What Causes a Toothache?

A toothache can have a variety of sources ranging from exposed nerves caused from decay of the outer layer of enamel to bone disease or infection. Unless the causes of a toothache are apparent, such as bleeding gums or a cracked tooth, it's necessary for a dentist to find the source of the pain through x-rays and physical examination.

Cavities

Cavities are holes in the teeth that have worked through the top of layer of enamel and the second protective layer of dentin to expose the nerves below. Cavities are caused by a bacterium that turns to sugar and acid, which eats away at the protective layers. As food and bacteria begin to fill the hole, pain ensues from the irritated exposed nerve endings. In addition to the toxins created by food, hot and cold material will cause the nerve to react.

Gum Disease

When bone loss in the mouth occurs, it creates a loose hold for the teeth and the tissues of the gums become inflamed. Over time, bacteria from food become lodged in the spaces created by the bone movements and irritate the underlying inflammation, causing a toothache. Bleeding around the gums may be present before the teeth actually begin to hurt. Pockets that form around the loose gums become infected and result in pain.

Roots

The nerve roots that are encased in enamel can become exposed for a number of reasons ranging from gum disease to bone deterioration due to osteoporosis or genetic deficiencies. Exposed roots will cause a toothache no matter how they became exposed. Hot, cold and sour food and drinks will exacerbate the pain.

Cracks

Cracks in the teeth due to injury can cause toothaches. When the enamel is loosened, it can cause pressure on the underlying nerves every time it is bitten down upon. Chewing and biting on hard objects will create sharp, shooting pain instead of the throb associated with cavities and gum disease.

Impacted

Teeth that grow in to full size but do not break the surface of the gum create toothaches. As the teeth press on the gums, they can create a pounding ache. The tissue becomes inflamed and swollen. Additionally, teeth that come in too close together can become impacted and the pressure on the neighboring teeth will create a throbbing toothache. Impacted teeth must be taken out surgically by cutting through the gums.

Resources

• Academy of General Dentistry