Pain in the Mouth? Maybe This Is Why

By Richard Seward

Published on June 17, 2008

Many of us probably do not care for our teeth as well as we should, and when we have a toothache, we may resist going to the dentist. However, seeking treatment at the onset of symptoms can potentially save you additional grief down the road. It may even save your life.

Dental Causes of Tooth Pain

Brushing. Flossing. Regular check-ups. All are essential to long-term oral health. Without a strong dental hygiene regimen, you may find yourself facing teeth and gum problems that can cause a significant amount of tooth pain – and make you wish you brushed, flossed, and visited your dentist more often.

Cavities

Not surprisingly, the most common cause of tooth pain is a dental cavity. Cavities are formed when bacteria in the mouth break down simple sugars into acid, which combines with saliva to dissolve the outer layers of the tooth, the enamel and dentin. Without treatment, a cavity can grow deeper until the pulp – the inner living tissue composed of blood vessels and nerves – is exposed. When food debris collects in larger, deeper cavities, the pulp can become inflamed by toxins secreted by festering bacteria or by hot, cold, sweet, or sour foods.

A dental filling can repair a small, shallow cavity. However, larger cavities require the placement of a dental crown or onlay. If the cavity has penetrated and infected the pulp, a root canal or tooth extraction may be necessary to repair the damage.

Gum Disease

Gum disease is the next major cause of tooth pain. It involves the inflammation of the gingiva (soft tissue) and the deterioration of the bone surrounding the teeth. Gum disease develops when bacterial toxins are produced from the plaque – a combination of food, saliva, and bacteria – that builds up along the gum line. Bleeding gums are an early, typically painless, symptom of gum disease. As the disease progresses, however, the loss of bone around the teeth can result in the formation of gum pockets that can collect bacteria, causing painful inflammation and infection, and further bone loss.

In its earliest stages, gum disease can be treated by removal of bacterial plaque. More advanced gum disease may require root planing and subgingival curettage. The former involves the cleaning of plaque and tartar from the exposed roots while the latter involves the removal of the inflamed gum tissue. In extreme cases, where there has been significant bone loss, extractions may be necessary.

Tooth Root Sensitivity

Left untreated, chronic gum disease can lead to root sensitivity. Seated in bone, the roots comprise the majority of the tooth structure. As the bacterial toxins dissolve more and more of the bone and tissue, the gums begin to recede and the roots become exposed. No longer protected by healthy gum and bone, the exposed roots can develop increased sensitivity to hot, cold, and sour foods.

A dentist can treat the early stages of root exposure with special toothpastes or fluoride gels. Unfortunately, where exposure has resulted in damage to the pulp, root canal therapy may be necessary.

Cracked Teeth

A fractured tooth can also be a source of intense pain. A blow to the mouth or biting down on hard objects and food can cause a tooth to break. Subsequent biting on the area of the fracture can produce sharp pain. A cracked tooth can often be repaired by placement of a dental crown. However, if the fracture has exposed the pulp to infection, root canal therapy may be necessary.

Temporomandibular Joint (TMJ) Disorder

Temporomandibular joint disorder is a painful inflammation at the point where the lower jaw – or mandible – connects to the skull. TMJ pain can be caused by a variety of factors, including arthritis, facial injury, and teeth clenching or grinding (bruxism). Spasms in the muscles surrounding the TMJ can cause difficulty in opening the mouth as well as related head and neck pain. Pain can also manifest in the teeth, jaw, and ears.

TMJ pain can be relieved with oral anti-inflammatory medications or through the application of warm, moist compresses to relax muscles in the joint areas. Reducing stress, eating soft foods, and repositioning the jaw with a TMJ dental splint may also be beneficial.

Impacted or Erupting Molars

As the molars erupt, they can cause surrounding tissue to become swollen and inflamed. When molars impact (press against) one another, they can also cause significant pain requiring medication and even extraction. This commonly occurs with impacted wisdom teeth.

Non-dental Causes of Tooth Pain

While tooth pain can signal dental problems that are often easily diagnosed and treated, a toothache may also be indicative of more serious health concerns. Pain in the teeth and jaw may indicate ear or sinus infections while, for some patients with heart problems, toothache or related jaw pain may be the only symptoms of their angina or impending heart attack. On rare occasions, chronic pain resembling a toothache can be caused by neuralgias and other nerve disorders.

Follow-up with a Doctor

Don't take your tooth pain for granted. Though it is likely that your pain is the result of a dental problem that can be easily and effectively treated by your dentist, don't ignore the symptoms. Careful evaluations by both dentists and physicians may be required to accurately diagnose the cause of your tooth pain. So get yourself checked out.

Comment on this article →