Causes of Toothache

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A common cause of toothache could originate from a number sources, but mainly from any of the following: dental cavities, gum disease, tooth root sensitivities, cracked tooth syndrome, impaction and eruption. To fully understand the cause of toothache it’s probably best to analyse each one and hopefully ascertain the cause of toothache in each individual case.

Dental Cavities are probably the most frequent cause of a toothache. They are the holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath the enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. The cause of toothache occurs when certain bacteria in the mouth converts simple sugars into acid. The acid softens and (along with saliva) dissolves the enamel and dentin, creating cavities and this is the cause of toothache. Small shallow cavities may not create pain and may go unnoticed, but the larger deeper cavities can collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods that are cold, hot, sour, or sweet; all pointing to the cause of toothache.

Gum Disease is perhaps the second most common cause of toothache. Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. The cause of toothache connected to gum disease is created by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria. Early symptoms of gum disease include gum bleeding without pain. The cause of toothache is a symptom of more advanced gum disease as the loss of bone around the teeth, which leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling and further bone destruction, I.e. the cause of toothache.

Tooth Root Sensitivities also contribute to the cause of toothache. The roots are the lower 2/3 of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The exposed roots can become sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone; and this is the cause of toothache. If the root exposure causes injury and ‘death’ of the inner living pulp tissue of the tooth, then a root canal procedure or tooth extraction may be necessary.

Cracked Tooth Syndrome is a cause of toothache refering basically to a broken tooth (tooth fracture) without associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. The cause of toothache in these instances are usually due to chewing or biting hard objects such as hard sweets, pencils, nuts, etc. Treatment normally involves protecting the tooth with a crown. However, if placing a crown does not relieve symptoms, and the cause of toothache confirmed, then a root canal procedure may be necessary.

Impacted (teeth pressing together) or Erupting (tooth growing out or "cutting") molar teeth (the large teeth in the back of the jaw) can be the cause of toothache. As the molar teeth erupt, the nearby tissues can become inflamed and swollen. Impacted teeth can require pain medication, antibiotics, and surgical removal. This most commonly occurs with impacted molar (wisdom) teeth.