Understanding Toothache and its causes

Toothache is possibly the most frequent cause behind a visit to the dentist. In some cases, toothache can be unbearable and can cause a relentless throbbing pain that is almost impossible to remedy without professional help. Yet, what most people do not understand is that toothache can be avoided.

Using a correct oral hygiene plan can prevent toothache for many people, and therefore, prevent another costly visit to the dentist!

What are the causes of toothache?

Tooth decay is the most common cause of toothache. Every day, plaque forms on our teeth. Within this plaque, there are bacteria. Although the body does use saliva as a natural defense against plaque - often this is not enough to prevent a buildup of plaque and subsequent tooth decay from happening. This plaque and decay is most likely to happen if a person has a diet that is high in sugars or carbohydrates.

When sugary foods are consumed, there is a reaction between bacteria in plaque and the sugars, and acid forms on your teeth. Tooth decay is caused by this acid as it erodes the hardened outer enamel of your teeth. Dentists refer to this erosion as ‘a cavity’.

Many people that have small cavities in their teeth will not even know that they are there – so toothache does not always happen straight away. However, cavities that are not noticed cause problems. As the tooth is eroded by decay, the outer enamel is eaten away to expose a layer on the inside of the tooth under the enamel. This layer is called the ‘dentin’.

The centre of the tooth is where the blood supply and nerve endings lie. Dentin exists to provide a protective secondary layer for this sensitive region of the tooth. The tooth usually starts to ache once the decay gets through the dentin and the cavity opens up the inner pulp of the tooth. At this point the patient will be left with little option but to visit their dentist. In the time that the plaque has been allowed to build up and the cavity allowed to form, damage to the tooth has taken place. When a tooth begins to ache and a cavity has developed, professional help from a dentist unfortunately cannot be avoided.

Cavities are not the sole cause of toothache, however they are often the trigger - once the pulp of the tooth has been exposed, infection can set in and this can lead to other types of toothache. Infection of this kind can lead to an abscess, which is an agonizing build-up of pus. Ordinarily at this stage the patient would need to seek the urgent help of an Emergency dentist.
How can your dentist help?

Generally toothache is a relentless pain that cannot be ignored. Focusing on daily tasks can be impossible and it is most likely the toothache will become steadily worse until the person cannot bear it any longer. It is for that reason that dentists will advise that at the first signs of toothache you visit your dentist. Early treatment can prevent worsening decay and toothache, and avoid unnecessary pain.

The initial visit with your dentist will be to identify which tooth is affected and where the cavity is located. Smaller cavities can be treated by being filled. In order to be sure that the tooth is clean and all signs of infection and decay are eliminated, your dentist may need to drill the tooth first.

The fillings used are generally Amalgam fillings. Amalgam is typically black or charcoal in colour and is a mixture of different metals so it is very hard-wearing. For this reason it is used where the most chewing is done - at the back of the mouth by the molars. Alternatively if you filling is likely to be seen when you smile or talk, your dentist may be able to provide tooth-coloured option, which although is more costly that Amalgam fillings, is more natural in appearance.

In some cases the cavity may have damaged the tooth to such an extent that the structure of the tooth is no longer viable; this may cause a tooth to split or even fracture. At this stage, repairing the tooth with a filling is not an option. A more serious problem such as this requires different treatment, such as fitting a crown. To do this, your dentist will drill to remove the decay and shape the tooth, cement is then used to fix a crown over the top of the whole tooth. The crown allows the natural tooth to remain in place whilst serving as protection for the damaged tooth.

Tooth decay at its worst may have spread to the inner pulp of the tooth. If infection has set in, this may be irreversible. On these occasions, the pulp will need to be removed using a technique called ‘root canal treatment’. This treatment involves your dentist drilling into the tooth, and then the pulp is removed by scraping it out through the root of the tooth. The tooth will now have no nerve endings or blood supply but it can remain in the mouth as a working tooth. A crown may be used if our dentist determines that tooth is at risk of further damage.

How can you help?

As explained, once you have a toothache it is a sign that decay has damaged a tooth, and you will need to seek the professional help of a dentist.

We understand that the pain of toothache is quite unbearable so to help ease the pain until you can be seen by a dentist you may find that over-the-counter painkillers and an icepack applied to the face at the point of pain may be of some comfort.

As always, prevention is better than cure, and it is essential that you look after your teeth correctly. You can avoid the build-up of plaque with regular brushing, and to help keep the enamel on your teeth strong, you could use a toothpaste containing fluoride.

Another step, recommended by dentists, is flossing. Plaque and other debris that builds up close to the roots of your teeth and your gums can be removed by regular flossing. This area is frequently where brushing does not effectively reach, therefore allowing for gum disease and cavities to develop.

You should not wait until you have toothache, regular check-ups with your dentist are essential. They will be able to keep a professional eye on your teeth and where necessary, scrape away any plaque that has not been removed by brushing. Even before there is any pain, your dentist will also able to spot cavities, which can be filled. This early treatment can avoid decay setting in and avoid further damage to the tooth.