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Toothache refers to pain in and around the teeth and jaws that’s usually caused by tooth decay. Sometimes it can be difficult to decide whether the pain is in your upper or lower tooth. When a lower molar tooth is affected, the pain can often feel like it’s coming from the ear while toothache in other upper teeth may feel like it’s coming from the sinuses.

The type of treatment you have for toothache will depend on the cause of the pain, so your dentist will examine your mouth and make out an X-ray to try to identify the problem.

What causes toothache?

Tooth decay

Tooth decay is the most common reason. In the early stages of dental decay there are no symptoms. Once the cavity has reached the dentine your tooth may become sensitive, particularly when you have sweet, acidic, cold or hot foods and drinks. As the decay gets near the dental pulp you may suffer from toothache that lasts longer and you may need to take painkillers. The biting surfaces of the teeth and the surfaces between the teeth are most likely to decay, because food and plaque can become stuck in these areas. But any part of the tooth can be at risk.

Tooth abscess

When tooth decay advances to the point of affecting the root beneath the visible tooth there is a high chance that the root and the surrounding tissue have become infected. This will result in a widespread pulsating pain that may make it hard to determine from which tooth the pain comes from.

Gum disease

Gum disease is characterized by a dull pain in the mouth, red, bleeding gums, and also sometimes tooth pain. A common cause of this is the oral bone and gums becoming inflamed. If left untreated, teeth, gums, and bones could be damaged or lost, and surgical measures may have to be taken.

Tooth fractures

Teeth can be cracked due to fall, playing sports or biting on something hard. If you feel pain in a fractured tooth, it means that the fracture has made its way to the middle of the tooth where the nerves are.

Temperature sensitivity

If you experience sharp tooth pain during or after eating or drinking something cold or hot, it means that your tooth enamel is damaged and the dentin (the layer where the tooth nerves are) is exposed.

Damaged fillings

When dental fillings are damaged, the sensitive part of teeth are exposed to extreme temperatures, food particles and bacteria. This can result in severe pain and need to be fixed to avoid further damage or decay.

Teeth grinding (bruxism)

This can result in painful teeth and jaw bones. Mouth guard has to be worn while sleeping to relieve the stress put on teeth and the jaw.

Misaligned teeth or impacted wisdom teeth

Teeth that are misaligned can press each other, resulting in aches and pains. Wisdom teeth that have failed to break through the gum line, can also be extremely painful. For misaligned teeth, an orthodontic solution will likely be proposed, such as braces, and surgery will be needed to fix impacted wisdom teeth.