If you have ever had a toothache, you will likely remember the pain. It is typically located in or around a tooth and indicates that you have something wrong going on with your teeth or gums. It can also be “referred pain,” meaning it’s coming from somewhere else in your body. Either way, tooth pain should never be ignored as it is telling you something is off and will likely only worsen with time.

Treating a Persistent Toothache

There are a variety of toothaches that can cause you discomfort, so having an evaluation will help determine the cause and the treatment for relief.

• Persistent Toothache: Ongoing pain can affect one or more teeth from damage to the nerve. It can arise from bruxism (tooth grinding), having an injury to the tooth, or severe untreated tooth decay from a poor diet and lax dental hygiene. If there is nerve damage or exposed root pulp, a root canal may be recommended.

• Intense, Throbbing Pain: If pain is accompanied by swelling in the face, you may have an infection or abscess in the surrounding tissue and bone. It can be resolved with antibiotics, treatment for the pain or a root canal treatment.

• Pain when chewing: This can arise from tooth decay or having a small crack in the tooth.

• Sharp, Intermittent Tooth Sensitivity or Pain: Teeth exposed to cold temperatures might mean you have gum recession, lost tooth enamel from brushing harshly (or just aging), a small cavity, and even just normal wear and tear on the tooth. Heat sensitivity might mean you have an abscess, crack or serious decay in the tooth.

• Pain in the back of your jaw: This toothache can arise from your back molars (impacted wisdom teeth), bruxism, or TMD (temporomandibular disorders), affecting the jaw joint (temporomandibular joint or TMJ). Wearing a mouth guard while you sleep protects the teeth. If the culprit is impacted wisdom teeth, they may need to be extracted.

• Gums are receding from a tooth: A gum graft can restore gums, which have receded. Gum tissue from the palate can be grafted to the tooth root, synthetic gum tissue can be used over the tooth (allograft), or gum tissue from an area near the root can be transferred to cover it (sliding graft).

• Extensive Enamel Loss: If a tooth has enamel loss (exposing the softer dentin layer below it) from too much acid in your diet, harsh brushing of your teeth, or just the normal wear, using desensitizers can give you relief. Lost enamel leads to chips, cracks and uneven teeth. A professional-grade desensitizer can be applied, or you can supplement with desensitizers at home (such as over-the-counter toothpaste made for sensitive teeth). Be sure to brush with a soft or extra-soft toothbrush using an up-and-down motion to protect your enamel.

When your teeth are in trouble with a painful toothache, treatment options may involve one of the following:

• Dental filling

• Root canal

• Dental bridge

• Dental crown

• Tooth extraction

Whenever possible, we strive to save a damaged tooth without extracting it so it can be returned to full function and appearance with a dental restoration.

When a Toothache Isn’t Just a Toothache

Sometimes a toothache is signaling that there is a serious health issue going on. Tenderness in the jaws and cheekbones or having problems chewing could indicate temporomandibular joint disorder (TMJ). Heart attacks can cause a feeling of pain on the left side of your jaw. If you have sinus problems, they can manifest as a pain in the upper molar teeth, which isn’t a tooth problem at all.

It is always a good idea to have a persistent toothache checked out. Thankfully, detecting the causes of toothache pain is easier than ever and can be done as comfortably as possible. If you have any questions or concerns about a toothache, please don’t hesitate to reach out to our endodontic team!