tooth health

Toothache - Causes

Definition of toothache

The term "toothache" means a generic pain, often very annoying and hardly bearable, which begins with penetrating pangs and circumscribed spasms; starting from the affected tooth, the pain tends to progressively irradiate in the neighboring gingival tissues and in the other adjacent teeth, up to involving in the most serious cases also the supporting alveolar bone.

Toothache - better defined as odontalgia - is a very variable symptom that depends essentially on the cause of origin. Depending on the disorder at the base, toothache can in fact assume an acute and pulsating connotation or develop milder pain that is accentuated in response to thermal / physical stimuli.

As we shall see in the course of the discussion, toothache is normally due to a dental infection or an inflammation of the gum; however, there are also cases of "psychological" or idiopathic toothache, which do not recognize an easily identifiable cause. Even chipped teeth, dental hypersensitivity and tooth growth can cause unpleasant dental discomfort.

Toothache, which regresses only with a correct treatment of the causes of origin, requires a dental examination to go back to the etiological factor (responsible for pain). Only after having ascertained the cause through the specialist check supported by a radiographic examination, it is possible to proceed with a specific intervention.

Causes of infectious nature

It would not be entirely correct to talk about toothache as a real illness. Odontalgia, rather, should be interpreted as a symptom that is common to most dental diseases.

Toothache finds its main causative agent in the kary-complicated (advanced stage). In addition to this dental infection, inflammatory toothache is explained in other infectious episodes, listed below:

  • Alveolite: inflammation of the alveolus (the bone cavity in which the dental roots dwell)
  • Dental abscess: accumulation of purulent material (bacteria, white blood cells, cellular debris and plasma) in the tissues surrounding a tooth
  • Dental cyst: pathological sac lined with epithelium of lining and filled with serous, mucous or gaseous fluid (typical complication of pulp necrosis)
  • Gingivitis: general inflammation of the gums that does not necessarily depend on an infection in the tooth
  • Granuloma: chronic inflammation, generally asymptomatic and non-suppurative, of the root apex and its surrounding tissues
  • Periodontitis (pyorrhea): severe gingival infection of the periodontium (supportive system of the teeth consisting of gingiva, elastic connecting fibers and mandibular / maxillary bone), which favors tooth loss
  • Pulpitis: infectious inflammation of the dental pulp, a typical complication of untreated caries

Broken teeth and toothache

Even broken or severely chipped teeth can give rise to an annoying toothache, especially if the trauma exposes the root in the oral cavity. In such circumstances, broken teeth (not necessarily infected) can become extremely sensitive: toothache tends to become more pronounced during chewing, especially if you have the habit of biting feathers or sucking hard candies. Sometimes, dental dislocation on broken teeth can give rise to acute and throbbing pain simply by touching the tooth enamel with the tongue.

Toothache and hypersensitivity

Toothache can also be interpreted as dentinal hypersensitivity. In this case, the painful, acute and pungent perception arises when cold, hot, acidic, salty or high-sugar foods come into contact with the tooth.

Toothache related to dental hypersensitivity may depend on a clumsy oral hygiene, performed for example by cleaning the teeth with toothbrushes with too hard bristles or brushing them inadequately (from the tooth towards the gum). Hypersensitivity toothache can also derive from the habit of constantly using whitening toothpastes, containing very aggressive substances that weaken the tooth enamel.

Even bulimic patients (who voluntarily procure vomiting), those suffering from bruxism and gum recession often tend to suffer from hypersensitivity toothache.

In the cases just described, toothache is not directly related to dental infections or gum inflammation: in such circumstances, pain does not require obturation or devitalization because the cause is not infectious. The only solution to treat or prevent dentinal hypersensitivity toothache consists in constantly performing a proper home dental cleaning (with toothbrush, toothpaste - possibly enriched with fluoride - and dental floss), avoiding taking acidic foods or all of them substances that could accentuate the pain.

Teeth fall and eruption

The growth of the first teeth in the newborn is always a cause for agitation and frenzy for the child. Toothache (if it can be considered as such) results in redness and inflammation of the gums.

When the milk teeth begin to fall and be replaced by the permanent teeth, the child tends to be agitated and he constantly puts his hands in his mouth. Although it is a completely physiological phenomenon, the fall of milk teeth is not always well accepted by the child, who reacts by accusing gum inflammation and manifesting an evident agitation.

The fall of permanent teeth - which has nothing to do with that of milk teeth - often finds explanation in serious dental infections that are not adequately treated (eg pyorrhea): in this case, the perceived toothache is clearly very acute, excruciating and unbearable.

Extra-dental causes

Toothache does not always depend on infection, trauma or dental inflammation. Often, odontalgia is a secondary symptom of conditions that have nothing to do with teeth. Among the most noteworthy, we mention: inflammation of the ears (otalgia), some heart problems (angina pectoris and myocardial infarction), sinusitis and trigeminal neuralgia. All these conditions can start with a terrible - and inexplicable - toothache.

Toothache can sometimes be a transient phenomenon, which manifests itself independently of a certain cause. This is the case of stress tooth ache: a subject who is particularly stressed or depressed tends to involuntarily clench his teeth without realizing it. The continuous grinding favors bruxism which, in the long term, can predispose to toothache. The most effective remedy for toothache derived from bruxism is to relax, carving out some time to dedicate to yourself. Autogenic training, pilates, yoga, exercise certainly help to harmonize the various parts of the body, with a positive reflex aimed at counteracting stress-related phenomena, such as bruxism toothache.