It is is something most people dread, but do we know what causes toothache? No matter how well you look after your dental health, using the best products you can afford, sometimes toothache strikes and it's not always clear what the underlying causes are.
Whether it's waking up with a dull ache during the night or a sharp pain after eating something, having a toothache can be a really miserable experience. We're going to break down some of the most common causes of discomfort, how you can avoid them, and what to do when they strike. While the treatment for toothache depends on the cause of the pain you're experiencing, we've put together some general tips to tide you over until you can get to see a dentist. You may also find our guide to the best electric toothbrushes useful.
To help us answer questions on this extensive topic, we've spoken to experienced dentist Dr. David Rice, founder of igniteDDS (opens in new tab), who travels the world sharing his knowledge with young dentists. He also runs a restorative and implant practice in East Amherst, NY (opens in new tab).
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What causes toothache?
Depending on how your toothache appeared, you may or may not know what caused it. While broken teeth or knocks to your jaw that cause damage to your teeth are obvious sources of pain, some toothaches arise from less obvious sources. Dr. Rice talked us through some of the most common causes of toothaches:
1. Untreated cavities that are close or into the nerve of a tooth
Where previously tooth loss was one of the biggest concerns in oral health, advances in technology and better access to oral hygiene products mean common tooth complaints are evolving. A study by the Journal of Dental Research (opens in new tab) has shown that between 1990 and 2010, untreated cavities became one of the most common oral health concerns worldwide. While not all cavities can be avoided, the best way to keep your teeth free from decay is to maintain a healthy oral hygiene routine. Generally, the best way to do this is to brush twice a day for two minutes, use fluoride toothpaste, and make sure you're up-to-date on your brushing technique.
2. Fractured teeth
A fractured or cracked tooth can occur for a few different reasons, but some of the most common include general wear and tear, teeth grinding, or jaw clenching. The type of pain associated with a fractured tooth includes pain when chewing or constant discomfort in and around the cracked tooth, according to Journal of Dentistry. If you break a tooth and a piece falls off that you can save, the NHS (opens in new tab) recommends keeping the fragment of the tooth in a pot of milk or saliva until you can make it to the dentist. If you look after the fragment well, the dentist may be able to re-attach the piece of tooth.
3. Nerve dying in your tooth
Dr. Rice listed some common causes of nerves dying in your teeth, including "big fillings or crowns, old fillings or crowns, trauma or a combination of factors." Your tooth nerves are found in the inner layer, known as the pulp. According to the Mayo Clinic (opens in new tab), when a tooth is damaged or infected, the blood supply to the pulp can be damaged, and the nerve may ultimately die. This process isn't always painful; some people will find they simply experience swelling around the affected tooth. Teeth that no longer have a blood supply can still be saved in some circumstances, says a study by the Journal of Family Medicine and Primary Care (opens in new tab), and if not, can be replaced with a denture or implant, for example.
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Getting an appointment with a dentist isn't always quick, so knowing how to care for a toothache can come in useful. That being said, taking care of a toothache without getting professional help is rarely a good idea: "Toothaches rarely go away. It's best to see your dentist as soon as you can to determine what is causing the toothache, as well as how to correct it," Dr. Rice told us. So, while you wait on an appointment, here's how to take care of that pain.
First things first, consider taking some painkillers. Dr. Rice advises Motrin or Advil: "If you can medically take Motrin or Advil, taking 600mg every 6 hours is very helpful." According to the Mayo Clinic (opens in new tab), this medication should help you manage the pain enough to allow you to focus on other tasks while you wait for further treatment. Other tips to help manage tooth pain include rinsing your mouth with warm water, applying ice (or frozen food) wrapped in a towel to the outside of your cheek. Make sure you don't have any food stuck in your teeth: if it's comfortable to do so, brush your teeth or use floss to dislodge any food that might be causing discomfort.
Have a look at our investigation into 'is milk good for your teeth' to see how drinking milk may help your dental health.
It's also worth considering if your toothache has a source that isn't directly linked to your teeth. According to research pubiished by the Australian Dental Association (opens in new tab), If you're very congested or have a sinus infection, you might feel pain in your teeth and jaw. It's worth letting your dentist know if you've been unwell before the pain started so they can rule out any other potential causes.
In rare cases, you may need to seek urgent medical care for a toothache. Seek urgent medical help if you have swelling around your eyes or in your neck area or swelling in your mouth or throat that makes it difficult to swallow or breathe, say the NHS (opens in new tab). In general, however, Urgent Care and the ER will only be able to prescribe painkillers or antibiotics instead of being able to treat the source of your toothache. Toothache is usually considered a reason for an emergency dental appointment if it's lasted for more than a couple of days, you have swelling in your jaw or cheek area, when you have a high temperature, red gums, pain when you bite down, or a bad taste in your mouth.