A toothache can originate from within the tooth or the surrounding bone, ligament and gum tissue. This pain ranges from mild to severe and may include swelling and other symptoms such as fever and swollen lymph nodes. Determining the source of pain is essential for ensuring effective treatment.
Pulp Disease
The inside of a tooth contains soft tissue called the dental pulp. It extends from the crown of the tooth to the tip of the roots, where it becomes continuous with tissues outside the root, according to the American Association of Endodontists. Although the pulp gains recognition as the nerve of the tooth, it also contains blood vessels and connective tissue. According to the University of Iowa College of Dentistry, cracks, dental fillings, trauma and tooth decay can cause inflammation and infection of the pulp. All of these can cause tooth pain.
Gum Disease
The periodontal ligament covers the outer surface of the root and connects it to the surrounding bone. This attachment of the ligament to the tooth and bone prevents bacteria from forming in areas that would be inaccessible to brushing and flossing. Plaque is the leading cause of gum disease, which breaks this attachment and allows a pocket to form between the tooth and gum, according to the Ohio State University Medical Center. This causes inflammation in the gum and if left untreated will turn into an infection. Redness, swelling and pain can occur with periodontal disease.
Treatment
A toothache caused by a diseased dental pulp necessitates either a root canal treatment or tooth removal. According to the American Association of Endodontists, a root canal treatment successfully saves most abscessed teeth. A small opening through the tooth allows access to the diseased pulp. Small root canal instruments placed through the opening clean the inside of the tooth. A root canal filling fills the space within the roots to seal it from future infection. Cleaning the periodontal pocket will often alleviate pain from disease, according to the American Academy of Periodontology. Severe cases of periodontal disease may require periodontal surgery.
Complications
If pulpal or periodontal disease remains untreated, a serious infection, also called cellulitis, can develop, according to the American Academy of Family Physicians. This can become a life-threatening situation with a compromised airway. Pain from a tooth can also signal a nondental problem such as a sinus infection or even a heart attack.
Prevention/Solution
Regular tooth-brushing, flossing and dental checkups prevent most tooth and gum pain from occurring. Consulting a dentist at the first sign of any discomfort in or around the mouth helps prevent more serious problems and complications from developing.
References
- American Association of Endodontists: Root Canal Treatment
- University of Iowa College of Dentistry: Saving Teeth Through Root Canal Treatment
- Ohio State University Medical Center: Periodontal Disease
- American Academy of Periodontology: Causes of Gum Disease
- American Academy of Family Physicians: Common Dental Emergencies
