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There is more than one cause of toothache. A toothache often occurs when a tooth's nerve is irritated, but there are numerous other reasons a person might experience toothache.

Among the risk factors for toothache; dental infection, gum disease, plaque, tooth decay, injury, broken teeth, poorly placed fillings or crowns, tooth loss (including tooth extraction), temporomandibular joint (TMJ) disorders, and obstructive sleep apnea. However, there are cases where the pain originating from the outside of the mouth spreads to the mouth, thus giving the impression that the pain originates from the teeth. This usually happens when there is a problem with the jaw joint (temporomandibular joint or TMJ), ears, nerves, sinuses, or muscles. Sometimes, heart problems can also feel like toothache. Pregnancy can also be a risk for dental problems that cause pain. Gingivitis and tooth decay can occur during pregnancy due to fluctuating hormone levels during pregnancy.


Conditions That Cause Toothache

Toothache is caused by the inflammation of the middle part of the tooth called pulp. Pulp inflammation can be caused by anything that comes into contact with the tooth. Common causes of toothache include:


Cavities / tooth decay

Sensitivity to temperature - hot or cold liquids / foods

  • Hot or cold weather
  • Clenching teeth
  • Orthodontic movement - braces
  • Abscess tooth
  • Affected wisdom tooth
  • Pregnancy
  • Gingivitis
  • Periodontal disease
  • Gum recession - exposure of the root of the tooth covered with gum or bone
  • Tooth fracture
  • Acid erosion
  • Damaged / broken fillings or crowns
  • Cold sores or thrush

What Symptoms and Signs Can Accompany a Tooth Pain?

Toothache and jaw pain are common complaints. It is not unusual for someone to experience mild pain from pressure and exposure to heat or cold to the tooth. However, if the pain is severe or if the pressure persists for more than 15 seconds after exposure to heat has ceased, this may indicate a more serious problem. If the tooth has severe inflammation, the pain may radiate to the cheeks, ear or jaw. The surrounding area of ​​redness may indicate the source of pain. If a person touches an infected tooth, it can make the pain more intense. This sign can indicate the problem tooth, even if the tooth appears normal.

A toothache needs to be distinguished from other sources of pain in the face. Sinusitis, ear, sore throat, or an injury to the temporomandibular joint (TMJ) that connects the jaw to the skull can be mistaken for toothache.

Pain from a deeper nature (called reference pain) can be passed along the nerve and felt in the jaw or tooth. Evaluation by a dentist is appropriate to identify the source of the pain and for relief.


Why Is Toothache More at Night?

There are many reasons why toothache is intense at night. Depending on the type of toothache, what caused it, and how long it has not been treated, you may experience a dull throat, sharp pain, or even severe discomfort. Unfortunately, an untreated toothache can seriously affect your oral health if neglected, while pain and discomfort can jeopardize your sleep and overall well-being.

Some of the most common causes of toothache at night include:

The simplest and most common cause of a toothache are food particles stuck between your teeth or gums. For example, popcorn kernels, apple skins, small seeds or nuts can easily get stuck between teeth and cause discomfort or pain. This can often be improved by simply brushing and flossing to remove jammed food.

Many people grind their teeth at night, especially during periods of extreme stress. If you wake up with a sore jaw or teeth, you may be clenching your teeth at night. However, if you already have a toothache due to an infection, gap, or food stuck between the teeth, the grinding motion can make the pain worse.

In addition, lying down at night can contribute to increased blood flow towards the head and the throbbing sensation of pain.


When to Consult a Dentist?

Toothache is not relieved with over-the-counter medications. Even when relieved, a dental exam can be helpful as pain can be something that can be corrected more easily if treated earlier.

  • If severe pain occurs for more than two days after a tooth is extracted, it is possible that the tooth socket does not heal properly. A condition known as "dry socket syndrome" may have occurred and the patient should see a dentist immediately.
  • The pain may be associated with swelling of the gums or face, or the patient may have discharge around a tooth. Fever is another sign of infection in dental diseases. These signs may indicate an infection surrounding the tooth, gum, or jawbone. Fever and swelling may indicate the presence of an abscess. Dental abscess may require antibiotics and surgical removal (drainage) of the abscess. When this procedure is recommended to be performed inside the tooth (endodontic drainage), a "root canal" is performed.
  • Broken teeth are unfortunately common. The dentist should be contacted as soon as possible, unless it is associated with more severe injuries. The sooner a patient seeks treatment, the lower the risk of infection and the greater the chance of getting rid of the teeth It is especially important that children who damage their primary teeth (baby teeth) get treated immediately, as such injuries can affect the secondary teeth (adult teeth).
  • High fever or chills: This indicates a more common infection that may require stronger medication than oral antibiotics. If the patient experiences headache, dizziness, nausea, vomiting, or other symptoms after a facial or mouth injury, the patient may have a more serious injury in addition to dental injury.
  • Any jaw pain that occurs with chest pain: Although jaw pain is most caused by dental disease, it is sometimes referred to as pain from other areas. People with heart disease, especially those with stent implants, people with diabetes or those who have had heart surgery, may have jaw pain as a sign of heart attack (myocardial infarction) or angina (ischemia). If jaw or toothache is associated with dizziness, sweating, or shortness of breath, the patient should see a doctor immediately.

Can Toothache Be Prevented at Home?

You can prevent pain with basic oral hygiene that you can care at home. You can eliminate most dental problems by flossing and brushing. There are many different products, such as xylitol and fluoride rinses and regular professional cleaning of teeth. The dentist can apply sealants, varnishes, and fluoride, which are especially important in children but may also be valuable for adults and the elderly.


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