Causes of toothache

There are many different causes of toothache. They can be categorized into two forms of short-lasting pains or long-lasting pains by our emergency dentist.

WHAT ARE THE CAUSES OF SHORT LASTING TOOTHACHE?

When we are talking about short lasting toothache, we are talking about a discomfort or pain that last in the matters of a few seconds. They are transient and quickly disappear with no persistence of continuity. Some more common example of these types of pain can be listed as:

• • Sensitivity to cold or touch like when brushing teeth. You can get a short sharp discomfort that as soon as the cause of it is removed, the discomfort stops.

• • Cracked tooth or cusps of the teeth. A short sharp pain on chewing that can be severe but as soon as you stop biting, the pain stops.

• Pain or sensitivity due to early stages of decay in a tooth. Usually hot or cold food and liquids, and sweets can start the sensation. This is also referred to as reversible pulpitis. In these cases, the infection has not yet reached the nerve house of the tooth (pulp) and can be fixed by removing the decay and placing a filling.

WHAT ARE THE CAUSES OF LONG LASTING AND MORE SEVERE TOOTHACHES?

Some of the most common causes of long-lasting toothache are:

• When decay has reached the nerve house of a tooth, known as the pulp, it can cause an acute throbbing pain with a varying intensity that can interrupt sleep. This is because infection causes inflammation and hence swelling of the pulp and severe pain. To relieve the pain only two options are available:
• To open and drain the tooth, known as pulp extirpation which is part of root canal treatment.
• Consider removing the tooth by extracting it. It is always advisable to save a tooth that is possible to restore. Extraction is advisable when it is not possible to restore the tooth predictably.
• Toothache as the result of a chronic infection. Sometimes after the acute pain phase, if not treated, eventually the pulp of the tooth loses its vitality and becomes necrotic. The infection can then further travel down and spread to the jaw bone around the root of the tooth resulting in a formation of an abscess or a cyst in the jaw bone. The solution for this type of infections are root canal treatments, if possible, or extraction.
• Pain associated with partially erupted or impacted wisdom teeth. In many cases, there is not enough space in the jaw bone to accommodate the wisdom teeth. They can be impacted against another tooth or partially go through the gum. Build up of food debris and bacteria under the gum can cause infection and inflammation around the tooth, otherwise known as pericoronitis. If this keeps happening and repeating, then it may be advisable to remove the wisdom tooth. Also, the impacted wisdom teeth have the potential of damaging the teeth next to them or cause crowding by pushing the teeth in front forward. It is advisable to have these teeth removed subject to clinical assessment by the professionals.
• Severe pain that usually starts few days after extraction of a tooth, otherwise known as Dry Socket. This is when the socket of the tooth after extraction develops an infection. Antibiotics have no effect on this type of pain and only use of powerful antiseptics locally can ease the pain. It is more often seen with difficult extraction especially if surgery has been involved. Smoking soon after extraction is a big contributing factor to the development of dry socket after extraction and should be avoided for a few days at least. Healing takes time.

Toothache relief

By visiting us at Bayswater Dental Clinic, we can identify the cause of the toothache and start treatment. We advise addressing the underlying cause of the toothache because:

• In the vast majority of the cases, especially with severe pains, most painkillers have a limited effect in controlling the pain.
• Pain killers usually have very limited effect when there is a build of pressure in the tissue due to inflammation (swelling) or pus collection as the result of an infection. Active treatment is needed to drain the tooth such as pulp extirpation/root canal treatment or draining any pus formation from the tissues around the tooth.
• Pain killers are usually effective in very early stages of pain when it is not severe. This should act as an alarm bell to seek attention as soon as possible before the pain becomes too severe.

Toothache painkillers

The types of the most commonly used over-the-counter available painkillers in the U.K. can be listed as:

• Anti-inflammatory drugs such as Ibuprofen. The maximum daily dose is 400mg every 8 hours. They are good against the pain that is caused by inflammation such as pulpitis.
• Paracetamol is another widely available form of painkillers and can be effective in managing mild to moderate pain until you can see a dentist for treatment. Paracetamol and Ibuprofen can be taken together as they work differently.
• Codeine-based medications such as co-codamol which has both codeine and paracetamol. The dosage varies but usually is 8-500mg which is 8 mg codeine and 500 mg paracetamol. Please be aware it should not be used in combination with paracetamol as there is a risk of overdosing.

Sensitive teeth causes

If you are avoiding eating hot or cold food or liquids, it might be time to address the underlying causes of teeth sensitivity.

Sensitive teeth can be caused by the following:

• Worn tooth enamel from using a hard toothbrush and using a strong grip while brushing aggressively.
• Tooth erosion due to highly acidic foods and beverages.
• Tooth decay, worn leaky fillings and broken teeth that expose the dentin of your tooth.
• Gum recession that leaves your root surface exposed.
• Grinding your teeth at night.
• Post dental treatment sensitivity – common, but temporary, especially with procedures such as crowns, fillings and tooth bleaching.
• Teeth sensitivity symptoms

People with sensitive teeth may experience pain or discomfort as a response to certain triggers. You may feel this pain at the roots of the affected teeth. The most common triggers include:

• hot foods and beverages
• cold foods and beverages
• cold air
• sweet foods and beverages
• acidic foods and beverages
• cold water, especially during routine dental cleanings
• brushing or flossing teeth
• alcohol-based mouth rinse

Your symptoms may come and go over time for no obvious reason. They may range from mild to intense.

Sensitive teeth pain relief

If your tooth sensitivity is mild, you can try over-the-counter dental treatments.

• When it comes to mouthwash, choose an alcohol-free mouth rinse, as it will be less irritating to sensitive teeth.
• Using softer toothbrushes and brushing more gently can also help. Soft toothbrushes will be labelled as such.
• It typically takes several applications for these remedies to work. You should see an improvement within a week.
• If home treatments don’t work, you can talk to your dentist about prescription toothpaste and mouthwash. They may also apply fluoride gel or prescription-grade desensitizing agents in-office. These can help to strengthen the enamel and protect your teeth.

If underlying issues are causing your teeth sensitivity, you should address them to stop it from happening.

Bonding resin for sensitive teeth

Dental Bonding can be used to create a natural-looking barrier on the roots of your teeth. This treatment involves applying tooth-coloured resin to your exposed tooth roots. The finished product blends in seamlessly with your smile and lasts between five and ten years.

Toothpaste for sensitive teeth

Choose toothpaste that’s labelled as being specifically made for sensitive teeth. These kinds of toothpaste won’t have any irritating ingredients and may have desensitising ingredients that help block the discomfort from travelling to the nerve of the tooth.

Before taking any form of medication, make sure you are not allergic to any of the ingredients. Read the instructions to avoid overdosing or other possible complications. Always consult with your doctor or dentist before taking any medication.