What a Pain in the Tooth: How to Diagnose Your Tooth Ache

Do you have persistent toothache? Does it hurt to chew? Use this handy guide to the most common types of dental pain to find out how to solve your toothache.

types of tooth ache

Image from Bosc d’Anjou on Flickr.

There are few things as uniquely frustrating as a persistent toothache. When it strikes, it is often very difficult to ignore. Even if the pain is not unusually intense or occurring in a stabbing or ‘jabbing’ sensation, soreness in the mouth can be a real problem. As the mouth and teeth are a source of so much activity, even mild pain can deteriorate quickly.

This is why it is important to keep up with regular dentist check-ups and examinations. They are designed to identify dental issues as early as possible, primarily so that pain does not get a chance to take hold. While there are, of course, plenty of things in life that can prevent us from visiting the dentist regularly, the advice is clear. If you maintain a healthy dental routine, you are much less likely to suffer with toothache.

If you have had a persistent toothache before, you will know what a nightmare it can be. It is distracting, annoying, and debilitating in some cases. You might have trouble concentrating at work. You may feel queasy and find it tough to carry out tasks and activities. And even more harmful, in some ways, is the psychological damage of toothache; namely, the worry about what might be wrong with your teeth.

The first step to take if you find yourself suffering with persistent toothache (for longer than a couple of days) is to call your dentist and schedule an examination. Your dental specialist is the only person who can help you. You may be able to take prescription medications to alleviate the pain, but this will not fix it. It will only mask the symptoms and, as soon as you stop taking the drugs, the pain will return.

Understanding How to Self-Diagnose Dental Pains

First things first; self-diagnosis, of dental or any other kind of physical pain, is for short term purposes only. In other words, it should be used only as rudimentary information until you get the chance to visit a doctor, dentist, or specialist. You should never take information that you find online and use it as a substitute for a qualified medical opinion.

Nevertheless, gathering as much information as you can may help you to approach your appointment with less fear and apprehension. It will also give you an idea of what to expect from your doctor, as regards diagnosis and further treatment. This is why personal research can be valuable.

There are as many different types of toothache as there are teeth in your mouth, so your symptoms may not match the ones described below. However, this guide will help you to describe your toothache to the dentist and help you to find some temporary relief while you wait for the appointment. You must not pick or play with problem teeth, because you will only introduce bacteria into the mouth.

You can use the following guide to the various different toothache (or odontalgia) types to try and diagnose the source of your dental woes.

Intermittent Sharp ‘Jabbing’ Pains

This is toothache that is less of an ache and more of an irregular jabbing or stabbing sensation within one or several teeth. It is usually felt in response to a stimulus. So, opening your mouth, chewing, eating cold foods, etc. It usually comes and goes, but is very painful when it does make an appearance. This type of pain may be caused by a crack, cavity, or abscess.

Sharp Tooth Sensitivity

This type of pain will feel similar to the one described above, but will only be felt when the tooth is exposed to changes in temperatures (eating ice cream or drinking coffee). In severe cases, even cold air can cause pain. As with a stabbing pain, it could be a product of a cavity or an abscess, but it may also be caused by rough brushing or gum recession.

Dull Nagging Toothache

This is the most common type of toothache and though it is usually quite mild, its persistence and deep, dull sensation can make it a tough problem to deal with. It will usually go away after taking over the counter painkillers, but you should not use this as a substitution for treatment. It may be caused by nerve damage or tooth decay, so consult your dentist immediately. This type of pain is frequently seen in people who grind their teeth.

Extreme Throbbing Pain

If you are suffering with an extremely painful tooth, you may need to ring the emergency number for your dentist and schedule an appointment for the next day (where possible). This is especially important if you can see that your face is swollen, because it means that you have developed an infection or abscess. It must be treated or you may start to feel poorly.

Pain Only When Eating

If you develop toothache only when eating, the problem is likely to be tooth decay or a dental fracture. Once again, schedule an appointment with your dentist as soon as you can. This type of pain can usually be controlled with over the counter medication, but you do not want to wait too long before your mouth examined.

Pain at the Back of the Jaw

This type of pain is not as common as the rest, because it usually signifies an impacted wisdom tooth and they are not something that happens for everybody. It can be pretty frustrating to learn that you have problem wisdom teeth (some people develop them without any pain or complications), but you still have to get them examined. If left untreated, they will only cause more pain in the future.

Knowing How to Respond to Toothache

Generally speaking, if your toothache is intermittent and seems to come and go, you can probably get away with not rushing out immediately for a dental exam. However, you must schedule an appointment for some time in the near future. On the other hand, if you have persistent and intense pain, you really do need to be urgently examined by a dentist.

The pain associated with tooth decay is very common and it has some identifying features. For example, ask yourself if the pain is always the same or does it change in intensity throughout the day? With tooth decay, it is often observed that the pain worsens in the morning and in the evening. It is also likely to flare up when you eat hard foods.

At your dental appointment, the specialist will use one or several techniques to diagnose the problem. In most cases, this takes a matter of seconds. If you do have a severely decayed tooth, for example, it will usually be fairly evident as soon as the dentist peers in. It can be a little trickier to identify things like root infections, so there may be some prolonged touching and contact with the gums and teeth.

Different Diagnosis Techniques to Expect

Your dentist may wish to take an x-ray of your teeth to check for abscesses, cavities, and other hidden problems. This is not a very invasive procedure and should only take a few minutes to perform. They may also perform a basic percussion test to identify the most vulnerable areas of the mouth. This is as simple as it sounds; the dentist taps lightly on different teeth with their finger or a special tool.

The majority of the diagnosis techniques will take this form. For instance, there is a biting pressure test, which requires the patient to bite down on a stick or applicator and then describe where the pain occurs more intensely. Similarly, the cold air test uses a soft stream of cold air to identify areas of unhealthy sensitivity and vulnerability. Once again, none of these tests are invasive. They may cause pain, but this is sometimes necessary to find the source of the issue.

Once the examination is over, the dentist will have a one to one chat with you about what the problem is and how it can be fixed. If a dental procedure is needed, they will explain how and why during this consultation. Ordinarily, patients are then required to schedule a further appointment in order to have this treatment. So, you may be prescribed medications to deal with the pain while you wait for the procedure.

The Most Common Diagnoses for Toothache

Tooth Decay

Tooth decay is just another word for cavity. If you have a decayed tooth, it means that its outer surface has been eaten away by plaque. This happens when plaque attaches itself to the tooth enamel and produces enamel dissolving acid. It spreads inwards, dissolving the tooth and feasting on the dentin (the middle layer). If it is allowed to move even further inwards, it can lead to severe pain as it hits the nerve.

Inflammation of the Pulp

This condition is commonly referred to as ‘pulpitis.’ It occurs when the tissues in the middle of a tooth become irritated and inflamed. This irritation leads to an accumulation of pressure inside the tooth and puts a strain on the gums and surrounding tissue. The treatment for pulpitis is usually a root canal procedure. It is important to get the condition treated quickly, because the associated pain can be severe.

Cracks and Fractures

It is also possible for small cracks and fractures to appear in teeth. These can be caused by general wear and tear or by biting down hard on a tough object. It is common for dental cracks to occur while eating things like ice and popcorn. In some cases, the crack will be evident immediately and you may even be able to feel it with your tongue. In others, however, it may only manifest as a dull pain when biting or a sensitivity to temperature changes.

Impacted Wisdom Teeth

A tooth can become impacted if it is restricted in its natural movement. So, for example, the most common incidence of this is with emerging wisdom teeth. As they develop much later than the rest of the adult teeth, their attempts to align with the other molars can be disrupted. In cases where there is no room for the wisdom teeth, they remain trapped beneath the gum and this can lead to pain and soreness.

Gum Disease

This condition is either known as gingivitis or periodontitis. It is characterised by an infection of the gum tissue that surrounds and secures teeth. If left untreated, it can lead to persistent tooth loss and total degeneration of the gums. The bacteria causes the gums to lose their grip on the teeth and recede, which forces the creation of gaps and pockets. These pockets then fill with bacteria and leave the tooth roots vulnerable to decay.

Sensitive Teeth

And, there are some people who simply have sensitive teeth. If there are no signs of infection or decay, but the teeth are still sensitive to changes in temperature and cold air, this may be the problem. As this is not actually a dental condition at all, no treatments should be needed. As long as the teeth are structurally healthy, a specially designed toothpaste can be used to control the degree of dental vulnerability.

Other Causes

A lot of people are surprised to find that dental pain can be caused by other parts of the body, particularly the nose and ears. If you can ever remember being told that the ears, mouth, and nose are ‘all connected’ as a child, you can now confirm that this is absolutely true, at least in a manner of speaking. There are some forms of toothache (usually in the upper row) that can be caused by sinus infection or congestion

Dental Abscess

A dental abscess is typically caused by a build-up of bacteria inside the pulp area of the tooth interior. If this becomes infected, the tooth root has to deal with a lot of pressure. This is the point where the infection naturally drains out, so the area can easily become inflamed and very sore. The most obvious symptom of an abscess is a painful facial swelling. Once again, the recommended treatment is usually a root canal.

The Right Way to Deal with a Dental Abscess

Out of all of these conditions, the most painful is usually the dental abscess. Though it is caused by a common problem – one which can be easily fixed – an abscess only occurs once the issue has been left untreated for some time. At this point, the pain is likely to be severe and require urgent attention. You need to contact your dentist immediately if you think that you might have an abscess.

The condition can be very serious, especially if it is allowed to spread to surrounding teeth. Fortunately, this is quite rare. The majority of abscesses are so painful that it really is not an option to leave them untreated for this long. If identified and treated in time (before irreversible damage to the pulp tissue occurs) there is a good chance that the tooth can be saved.

The longer you leave the problem, however, the higher the likelihood of a full extraction. The most common symptoms of an abscess are pain while eating, swelling of the gum tissue, persistent bad breath, and extreme sensitivity to temperature changes. In extreme cases, there will also be a noticeable swelling of the face and maybe even fever like symptoms.

Relieving the Pain of an Abscessed Tooth

There are a number of ways in which you can minimise the pain of an abscessed tooth while you wait for your dental appointment. To reiterate, these pain methods should not be used as a substitute for proper dental treatment. If you have an abscess, call your dentist immediately and schedule a check-up. This is the first stage of seeking the treatment that you need.

In the interim, avoid eating foods that are either very hot or very cold. For example, coffee, tea, ice cream, milk, and yoghurts. As the dentin layer of the tooth has been eaten away, the nerves are exposed and are going to be vulnerable to external stimuli. You need to treat them carefully until your dentist has a chance to examine them. The same rules apply for any drinks or liquids that are very sugary or acidic.

The vast majority of over the counter painkillers are perfectly fine and will not interfere with anything that your dentist may prescribe you later on. Make sure that you do not exceed the recommended dosage, no matter how severe your toothache or swelling. If possible, opt for an anti-inflammatory drug, because these medications soothe the tissues and the nerves.

If painkillers are not enough or you cannot take them, it could be useful to go old school and try oil of cloves. This culinary spice is widely available in supermarkets and is actually included in a great many dental treatments. It has antiseptic and anesthetic characteristics, so pick some up from your local store. All that you have to do is soak a clean cloth in the oil and hold it gently over the painful tooth for 10-15 seconds.

It may also help to sleep with your head and mouth slightly elevated. This will alleviate some of the pressure on the infected tissue and prompt a reduction in pain symptoms. And finally, for a last ditch attempt at pain management before your dental appointment, try a salt water soak. As salt water is a mild antiseptic, rinsing 2-3 times a day may minimise the pain.

In some cases, brushing and flossing may also temporarily relieve pain. You should, of course, be keeping up with your regular dental routine as far as possible, even if you are suffering with an abscess. The trick is to take your time. You may need to brush very softly and very slowly, in order to avoid irritating the affected area. Sometimes, flossing between the teeth to remove food particles can help to sooth an aching tooth.

Ultimately, the best course of action is and always will be to see your dental specialist as soon as you can. You may need a root canal to fix the source of the problem. This can be a complex and lengthy procedure, but it rarely involves any pain. The dentist will create a passage all the way through the tooth, down to its root, so that he or she can suck out all of the infected fluid and tissue. At a later date, a crown or filling will be added to protect the empty tooth structure.

People at Increased Risk of Dental Problems

There are some people who are more prone to developing dental problems than others. They usually include those with underlying medical problems. So, for example, the most common type of tooth decay linked to physical sickness is that which is accelerated by diabetes. If you are diabetic, it is even more important that you keep up with regular dental appointments.

Your teeth may be at increased risk of developing cavities, cracks, and fractures. You can minimise the danger, however, by brushing regularly, flossing, and avoiding fizzy drinks and sugary snacks. Your dentist will be able to give you more information on tooth care for diabetic patients, if you ask. The other ‘at risk’ group is older people, because the gums and surrounding tissues naturally recede with age.

This can lead to problems with abscesses in the gums, so it is similarly important to maintain a proper dental health routine. As your teeth age, your dental hygiene and health requirements will change, so it is vital to stay in touch with your dentist and follow all recommendations provided. If you do all of these things, your teeth should stay strong and healthy for a long time, if not for the duration of your life. And if you take care of your teeth, the rest of your body will follow suit.


Image: Bosc d’Anjou @ https://www.flickr.com/photos/boscdanjou/7558867436

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