Toothache is very unpleasant and often indicates tooth decay. You can find out here what other causes can be behind the symptoms and to what extent home remedies and medication help!
- © Getty Images/Tom Werner
Quick Overview: Toothache
causes: The reason for toothache is often tooth decay, but inflammation of the nerves, teeth grinding, defective fillings and diseases outside the mouth are also possible.
home remedies: Cold, cloves, mouthwashes and oil pulling are said to relieve toothache, but cannot replace a visit to the dentist’s office.
Treatment: The therapy depends on the cause of the toothache and is correspondingly varied.
diagnosis: In the dental practice, the face, oral cavity, teeth and gums are examined and the fit of fillings and dentures is checked. X-rays can be used to identify deeper causes.
At a glance:
Recognize oral diseases through pictures
What is a toothache?
Toothaches are usually very unpleasant. They are often due to a diseased tooth, but the reasons can be varied. It is crucial that those affected take the symptoms seriously and seek dental help promptly.
Untreated toothache can lead to tooth loss and inflammation can spread through the bloodstream to other areas of the body. If a tooth is broken, knocked out or the cheek swells, it is a dental emergency.
Causes of toothache
A variety of causes can be responsible for the sudden or recurring occurrence of toothache. Experts generally differentiate between triggers that come from the teeth themselves and causes that lie outside the mouth (non-odontogenic toothache).
Possible causal dental diseases
Tooth decay is the most common cause of toothache. If the teeth are not cleaned adequately, a plaque forms on the teeth in which tooth decay bacteria settle. These convert sugar into acid, which attacks tooth enamel and eats holes in it.
Once the sensitive interior of the tooth, the dentin, is reached, anything sweet, sour, hot or cold causes massive toothache.
If the bacteria penetrate into the inside of the tooth, i.e. into the dental pulp (pulp), they can lead to inflammation of the tooth nerve (pulpitis). The increasing pressure inside the tooth usually causes severe, pulsating pain. If these suddenly disappear, this may indicate that the tooth nerve has died – quick action is required.
Other possible reasons for the complaints are:
abscess: If the inflammation spreads to the surrounding tissue and jawbone, a collection of pus (abscess) can form, which is typically accompanied by very severe pain and hot swelling.
Periodontitis: Prevailing bacteria are also the trigger for periodontitis. In this case, they lead to inflammation of the gums (gingivitis), which is initially painless and only causes redness, swelling and bleeding gums. However, if left untreated, the inflammation can lead to gum recession, exposing the necks of teeth and leading to tooth loss.
Tooth fracture: Teeth can also break – for example due to an accident or when something hard is bitten. Such a tooth fracture can cause great pain at the moment it occurs or can only lead to problems years or decades later.
Bruxism: Massive, often nocturnal teeth grinding (bruxism) can wear down the surface of the teeth. If this protective hard layer falls away, chewing can cause severe pain.
Tooth eruption: The eruption of teeth can cause massive pain, especially in babies. But the eruption of wisdom teeth in adults is often very painful.
Defective fillings and damaged dentures: If crowns or bridges no longer provide a sufficient seal, they make the ground tooth susceptible to irritation and pain.
Reasons for non-odontogenic toothache
Toothaches that are not directly caused by sick or defective teeth or gum disease are called non-odontogenic toothaches. Possible causes are:
Inflammation of the paranasal sinuses or maxillary sinuses: Typical symptoms include pressure pain at the bottom of the eye and an increase in pressure when those affected lean forward.
Trigeminal neuralgia: Inflammation of the trigeminal facial nerve is accompanied by sudden, one-sided pain, for example when touched, eating or brushing teeth.
Cranio-manibular dysfunction: This dysfunction in the chewing apparatus is caused by incorrect strain on the chewing muscles (e.g. grinding teeth at night) and is characterized by dull muscle pain in the head, jaw and neck area.
Shingles (herpes zoster), migraines, ear infections, jaw cysts, a malfunction of the salivary glands, tumors in the head or heart disease are much less likely to be behind the toothache.
Home remedies for toothache
If you have a toothache, home remedies may be able to provide short-term relief, but they are not a permanent solution and should only be used to bridge the gap until an appointment at a dental practice. For example, some sufferers swear by the following remedies:
- Cool with ice or cool packs if your cheek is swollen
- Apply or place clove oil or chewed cloves on the painful tooth
- Mouthwashes with rosemary, sage, chamomile, propolis or salt water
- Strain cold-pressed sunflower, olive, sesame or coconut oil between your teeth for several minutes and then spit out
If home remedies are not enough, taking painkillers with active ingredients such as acetylsalicylic acid, ibuprofen or paracetamol can bridge the time until you visit the dentist.
Painkillers should not be used for more than three days in a row without medical advice.
Treatment of toothache at the dentist
Dental treatment for toothache depends on the cause of the pain. Some examples:
Caries: In the case of tooth decay, the affected area is generously removed and treated with a filling, crown or bridge. If the tooth needs to be extracted, it may be possible to replace it with an implant (an artificial tooth that is attached to the jawbone).
pulpitis: The inflammation of the nerves is resolved by treating the tooth root (root canal treatment). The inflamed root canals are exposed, cleaned and sealed with a filling.
abscess: The pus-filled swelling is opened and drained through a small incision with a scalpel.
Periodontitis: If you have this disease, it is important to have the gum pockets professionally cleaned. An antibiotic may need to be taken to combat the bacterial pathogens.
Bruxism: Anyone who grinds their teeth and experiences pain as a result will receive an individually tailored splint that is worn at night and prevents further erosion of the protective tooth structure.
Defective fillings, damaged crowns or bridges and tooth fractures are repaired or professionally treated in the dental practice.
If the cause of the toothache is not in the mouth, you will be referred to another specialist practice and appropriate treatment will be initiated.
Medical diagnosis for toothache
The diagnosis in the dental practice begins with a detailed conversation (anamnesis), in which the specific complaints, previous dental treatments and any previous illnesses are inquired about.
This is followed by a physical examination of the face, oral cavity, teeth and gums, and the tightness and fit of fillings and dentures is also checked.
X-rays can be used to detect damage between teeth and under fillings, tooth root inflammation and abscesses. Under certain circumstances, secretion samples may also be taken to detect the specific pathogen causing the inflammation.
If the cause of the toothache cannot be determined using these methods, you may be referred to another specialist practice for further examinations.
Course and prognosis of toothache
Toothache should always be treated in a dental practice in order to eliminate the underlying cause as quickly as possible. If left untreated, they can lead to the loss of one or more teeth, and bacterial infections can spread to other areas of the body and, for example, trigger heart valve inflammation.
However, if the cause of the toothache is recognized and eliminated in a timely manner, in most cases it will heal without any consequences. If necessary, patients may have a new dental filling, crowns, bridges or implants after the treatment.
Prevention: How can toothache be prevented?
The best prevention against toothache is good oral hygiene and dental care. Regular and thorough cleaning of the teeth and between the teeth (twice a day) helps to prevent tooth decay, periodontal disease and inflammation of the tooth roots.
Regular check-ups in the dental practice, professional teeth cleaning and a low-sugar diet complete the prophylactic program to avoid toothache.
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