, you will want to see the dentist as soon as they can see you and follow all of his or her recommendations for medications and dental treatment.  Dental infections do not go away on their own.  They always require intervention.

In the meantime, you can manage the pain of a toothache using over-the-counter pain relievers like Tylenol or Advil.  Alternating between those two medications will provide advanced pain relief as they work on different pain receptors in the body.  We also recommend thoroughly rinsing your mouth with warm salt water for one to two minutes up to five times per day.  This flushes away debris and reduces inflammation in the tissues.

If you can see or feel a large hole in the tooth that is hurting, you may also find some relief by placing a temporary filling material into the tooth.  These are available at most pharmacies and grocery stores in the dental care aisle.  Look for the ingredient “Eugenol” for pain relief.  You can also use clove essential oil, as it, like eugenol, will calm down the nerve inside the tooth.

More Questions about Toothaches?

Call your nearest Premier Dental of Ohio location today if you or a loved one has a toothache.  We would also love to add you as a new patient so that you have a dentist to call if one develops.

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