Toothaches

Considerations:
A toothache is generally the result of tooth decay . Tooth decay is often caused by poor dental hygiene , although the tendency to get tooth decay is partly inherited.

Sometimes, pain in other locations is perceived as occurring in the teeth (this is called referred pain or radiating pain).

Common Causes:

Note: There may be other causes of toothaches. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for toothaches, occurring alone or in combination with other problems.

Home Care:
Over-the-counter pain medications may be used while waiting to see the dentist or primary health care provider.

For toothaches caused by a tooth abscess the dentist may recommend antibiotic therapy and other treatments.

To prevent tooth decay , use good oral hygiene . A low sugar diet is recommended along with regular flossing, brushing with fluoride toothpaste, and regular professional cleaning. Sealants and fluoride applications by the dentist are important for preventing tooth decay.

Call Your Healthcare Provider If:

  • there is a persistent (longer than a day or 2) or severe toothache.
  • there is a fever , earache , or pain upon opening the mouth wide.

Note: The dentist is an appropriate person to see for most causes of toothaches. However, if the problem is referred pain from another location, you may need to see your primary health care provider.

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting toothache in detail may include:

  • time pattern:
    • When did the pain start?

  • quality:
    • How severe is the pain?

  • location:
    • Where is the pain located?
    • Does it involve the jaw or ears?
    • Does it radiate to other parts of the body, such as the neck, shoulder, or arm?

  • aggravating factors:
    • What makes it worse?
    • Is it worse after cold foods or liquids?
    • Is it worse after sweet foods or liquids?
    • Is it worse after chewing?
    • Is it worse after drinking?
    • Is it worse when you touch the area?
    • Is it worse after physical exertion?

  • relieving factors:
    • What helps?
    • Is it better after you use medications? (Which ones?)
    • Is it better after you use a heating pad?
    • Is it better after you rest?

  • other

  • additional important information
    • What medications are being taken?
    • Have there been any injuries?
    • When was the last checkup with the dentist?

The physical examination may include an examination of the mouth, teeth, gums, tongue, throat, ears, nose, throat, neck. Dental X-rays may need to be performed. Other tests may be recommended depending on the suspected cause.

Intervention:
The dentist will fill cavities or extract the tooth if necessary. With baby teeth, extractions are more common. Root canals might be performed on permanent teeth if the problem is severe. If there is a fever or swelling of the jaw, an antibiotic will usually be prescribed.

After seeing your health care provider:
You may want to add a diagnosis related to toothaches to your personal medical record.


A cross section illustration of the tooth. The gums are shown in pink and the bone is yellow.