A throbbing toothache can occur without warning. The severity of pain can interrupt work, school and routine daily activities. The pain may be localized to a single tooth or diffuse, involving the whole head. Dental treatments such as fillings or root canals bring resolution for most toothaches. Some, however, are indicative of more serious problems and require complex treatment. Understanding the various causes of toothaches can help allay anxiety.
Dental Caries
Dental caries, or tooth decay, is the most common cause of toothaches, according to Children's Hospital of Pittsburgh. Bacteria in dental plaque produce certain acids that cause a cavity in the enamel of a tooth. Once the enamel is penetrated, the decay moves quickly through the softer underlying dentin. The dental pulp which lies beneath the dentin becomes inflamed as the tooth decay moves deeply into the tooth. This toothache is mild or severe depending on the depth of decay.
Dental Treatment
According to the American Association of Endodontists, repeated dental procedures such as fillings and crowns can result in diseased dental pulp and toothache. Each time a tooth receives dental treatment, a pulpitis, or inflammation, occurs. The accumulated effect of procedures after several years can lead to severe inflammation and a toothache. This can occur due to heat generated during tooth preparation as well as certain dental cements used during crown procedures, according to the "Journal of Applied Oral Science."
Trauma
According to the New York-Presbyterian Hospital, trauma or a blow to the tooth can damage the dental pulp. The blow may be of sufficient force to cause severe inflammation and rapid necrosis, or death, of the pulp tissue. A toothache may result from pressure building with the tooth during inflammation. Pain may also occur once the pulp necroses and an infection occurs in the bone surrounding the tooth. Discoloration of the tooth frequently accompanies trauma to a front tooth.
Periodontal Disease
According to the National Health Service, receding gums that expose a root surface can cause a toothache. Cementum covers roots instead of enamel. Tooth brushing and chewing easily remove cementum after the gums recede, exposing the root surface. This exposes the underlying dentin that contains microscopic channels into the nerve of the tooth. This can cause a toothache. An abscess or ulcer in the gum also produces pain in a tooth.
Referred Pain
According to the National Health Service, angina or a heart attack can refer pain to the jaw. This may incorrectly be perceived as a toothache. An inflamed or infected sinus can also refer pain to a tooth. The temperomandibular joint attaches the jaw to the skull. Inflammation of this joint due to tooth grinding, a poor bite or trauma can feel like a toothache.
