Beneath the hard outer structures of a tooth lies a small quantity of soft tissue known as the dental pulp. This tissue contains blood vessels, nerve fibers and connective tissue that build the tooth during its development, according to the American Association of Endodontists. The pulp has no vital function in maintaining a fully developed tooth. Inflammation or infection of this small amount of tissue can cause a severe toothache and require immediate treatment.
Root Canal Treatment
Repeated dental procedures, cracks, trauma and tooth decay can cause inflammation of the dental pulp, according to the American Dental Association. Severe inflammation is painful and can lead to necrosis of the pulp tissue and an abscessed tooth. Root canal treatment removes the inflamed or infected pulp and brings pain relief. The procedure involves making a small opening in the tooth in order to gain access to the diseased pulp. Small endodontic instruments and anti-bacterial solutions clean the inside of the tooth. An inert material such as gutta-percha fills this space and seals the root from further infection. According to the AAE, a root canal treatment successfully saves most abscessed teeth.
Non-Prescription Pain Medications
Until appropriate dental treatment, over-the-counter pain medications often help relieve toothache pain. Ibuprofen, acetaminophen and aspirin are the most common ones used. The advantages of ibuprofen are its anti-inflammatory effect and less irritation to the gastrointestinal tract. These medications are also effective in managing discomfort after dental treatment, such as a root canal.
Prescription Pain Medications
A toothache can be so severe it requires a stronger pain medication such as a narcotic. The most common narcotic drug prescribed is codeine, according to the ADA. The prescription usually calls for codeine in combination with another medication such as acetaminophen. Narcotic analgesics relieve pain by acting on the central nervous system and require cautious use. The prescribing dentist must consider drug allergies and possible interactions with other medications.
Antibiotics
An abscessed tooth can cause both severe pain and swelling. Occasionally, the infection can spread and possibly pose a significant cellulitis, according to the American Academy of Family Physicians. This may lead to swelling around the eye, face or neck. In severe cases, breathing complications result from an obstructed airway. To control a dental infection and guard against its spread, a dentist may prescribe an antibiotic.
Tooth Removal
Deep tooth decay and severe fractures can produce an extreme toothache. A root canal treatment cannot save some of these teeth, which require replacement with a dental bridge, implant or other prosthesis.
