Toothache

• Pain in or around a tooth.
• Pain that increases in severity may indicate that infection has spread into surrounding tissues.
• Bleeding or swollen gums may indicate gum disease (gingivitis or periodontitis).
• In some cases, people experience tooth pain when teeth are exposed to hot or cold temperatures.

Cavities (caries) are the most common cause of toothache. They are predominantly due to poor dental hygiene, which allows a sticky coating (plaque) to build up on the teeth, and the bacteria it contains convert sugars (such as glucose, fructose and lactose) into acids, which in turn erode the teeth, causing holes to form. The pain itself is due to the nerve endings being exposed.

Toothache may also be caused by gum disease or infections (e.g. abscesses), and like cavities, these are often due to plaque build-up.    

Heredity may influence the tendency to develop cavities, and low saliva levels may also be involved. (Saliva aids the prevention of cavities by neutralising acids and enzymatically clearing bacteria).

Other causes of toothache may include:

• Radiating pain from an infection in the ears or sinuses.
• Injury to the mouth.
• Heart attack, which may present as toothache and/or jaw pain that comes on suddenly. (Call for an ambulance immediately, as it is better to be safe than sorry).

It is not known why some people’s teeth are sensitive to temperature while others are not.

• Most cases of toothache require dental attention. Depending on the cause of the problem, your dentist may repair the tooth with a filling, recommend antibiotics, or advise you about other treatments such as root canal surgery or the removal of the tooth.
• If a toothache goes away, don’t assume that the problem is fixed. The nerve of the tooth may have died, preventing you from feeling any more pain, however the decay may still be continuing .
• Maintain regular dental check-ups. 
• Regular and thorough brushing of the teeth can help to reduce plaque build-up and prevent both toothache and gum disease. Brush your teeth after each meal or snack with a soft, small-headed toothbrush. Pay particular attention to the junction of the gum and the teeth – even at times when the gums are bleeding and sensitive. 
• Dental authorities recommend the use of fluoridated toothpaste for adults and children over 6 years old, and low fluoride toothpaste for younger children and toddlers. Most dentists also recommend drinking fluoridated water, however some natural health practitioners have concerns about the safety of this practice.
• Use dental floss daily too. It helps prevent the build up of plaque.
• Mouthwash may also help to prevent plaque by temporarily reducing the number of bacteria present in the mouth, however the effect is short-lived .
• Avoid sugary foods and drinks (e.g. soft drinks, cordials and juices) as they may contribute to decay. It is particularly important to avoid sugars between meals, as the delay until the teeth are brushed can cause the sugary residue to remain on the teeth for long periods of time, allowing damage to occur.
• Chewing on sugar-free gum may help prevent cavities by stimulating the production of saliva.
• If your teeth are sensitive to temperature, use toothpaste specially formulated for your needs. You may have to test a few different brands to find one that suits you.
• Prevent injuries to the teeth and jaw by wearing protective headgear or a mouth guard when participating in sport.
• If a tooth is knocked out, look after it carefully and take it straight to the dentist, who may be able to replace it for you. The best way to protect it from damage is to put it into a container of milk, or wrap it in plastic.
• Stop smoking, as it significantly increases the risk of gum disease, and also increases the risk of mouth cancers (as does the excessive consumption of alcohol).
• The essential oil of cloves has pain-relieving and anaesthetic properties, and is sometimes rubbed onto the gums to numb the pain of toothache. However, note that it should only be used for temporary pain relief until you can get to your dentist. Furthermore, it may irritate the mucous membranes of the mouth in sensitive people, and it should not be used during pregnancy, as its safety at this time has not been ascertained.

• Gum disease can be associated with heart disease - make sure you have regular medical check-ups.
• Consult your dentist if:
  - Your gums bleed easily or regularly
  - Your toothache is severe, or is accompanied by symptoms that may indicate the presence of infection, such as fever a feeling of being unwell, or a swollen jaw or face
  - Your toothache persists for more than two days
  - Your toothache or jaw pain was caused by an injury