Causes of Dental Pain & Referred Pain Toothaches & Its Symptoms, Types, Treatment

What is a Dental Pain?

Dental pain is a term used to refer to toothache. Toothache is a pain you feel in and around a tooth or teeth. There are many types of toothaches, and sometimes it becomes difficult to determine whether you should contact your dentist about the pain or just take some pain relievers, and it will go away. However, ignoring a persistent toothache is never a good idea as a pain in your tooth or teeth is usually an indication that something is wrong with the tooth or gums. Sometimes, though, dental pain might also be due to referred pain, meaning that the pain is being caused by a different problem somewhere else in the body.1

Nevertheless, it is never a good idea to ignore dental pain. Toothaches caused by tooth decay, especially, will only get worse if you leave it untreated. Even though dental pain is not a life-threatening condition, but it may sometimes be a sign of a more serious condition that requires immediate medical attention. To learn more about dental pain, read on about the different types and causes of toothaches.

Symptoms of Dental Pain

Dental pain or a toothache can happen due to a wide variety of reasons, including tooth decay, tooth fracture, abscessed tooth, damaged filling, infected gums, and many others.2

Some of the common symptoms of dental pain may include:

Toothache that may be sharp, constant, or throbbing. In some cases, the pain may only happen when pressure is applied to the tooth or when there is a temperature variation.

  • Fever or headache
  • Swelling around the tooth
  • Foul tasting discharge from the infected tooth
  • Sharp pain when you bite down or touch the tooth
  • Achiness and tenderness in and around the affected tooth
  • Painful sensitivity in the tooth when you have hot or cold foods or drinks
  • Shock-like or burning sensation

Types of Dental Pain

Sensitivity to Hot or Cold

Sensitivity, usually for a brief period, to hot or cold foods and beverages, can feel like a sharp pain in the tooth. However, this typically does not mean that there is an underlying problem. Nevertheless, if this sensitivity continues to occur, it might mean that there is a more serious problem. Minor tooth decay, a loose filling, and minimal gum recession are all some of the issues that can cause sensitivity and tooth pain.3

For most people, using a toothpaste specially formulated for sensitive teeth can help provide relief from sensitivity to hot or cold. Using a soft or extra-soft toothbrush can also help. Brushing up and down instead of side to side can help since brushing sideways can wear out any exposed roots.

Lingering Pain After Eating Hot or Cold Foods/Beverages

If instead of experiencing a brief pain after consuming hot or cold foods and beverages, you experience pain for longer than 30 to 40 seconds, then tooth decay or trauma to the teeth that could have damaged the pulp in the teeth could be a reason. In such a case, you should schedule an appointment with your dentist at the earliest. You might need to undergo a root canal treatment.

Jabbing Pain While Biting on Food, Clenching Teeth, or Opening Mouth

Unlike sensitivity, while eating hot or cold food/beverages, experiencing a temporary, jabbing, and sharp pain in the teeth usually points to a problem. The causes for this could include tooth decay, a crack in the tooth, loose fillings, damaged tooth pulp, an abscess, or even a cavity.4

If you are experiencing a sharp, jabbing pain, you should book an appointment with your dentist at the earliest.

Pressure or Dull Ache in the Upper Jaw or Teeth

Experiencing a dull pain in your upper jaw is usually indicative of a sinus headache or grinding teeth. If you are grinding your teeth, you should consult a dentist on how to stop, as this can cause immense and permanent harm to your teeth. Grinding leads to worn out and damaged teeth if it is left untreated.

If sinus headache is the cause of this type of pain, taking over-the-counter pain relievers or sinus medications can help. If you suffer from chronic sinus headaches, consulting a doctor and coming up with a proper treatment plan is best.5

Minor Swelling and Dull Pain at the Gum Line

If your tooth hurts and there is swelling at the gum line, then the simplest cause could be that a piece of food has gotten stuck between the tooth and gum. Flossing regularly will help prevent any food particles from getting stuck in the gum line. The swelling will go down automatically one the food debris is removed.

Pain at the Back of the Jaw

One of the most common reasons for experiencing pain in the back of the jaw is an impacted wisdom tooth. If you are experiencing this type of pain, it is best to consult your dentist at the earliest before the pain gets worse. Your dentist will evaluate the situation by taking X-rays of your mouth to determine whether the wisdom tooth needs to be taken out or the problem can be solved with medications.6

There can also be several other types of dental pain. If you find that the pain persists for over a week, it is a good idea to have it checked out by a dentist to avoid any serious problems in the future.

Causes of Dental Pain

Let us now take a look at some of the common causes of dental pain.

Tooth decay is the most common cause of toothaches. If left untreated, then tooth decay can cause an abscess to form. An abscess is a type of infection near your tooth or even in the pulp present inside the tooth. If you think that you might be having a dental abscess, then it is necessary to see your dentist right away.7,8

In some rare cases, the infection from your tooth can spread to your brain, creating a life-threatening situation.9,10 This is why it is so essential that you never leave tooth decay untreated. See your dentist at the first sign of tooth decay.

Here are some of the common signs and symptoms of tooth decay:

Toothache – this can either be a persistent pain that keeps you awake or an occasional sharp pain with no apparent reason. Tooth decay can sometimes also be painless.

Tooth sensitivity – you may feel pain or tenderness when eating or drinking something sweet, hot, or cold

  • Brown, black, or grey spots on the teeth
  • Unpleasant taste in the mouth
  • Bad breath

Another common cause of toothache can also be an impacted tooth. This happens when one of your teeth, mostly a wisdom tooth, gets stuck inside the gum tissue or bone. Due to this, it is unable to grow in or erupt, thus causing moderate to severe pain.

In such a case, also, seeing a dentist at the earliest is necessary to prevent the situation from becoming worse.

Causes of Referred Pain Toothaches

Referred pain toothache means that the pain you are experiencing in your tooth is actually stemming from another part of the body. Sinusitis is the most common condition that causes referred pain toothaches. Sinusitis is a condition in which the sinuses become swollen due to a bacterial, viral, or final infection in the sinus cavity. Since the roots of your upper teeth are located very close to the sinuses, inflamed sinuses can lead to pain in the upper teeth or upper jaw.11

Lung cancer and heart disease can also sometimes lead to toothaches. Sometimes, a toothache can serve as a warning sign of a heart attack. This happens because of the location of the vagus nerve, which runs from the brain to various organs of the body, including the lungs and heart. It also passes through your jaw, which is why lung and heart disease can cause toothache.12,13

Occipital neuralgia and trigeminal neuralgia are some other painful neurological conditions that can cause the occipital and trigeminal nerves to become inflamed or irritated. These nerves serve your teeth, face, and skull, which is why when they become inflamed, it feels like the pain is stemming from your teeth.14,15

Treatment of Dental Pain

Usually, most persistent toothaches require medical treatment and a visit to the dentist. Natural remedies or home treatments can only relieve your pain for some time, but ultimately you will need to see a dentist.

Your dentist will use a physical exam and X-rays of your teeth to check for tooth decay or any other dental problems. They will prescribe you antibiotics and pain medication for treating a potential infection.

If your toothache is being caused by tooth decay, your dentist will first remove the decay with a drill and then fill the space with specific dental materials. If there is an impacted wisdom tooth, it might need to be removed surgically.

If your toothache is caused by sinusitis, then your doctor will treat it with antibiotics or decongestants. However, for toothache caused by occipital neuralgia and trigeminal neuralgia, there is no cure. Treatment involves relieving the pain with pain medications.

To help prevent dental pain, it is necessary to brush and floss your teeth at least two times a day. Getting regular dental checkups and a proper cleanup done twice a year, or as your dentist recommends. You can also keep your heart and lungs healthy by following a good lifestyle, not smoking, eating a high-fiber and low-fat diet, avoiding processed foods, and exercising regularly.

References:

  1. Van Wijk, A.J. and Hoogstraten, J., 2005. Experience with dental pain and fear of dental pain. Journal of dental research, 84(10), pp.947-950. Klausen, B., Helbo, M. and Dabelsteen, E., 1985. A differential diagnostic approach to the symptomatology of acute dental pain. Oral Surgery, Oral Medicine, Oral Pathology, 59(3), pp.297-301.
  2. Yamada, M., SUZUTA, K. and KUMANO, T., 1971. A consideration on the excitation mechanisms of toothache caused by thermal stimulation. The Japanese journal of physiology, 21(2), pp.133-147.
  3. Pau, A.K.H., Croucher, R. and Marcenes, W., 2003. Prevalence estimates and associated factors for dental pain: a review. Oral health & preventive dentistry, 1(3).
  4. Balasubramaniam, R., Turner, L.N., Fischer, D., Klasser, G.D. and Okeson, J.P., 2011. Non-odontogenic toothache revisited. Open Journal of Stomatology, 1(03), p.92.
  5. Kitade, T. and Ohyahu, H., 2000. Analgesic effects of acupuncuture on pain after mandibular wisdom tooth extraction. Acupuncture & electro-therapeutics research, 25(2), pp.109-115.
  6. Tuncturk, F.R., Uzun, L., Kalcioglu, M.T., Egilmez, O.K., Timurlenk, E. and Erguven, M., 2015. Carotid sheath abscess caused by a tooth decay infection on the opposite side. Case reports in otolaryngology, 2015.
  7. Maragou, C., Theologie-Lygidakis, N., Ioannidis, P., Stenou, A., Kanavaki, S., Iatrou, I. and Tsolia, M.N., 2010. Primary tooth abscess caused by Mycobacterium bovis in an immunocompetent child. European journal of pediatrics, 169(9), pp.1143-1145.
  8. Li, X., Tronstad, L. and Olsen, I., 1999. Brain abscesses caused by oral infection. Dental Traumatology, 15(3), pp.95-101.
  9. Mylonas, A.I., Tzerbos, F.H., Mihalaki, M., Rologis, D. and Boutsikakis, I., 2007. Cerebral abscess of odontogenic origin. Journal of Cranio-Maxillofacial Surgery, 35(1), pp.63-67.
  10. Kim, K.M., Byun, J.S., Jung, J.K. and Choi, J.K., 2016. Non-Odontogenic Toothache Caused by Acute Maxillary Sinusitis: A Case Report. Journal of Oral Medicine and Pain, 41(2), pp.80-84.
  11. Okajima, Y., Hirai, A., Higashi, M. and Harigaya, K., 2007. Vasospastic angina in a 13-year-old female patient whose only symptom was toothache. Pediatric Cardiology, 28(1), pp.68-71.
  12. Myers, D.E., 2010. Toothache referred from heart disease and lung cancer via the vagus nerve. General dentistry, 58(1), pp.e2-5.
  13. Murayama, R.A., Stuginski‐Barbosa, J., Moraes, N.P. and Speciali, J.G., 2009. Toothache referred from auriculotemporal neuralgia: case report. International Endodontic Journal, 42(9), pp.845-851.
  14. Spencer, C.J., Neubert, J.K., Gremillion, H., Zakrzewska, J.M. and Ohrbach, R., 2008. Toothache or trigeminal neuralgia: treatment dilemmas. The Journal of Pain, 9(9), pp.767-770.

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