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Dental pain treatment based on the type and nature of pain

For your mouth to tell your brain that it is in distress, the affected area begins to pain, letting you know that something is wrong. The symptoms of toothache are often confusing. It can be difficult to decide which tooth is causing the pain or even whether it’s coming from an upper or lower tooth. Sometimes the pain can feel like it is coming from a distant site, such as your ear. Common symptoms of toothache are pain in and around the tooth or sensitive teeth.

Pain, depending on its gravity, can be treated at home using home remedies. You can also purchase over-the-counter drugs to numb it. However, the relief may be temporary and you might need to see a dentist for permanent relief.

Dental pain causes

Dental pain causes

Toothaches can range from mildly annoying to downright debilitating. In fact, toothaches are one of the leading reasons that people visit the dentist’s office. When considering a toothache– which is pain in or around the tooth– most people assume the cause is tooth decay, or a cavity. While this is often the case, decay isn’t the only cause of toothaches. What else can cause that throbbing pain in your mouth? Let’s consider some other potential culprits behind your toothache:

Abscessed tooth

An abscessed tooth is a severe infection located at the root of the tooth or in between the gum and the tooth. This painful infection can be caused by a number of factors including severe tooth decay, injury to the tooth, and gum disease. The infection can also spread from the root of the tooth to the surrounding bones. How can you know if your toothache is caused by an abscessed tooth? Only your dentist can tell you with certainty, but some of the symptoms you should look out for include:

  • Fever
  • Severe and persistent tooth pain
  • Swollen glands in the neck
  • A general feeling of being ill or uncomfortable
  • Foul-smelling breath
  • Tooth sensitivity, specifically to hot or cold food and drinks


Bruxism– or the grinding and clenching of teeth– can also lead to tooth pain. Most people clench or grind from time to time without any ill effects. However, chronic bruxism– either during the day or while sleeping at night– can lead to a number of oral health concerns. This is because persistent grinding wears down the protective enamel, leaving the dentin layer exposed. This causes extreme tooth sensitivity and even pain. Bruxism can also cause teeth to fracture and, if left untreated, can ultimately result in tooth loss. So, could you be unknowingly suffering from bruxism? Some common symptoms include:

  • Tight jaw muscles
  • Face, neck, or upper back pain
  • Disrupted sleep due to nighttime bruxism
  • Tooth sensitivity
  • Flattened, chipped, or fractured teeth

Periodontal disease

Periodontal disease

Periodontal disease– otherwise known as gum disease— might also be a potential culprit behind your tooth pain. The earliest stage of gum disease, gingivitis, results in inflammation of the gums due to bacteria built up in plaque. If left untreated, gingivitis can progress to periodontitis, and ultimately result in the loss of teeth. How can you determine if your tooth pain might be related to gum disease? Of course, a visit to your dentist is necessary for a definitive diagnosis, but consider the following symptoms of periodontal disease:

  • Bleeding gums, particularly during tooth brushing
  • Gum recession
  • Foul-smelling breath
  • Gums that are swollen, red, or tender
  • Teeth that are loose or shifting

Tooth trauma

Tooth trauma can range from relatively mild, such as a slightly chipped tooth, to an injury that causes one or more teeth to completely dislodge. Tooth trauma can be caused by a number of events, but the most common culprits are accidents and sports-related injuries. Dental treatments will vary depending on the nature and severity of the injury, but it’s important to seek help immediately for tooth pain related to tooth trauma.

Toothache symptoms and possible problems

Toothache symptoms and possible problems

The following is a list of common toothache symptoms and possible problems.

Sensitivity to Hot and Cold Food and Drinks

If sipping on hot or cold drinks releases a sharp pain, you have a cavity, loose filling, or an exposed root due to receding gums or an abrasion. You will have to try to decrease the buildup of plaque on the teeth and gum line. Brush twice a day with a soft toothbrush using fluoride toothpaste. If the pain persists, see your family dentist.

Sensitivity after Dental Procedure

Perhaps, you have come home from the dentist after getting a dental procedure and now, you feel pain. The pain is due to inflammation in your tooth, but do not worry, as in a few weeks or days, it will go away. If you have received treatment for tooth decay or received a crown, the pain will take one to two weeks to disappear. If the pain is unbearable, you can take over the counter pain meds.

Chewing Causes Sharp Pain

If chewing food is causing you pain, tooth decay, a loose filling, and a chipped tooth may be the reason. A dentist can replace a loose filling, clean the cavity, and repair the chipped tooth. No home remedy can fix this solution.

Lasting Pain after Eating

If the pain lasts after you eat your food, it is an indication of tooth decay and if you do not see your  dentist, you risk losing your tooth. The dentist may even have to perform a root canal procedure to save what is left of your tooth. A worst-case scenario would be to undergo a tooth extraction procedure.

Feeling Intense Pressure on the Upper Teeth

Did you know your upper teeth in the back share nerves with your sinus cavity? For this reason, the pressure on the upper teeth can be due to sinus problems. If you do not have any sinus problems, you can explain the pain to your habit of grinding your teeth and clenching your jaw tight. You must see your dentist if the pain worsens overtime.

Never-ending Pain

Never-ending Pain

For ongoing pain, you must see your dentist, as you might have an infection. Your dentist needs to treat the infection before it travels and spreads throughout your bloodstream. The dentist may perform a root canal procedure, treat it with antibiotics, and pain killers to eliminate the infection.

When should I see my dentist?

See your dentist if:

  • you have any kind of toothache, especially if it lasts more than 2 days
  • the toothache doesn’t go away when you take pain medication
  • if you also have a high temperature and pain when you bite, or your cheek or jaw are swollen.

How is dental pain diagnosed?

In order to identify what has caused the dental pain, the dentist may use one or more of the following tests.

Test for sensitive teeth

The dentist uses a special device to test if the tooth is still vital (alive), or not. This test may be repeated several times in different appointments.

Cold test

The dentist applies a special cold dental material to the tooth in question. This will aid in diagnosis and decision making whether the tooth needs a root canal treatment or a filling.

Heat test

The dentist applies a special hot dental material to the tooth in question. This will aid in diagnosis and decision making whether the tooth needs a root canal treatment or a filling.

Looking for cavities in your mouth

Using certain examination instruments, the dentist will be able to perform a full check-up to look for dental caries.

Tapping on the teeth

The dentist will use the handle of the dental mirror to tap on the tooth in question and adjacent teeth. This sometimes aids in locating the tooth causing the dental pain.

Check if the teeth are mobile

Using two handles of two dental instruments, or using one handle and one finger, the dentist can check the mobility of the tooth (how much it moves).

Check the structures around the teeth

Passing one or two fingers on the gums and cheeks, the dentist can check for other abnormalities in the mouth that may cause the dental pain.

Biting on cotton or gauze

The dentist places a cotton roll on the tooth in question and asks the patient to close the mouth. This will aid in diagnosis of cracked teeth.

Taking x-rays

X-rays are an important diagnostic test in dentistry, the dentist can inspect hidden areas of the teeth, the bone around the teeth, dental caries, and any other abnormalities.

Treatment of dental pain

When the dentist has identified what is causes the dental pain, they will be able to treat your teeth efficiently. Treatment is dependent on the type and nature of pain. Treatment of the pain may require root canal treatment, removal of the tooth, or simply fluoride application.You might end up with the following types of treatment.

Home remedies

There are a few simple things you can do to help reduce the chances of dental problems happening in the first place:

However, if the pain persists, or if there is an obvious physical problem such as a tooth cavity, broken filling or bleeding gums, you should go to your dentist straight away.

ways to address the challenge of how to relieve tooth pain include:

  • Eat foods that are easy to chew and swallow
  • Avoid very hot or cold foods and drinks
  • Avoid hard foods such as grainy bread
  • Mix a teaspoon of salt in a cup of warm water and hold it in your mouth for a minute, covering the painful area, before spitting the salt water out
  • Lie with your head propped up on a pillow, as being horizontal can make any pain worse
  • Wrap an ice pack in a cloth and hold it against your face



Antibiotics may be prescribed as an adjunct to the main dental treatment, especially in cases of bacterial infection (dental abscess). Antibiotics by themselves are not an effective treatment for dental pain.

Pain killers

Pain killers can temporarily relieve dental pain. They are not a definitive treatment because the underlying cause of dental pain still needs to be treated.

Fluoride application

Fluoride can be supplied in three forms: fluoride varnish, fluoride gel and fluoride mouthwash. The dentist may use a small brush to apply the fluoride varnish or a tray for the fluoride gel. On the other hand the dentist may instruct you to use a fluoride mouthwash at home.

Fillings for your cavities

Fillings for your cavities

Generally dentists use white fillings (composite) for anterior teeth (teeth in the front of the mouth) and silver fillings (amalgam) for posterior teeth (teeth in the back).

Scaling and polishing of your teeth

Cleaning your gums and teeth professionally.

Root canal treatment

The dentist will remove the dental pulp (the nerve and blood supply of the tooth), clean and shape the root canal over a series of appointments and then place a sterile filling inside the root canal.

Removal of the tooth

This is simply extraction of the tooth and is always the last treatment option when all other treatments fail.

How can I prevent toothache?

How can I prevent toothache

The best way to prevent toothache is to keep your teeth and gums as healthy as possible.

  • Have regular dental check-ups.
  • Have sugary foods and drinks only as an occasional treat at mealtimes.
  • Clean between your teeth using floss or an interdental brush every day to remove food, debris and plaque.
  • Brush your teeth methodically after breakfast and before going to bed
  • Choose a fluoride toothpaste
  • Use a soft toothbrush and avoid scrubbing too hard

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Dr. Tafreshi

is a Specialist in Cosmetic Dentistry

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