A Guide to Toothache

Toothache is probably the most common reason why people visit their dentist. At its worst, toothache can be really severe and can cause a constant throbbing pain that is very difficult to soothe without professional treatment. However, what many people do not realise is that toothache is preventable. With the right oral hygiene programme, most people can avoid getting toothache – and therefore avoid another expensive visit the dentist!

What causes toothache?

Toothache is caused by tooth decay. On a daily basis, plaque forms on our teeth which contains bacteria. Saliva is the body’s natural way of combating plaque. However, it is not always sufficient to stop plaque from building up and decay from occurring. This is particularly the case if a person has a diet which is high in sugars or carbohydrates.

When you eat sugary foods, the bacteria in plaque reacts with the sugars and acid forms on your teeth. It is this acid which causes tooth decay as it erodes the tough outer enamel of your teeth. This erosion is what is known by dentists as ‘a cavity’.

Often, you can have a small cavity in the enamel of a tooth without even knowing it is there. It will not necessarily make your tooth ache. The problems begin when the cavity goes unnoticed. As the decay eats away at the tooth, it eventually gets through the outer enamel to a layer called the ‘dentin’. Dentin lies on the inside of the tooth under the enamel. The dentin is there to provide a secondary layer of protection to the sensitive pulp of the tooth – the centre of the tooth where you will find the nerve endings and blood supply.

If the decay gets through the dentin and the cavity opens up the inner pulp of the tooth, this is usually when the tooth starts to ache. Of course, by this time, there is little the patient can do other than visit their dentist. The damage has already been done while the plaque has been allowed to build up and the cavity allowed to form. Once a cavity has grown to a certain size and the tooth begins to ache, a visit to your dentist is unfortunately inevitable.

It is not only cavities that cause toothache, but a cavity is usually the trigger for most other types of causes of toothache. If the cavity reaches the pulp of the tooth, the inner part of the tooth can become infected. If untreated, this infection will lead to the build-up of pus which can form an abscess. An abscess can be very painful and will usually require immediate emergency dental treatment.

What can your dentist do?

Toothache is normally a nagging, constant pain that is very difficult to live with. It makes it hard to concentrate on everyday tasks and, usually, the toothache will become gradually worse until it becomes unbearable. Therefore, most dentists will recommend that you make an appointment to see your dentist at the first twinge of a toothache, even if it is only mild. The more you let the tooth decay, the worse the toothache will become – so it is best (and probably less painful) to get the problem resolved as early as possible.

When you visit your dentist, the first task will be to identify which tooth is aching. Often, with toothache, the pain can feel as though the entire side of your mouth and jaw are aching. Therefore, your dentist will have to identify where the cavity is.

If the cavity is still relatively small, your dentist can fill it. First, however, your dentist will need to ensure that the tooth is thoroughly cleaned out and that any signs of infection are removed. This may involved drilling into the tooth a little deeper, to clear away the decay.

Most fillings are amalgam fillings, which are usually black or charcoal in colour and made from an amalgamation of a number of different metals. Amalgam fillings are very durable and are particularly used for the molars at the back of the mouth, which we use to do the majority of our chewing. If your filling is nearer the front of our mouth, and therefore potentially visible when you smile or talk, you may want to ask your dentist about the availability of other types of material. Many dentists now offer tooth-coloured fillings, which are usually more expensive that amalgams but also much more natural looking.

On occasions, it could be that the cavity has developed to such an extent that the structure of the tooth is no longer sound. Sometimes, a tooth which has been weakened by a cavity may fracture or split. At these times, there is little point in your dentist trying to fill the cavity as the issue with the tooth is now much more serious.

The treatment required for teeth where decay has made them structurally unsound is usually to fit a crown. Your dentist will drill away the decay and shape the tooth so that a crown can be fitted over the top of the entire tooth. It is held in place by cement. The benefit of the crown is that is protects the damaged tooth, while enabling the natural tooth to stay in place.

Finally, if the decay has reached the inner pulp of the tooth, there is a possibility that infection has set in which cannot be reversed. On these occasions, the pulp will need to be removed using a technique called root canal treatment. During this process, your dentist will drill into the tooth and clear the pulp away by scraping it out through the root of the tooth. Though the tooth now has no blood supply or nerve endings, it can continue to function so it does not need to be extracted. If your dentist thinks the tooth is vulnerable, they may choose to place a crown on the tooth.

What can you do?

As we mentioned above, once decay has set into one of your teeth, then professional treatment is absolutely inevitable. So you are not going to be able to cure your toothache at home. However, there may be a couple of steps that you can take to ease the pain until your dentist can see you.

Toothache is often a throbbing pain that seems to spreads across one side of your face. Many people find that it helps to ease the pain if they apply an icepack to the outside of their face. You can also take over-the-counter painkillers to help ease the pain.

Some people also recommend rubbing some Clove Oil on the affected tooth and the surrounding gums. If you can identify the sore tooth and the cavity, you may be able to cover it temporarily with a piece of sugar free gum or a piece of dental wax. This will stop the tooth from being so sensitive.

Apart from these simple measures, the best treatment for toothache is to try and stop it happening at all. As most cases of toothache result from the onset of serious decay, it is important to look after your teeth properly. Regular brushing will help stop the build-up of plaque and using a flouride toothpaste will help to ensure that the enamel on your teeth remains strong.

Dentists also recommend that you should floss regularly. Flossing help to remove the plaque and other debris that accumulates close to the roots of your teeth and your gums. These are exactly the areas where brushing often fails to reach effectively, meaning that plaque is allowed to build up and cavities are likely. It can also cause gum disease.

It is also very important that you visit your dentist for regular check-ups. Do not wait until the onset of toothache before visiting your dentist. Preventative techniques are much more effective in ensuring that you avoid toothache and painful visits to the dentist.

If you visit your dentist regularly, they will be able to monitor your teeth effectively and scrap away the plaque that everyday brushing does not remove. They are also able to spot cavities early, even before they cause any pain. These cavities can then be filled before decay sets in and the tooth suffers any further damage.

Are some people more susceptible to decay?

Everybody has different teeth and a different diet. For a small number of people, teeth can still rot regardless of how often they brush their teeth. Decay sets in a various rates and people do sometimes seem more susceptible to decay. This can often be because the enamel on their teeth is not as strong as normal, so the tooth decays faster.

If you think your teeth are more susceptible to decay, do not wait to get cavities. Visit your dentist as soon as possible and ask their opinion. They may be able to show you different brushing techniques that can help or they may be able to recommend different products and cleaning agents. They may also suggest you consider flouride supplements, to help strengthen the enamel on your teeth.

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