& Tooth Pain Guide!
What is a
"Toothache" is pain typically around a
tooth, teeth or jaws. In most instances, toothaches are caused by a
dental problem, such as a dental cavity, a cracked or fractured tooth,
an exposed tooth root, or gum disease.
Sometimes diseases of the jaw joint (temporomandibular
joint), or spasms of the muscles used for chewing can cause toothache
The severity of a toothache can range from chronic
and mild to sharp and excruciating. It can be a dull ache or intense.
The pain may be aggravated by chewing or by thermal foods and liquids
which are cold or hot. A thorough oral examination, proper tooth
testing and evaluation, along with appropriate dental x-rays, can help
determine the cause. What we want to know is whether the
toothache is really coming from a tooth or somewhere else.
all toothaches caused by a tooth
or several teeth?
Nope. Sometimes, a "toothache" may
be caused by a problem not originating from a tooth or the jaw at all.
Pain around the teeth and the jaws can be symptoms of diseases
of the heart (angina,
heart attack), ears (such as
inner or external ear infections), and sinuses
(air passages of the cheek bones) such as sinusitis (infection of the
sinus cavities). For example, the pain of angina is usually located in
the chest or the arm. However, in some patients with angina, a
toothache or jaw pain are the only symptoms of their heart problem.
Infections and diseases of the ears and sinuses can also cause pain
around the teeth and jaws. Therefore, evaluations by both dentists and
doctors are sometimes necessary to diagnose medical illnesses causing
Keep in mind, while rare, some chronic toothache
like pains are caused by neuralgias and other nerve ailments.
are some Dental causes of Toothaches?
|A dental cavity or decay which has inflamed
the pulp. Left untreated this will progress to an abscessed
tooth. Sometimes, in spite of the decay removal and restoration
the pulp has become so inflamed that it continues to degenerate.
|Decay which has progressed to invade the
pulp and cause the pulp tissue to become infected resulting in an
|Cracked, Split and Fractured teeth can
cause inflammation of the pulp and the tissues around the tooth.
|Periodontal disease and receding gums can
expose tooth roots making them more sensitive to hot and cold foods.
Periodontal disease can cause pulpal inflammation via small canals
that extend from the outside of the tooth to the inside called lateral
or accessory canals.
& Oral Pain Symptoms Guide
provided in this guide is for educational purposes only. Your
specific symptoms may require different actions than provided in this
chart. It should not be a substitute for professional Medical
and Dental attention, diagnosis, and treatment.
sensitivity to hot or cold foods without recent dental work.
the discomfort lasts a fleeting moment to hot and cold foods it may
not signal a problem. Unfortunately, it sometimes is a sign of another
The sensitivity may be caused by a
loose filling, decay, crack / fracture in the tooth, or by minimal gum
recession which exposes small areas of the root surface.
Have the tooth / area checked by your dentist or endodontist. It
may be nothing important, but consider it could be an early indicator
of a problem!
2. Treatment may be needed such
as replacement of a loose filling, restoration, or some type of
coverage over an exposed root.
3. In some cases, changing your
brushing techniques or switching to a toothpaste for sensitive teeth
may decrease the problem.
or prolonged sensitivity / awareness to hot or cold foods without
recent dental work.
probably means the pulp has been irreversibly damaged by deep decay,
crack/fracture, periodontal disease or trauma.
your dentist or endodontist. You're probably going to need nonsurgical
endodontic therapy or root canal (RCT) to maintain your tooth.
Waiting may cause the tooth to be unrepairable or unsalvagable so do
sensitivity to hot or cold foods after recent dental treatment.
work may inflame the pulp, inside the tooth, causing temporary
sensitivity. This type of sensitivity lasts only a fleeting
second and potentially may be quite intense. Fortuantely, the
pulp tissue usually recoperates from this trauma and the sensitivity
diminishes within a few days to weeks.
four to six weeks. If the pain persists or worsens, see your dentist
or prolonged sensitivity / awareness to hot or cold foods after
recent dental treatment.
work inflamed the pulp such that the tissue inside the tooth is
beginning to degenerate. Chances are your tooth is NOT going to
repair the problem without intervention. Don't blame your
dentist, most likely you had a cavity near the pulp tissue or was
missing a substantial portion of the tooth prior to restoration.
your dentist or endodontist. There is a good chance nonsurgical
endodontic therapy or root canal (RCT) is going to need to be
performed to maintain your tooth.
ache near a tooth &/or Biting sensitivity after recent
an indicator the pulp tissue is inflamed. Because many of these
require treatment, such as endodontic therapy to remove inflamed pulp.
Occassionaly, if just biting sensitive, it may be related to your
trip to your dentist or endodontist for an endodontic evaluation is
warranted. Many of these may require endodontic
therapy to eliminate this problem.
Sometimes this can be bite related and
may just require and adjustment. Repeated adjustments are a
commonly a sign endodontic therapy may be needed.
pain when biting down on food
are a lot of problems which can cause this symptom. Here are a
probably guessed the answer already. Go see your dentist or
endodontist for an evaluation.
Treatment will depend on the cause of
and severe pain with pressure, swelling of the gum, and sensitivity to
tooth may have become abscessed, causing the surrounding bone to
your dentist or endodontist for evaluation and treatment to relieve
the pain and maintain the tooth. Many times you're going to
require endodontic treatment of some type
to maintain the tooth.
If your tooth has already had
endodontic threapy, retreatment
or endodontic surgery may be needed to maintain your tooth
tooth hurts when I tap on it with my finger from the side.
this is your only symptom, there are a variety of reasons this might
I had a tooth treated once
endodontically and it remained sensitive for 6 months like this.
This is a marker that your periodontal
ligament is probably inflamed
are potentially several causes of this. See your dentist or
endodontist for an evaluation of the tooth.
that sprouts and may become tender but then pops and goes away.
a periodontal (gum) abscess or an endodontic abscess
your dentist, periodontist, or endodontist for diagnosis and
If this is caused by an endodontic
problem, endodontic therapy will be needed to maintain the tooth.
ache and pressure in upper teeth and jaw
pain of a sinus problem such as sinusitis or infection of the sinuses
is often felt in the face and teeth.
Grinding of teeth, a condition known as
bruxism, can also cause this type of ache.
your sinuses seem to be the problem see your physician.
If your muscles around your face or
your TMJ (joint that connects your lower jaw to your skull) is sore,
see your dentist.
pain in head, neck, or ear
pulp-damaged teeth cause pain in other parts of the head and neck, but
other dental or medical problems may be responsible.
your endodontist for evaluation. If the problem is not related to the
tooth, your endodontist will refer you to an appropriate dental
specialist or a physician.
a specific spot in or near your mouth triggers a sharp, jabbing pain
lasting a few seconds. Sometimes talking may also cause this to
a neurological condition known as Trigeminal Neuralgia
your dentist or endodontist to rule out a possible dental cause.
You will most likely be referred to dentist that treats this type of
pain or physician such as a neurologist. Neurologists specialize
in treatment of nerve problems
or pop is heard when opening your mouth. Opening / Closing your
mouth may be painful
your TMJ (Temperomandibular Joint) which connects your lower jaw to
your skull has a problem. It's also known as TMD for
your dentist. Treatment will vary depending on the symptoms and
severity of involvement.
do you diagnose whether it's a tooth problem
Good Question. Endodontic diagnosis
requires a practioneer to be through and knowledgeable of anatomy of the
region in addition to pain referral patterns. We
will test your suspect tooth and other teeth in the area with many different
tests. We always check if it is temperature sensitive to cold and
possibly heat and/or electricity (sounds terrible but it's not so bad -- I
have had it done to myself). Other
tests that we routinely complete include: tapping on your tooth to see
if inflammation is present, rubbing the gum area near the end of the roots
for sensitivity, and measuring your gums to check the periodontal
health of the area including the "wigglyness" of your tooth.
Sometimes we have you bite on a stick and/or use a fiber optic light to
check for cracks or fractures which go through your tooth. Usually we
will take x-rays at various angles. Not only are we looking for an
abscess but also the anatomy of your tooth. Since you are 3
dimensional and X-rays are 2 dimensional we lose information that we attempt
to make this up by taking specialized angles. X-rays alone are not
sufficient for diagnosis. Just because there's nothing on the X-ray's
does not mean there is not a problem. Early stages of pulp
degeneration and some small abscess are not visible on the X-rays.
Hence, the reason we perform other tests!
do I make my Toothache Stop?
Back in the 1800's, individuals had access to this
We don't recommend this. Just thought we'd show a
little dental history!
Endodovgan.com is provided for information and educational purposes only.
No doctor/patient relationship is established by your use of this site. No
diagnosis or treatment is being provided. The information contained here
should be used in consultation with a dentist and/or endodontist of your
choice. No guarantees or warranties are made regarding any of the
information contained within this website. This website is not
intended to offer specific medical, dental or surgical advice to anyone. Hence,
you should not rely on this information as a substitute for personal,
medical and/or dental attention, diagnosis, and care. Dr.
Dovgan takes no responsibility for the websites that hyperlink to or from
this site, and such hyperlinking does not imply any relationship or
endorsement of those sites.
Joseph S. Dovgan, D.D.S., M.S., P.C.
Practice Limited to Endodontics
10585 N. Tatum Blvd., Suite D-132
Paradise Valley, Arizona 85253 USA
"Where caring, skill, will and technology intersect while striving for endodontic excellence."
Serving Phoenix, Scottsdale & Paradise Valley, Arizona
Copyright 2000-2004 Joseph S. Dovgan, D.D.S., M.S. All rights reserved.
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