Toothache

While decay often is cited as the primary cause of a toothache, it's important for you to have a complete oral examination to determine the cause. Other dental causes of a toothache include: infection, gum disease, grinding teeth (bruxism), tooth trauma and an abnormal bite. Tooth eruption may be the cause of tooth or jaw pain in babies and school-age children.

TMJ, sinus or ear infections and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache. Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician.

You may have a dental cavity or advanced gum disease. The first sign of decay may be the pain you feel when you eat something sweet, very cold or very hot. If the pulp ? the inside of the tooth that has tissue and nerves ? has become irritated, this can cause pain in your tooth.

Because the symptoms of a toothache may resemble other medical conditions or dental problems, it can be difficult to diagnose the cause without a complete evaluation by your dentist. If you notice pus near the source of the pain, your tooth may have become abscessed, causing the surrounding bone to become infected. Or the pus could indicate gum disease, which usually is characterized by inflammation of the soft tissue and abnormal loss of bone surrounding the teeth.

Contact your dentist immediately if you have any of the following symptoms:

• Fever
• Difficulty breathing or swallowing
• Swelling around the tooth area
• Pain when you bite
• A foul-tasting discharge

Anyone with a toothache should see a dentist at once for diagnosis and treatment because, if left untreated, your condition can worsen. However, if you are unable to schedule an emergency appointment, a self-care treatment can temporarily alleviate pain and inflammation from a toothache:

• Rinse with warm salt water.
• Gently floss teeth to dislodge any food particles trapped between teeth.
• Take an over-the-counter pain reliever such as aspirin, ibuprofen or acetaminophen to relieve pain. If your child has a toothache, use acetaminophen.
• Never put aspirin or any other painkiller against the gums near the aching tooth, as it may burn the gum tissue.
• Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) may also help to numb the gums. The oil may be rubbed directly on the sore area or soak a small piece of cotton and apply it to the sore tooth.
• If there has been some trauma to the tooth, a cold compress may be applied on the outside cheek to relieve pain or swelling. If your tooth has been knocked out, forced out of position, loosened or fractured, visit the dentist's office or a hospital emergency room immediately.

Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take X-rays looking for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone ? problems that the dentist may not be able to find through a routine exam.

Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If, by the time you see your dentist, your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth.

The key to preventing toothaches is establishing a regular oral hygiene routine and sticking to it. For example, failure to brush and floss regularly after meals can significantly increase your risk of developing cavities. After you eat, bacteria in your mouth feed on sugar and starch and produce acid that can "eat" a hole (or cavity) in your tooth's enamel. If the cavity is not filled, it can cause considerable pain and potentially destroy the dentin, pulp and the tooth's nerve.

Here are a few tips to help reduce your risk for developing a toothache:

• Brush at least twice a day, preferably after every meal and snack.
• Floss once a day to prevent gum disease.
• Visit your dentist twice a year for oral examinations and a professional cleaning.