Doctor's Notes on Toothache
A toothache is pain that is felt inside or around a tooth. There are many causes of toothache. Toothache can be caused by decay or abscess of a tooth, fracture (breaking) of a tooth, gum infection (called periodontitis), repeated tooth grinding, or damage to a previous filling or dental work.
The pain of a toothache may be throbbing, sharp, or dull. The pain may occur constantly or may only occur when there is pressure on the tooth, such as when eating. Symptoms that can be associated with toothache depend on the cause of the pain and may include redness and swelling of the gums and tissues around the tooth, fever, jaw pain, headache, or drainage of pus from the painful area. Toothache caused by trauma may be accompanied by breaking or chipping of the affected tooth.
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Broken or Knocked-out TeethBroken teeth are caused by trauma to the face. Jaw pain, toothache, pain with chewing and temperature changes may indicate a broken or cracked tooth. Sometimes teeth may be reimplanted if they come out whole, but fractures may require crowns or removal of the tooth.
Dental AbscessBacteria from a tooth cavity can cause a dental abscess, or infection of the mouth, jaw, or face. Symptoms include pain, swelling, facial redness, gum inflammation, pus drainage, and occasional difficulty fully opening the mouth. Unless the abscess ruptures on its own, the abscess will need to be cut open and drained by a health-care professional. Dental abscesses can be deadly if left untreated.
GingivitisGingivitis is an inflammation of the gums surrounding the teeth. Gingivitis is caused by a bacterial infection of the gums. Symptoms may include pain, redness, swelling, and bleeding of the gums. Treatment includes good dental hygiene and regular dental visits.
Periodontal Disease (Gum Disease)Periodontal disease is an infection of the tissues that support the teeth. Teeth are supported by the gums, or gingiva. A tooth's root is anchored to its socket by fibers called periodontal ligaments.
Temporomandibular Joint (TMJ) SyndromeTemporomandibular joint disorder (TMJ) is pain in the jaw joint. Causes include disease, trauma, wear and tear, or habits. Symptoms and signs include swelling, ear pain, tinnitus, hearing loss, muscle spasms, trouble swallowing, headache, dizziness, and a locked jaw. Treatment incorporates ibuprofen, eating soft foods, applying warm compresses, getting fitted with a bite plate, cortisone injection, or surgery.
Tooth SqueezeTooth squeeze is a painful condition that occurs during the ascent while scuba diving. As the scuba diver ascends to the surface, air that has become trapped in a cavity or dental filling expands causing pain. Treatment for tooth squeeze include over-the-counter pain medication such as ibuprofen or acetaminophen. Medical care should be sought should the pain not resolve.
When to Visit the DentistMost symptoms and problems that occur with your mouth, teeth, and gums are not emergencies and usually can wait for an appointment with your dentist. Urgent dental problems include: traumatic injury that cracks or breaks teeth; cuts to the gums or mouth; tooth pain; gum swelling or redness; or jaw pain.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.