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This is the dreaded word that most people can identify with either because of direct experience or experience of people close to them.

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We often say everything in the mouth feels a lot bigger than it is and that includes toothache. For some it can be quite paralysing disturbing their normal function. The following are different grades and description of toothache and possible cause:

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Sensitivity

This can be sensitivity to hot or/and cold drink, food or air or sensitivity to sweet things. This can occur where there is tooth decay with or without obvious hole in the tooth. Where there is tooth decay without obvious hole, the best way to detect it is by your dentist taking radiographs (x-ray). Sensitivity to cold temperature can also occur if there is gum recession which exposes that sensitive part of the tooth that nature intends to be buried under the gum. This recession can be visually detected and sensitive toothpaste can be helpful in some cases.

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Throbbing Pain

This is usually more severe and ongoing than sensitivity. It may or may not keep the individual up at night. It can also be caused by any of the causes mentioned above for sensitivity. In this case, there is usually a measure of nerve (pulp) irritation and in some cases the nerve is exposed. Acute gum infection/abscess or tooth abscess can also cause throbbing pain

Pain on biting: This can be an indication of cracked tooth. Cracked tooth is one of the causes of toothache that is difficult to detect because most times it is not visually obvious and is not detectable on radiographs hence special illumination tests and bite tests in conjunction with the symptom reported would have to be carried out by the dentist to confirm this. Pain on biting can also be because of abscess around the root of a tooth due to severe pulp damage.

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Chronic Orofacial Pain

It is not caused by tooth problem hence it is technically not a “toothache” however it is important to mention this because it can mimic toothache and patients sometimes report it as toothache. This is an umbrella name given to pain that can be caused by jaw joint problem (Temporomandibular joint disorder), jaw muscle pain (myofascial pain), or jaw nerve pain (neuralgia) and other causes of pain around the face and jaw that is not from a tooth. It is important to be able to diagnose and differentiate this pain from one relating to tooth.

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The following are important points and questions that your dentist would ask regarding your pain in order to arrive at the correct diagnosis:

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Toothache HOT QUESTIONS

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• Do suffer sensitivity to hot, cold or sweet?

• Does it hurt to bite?

• Is the pain waking you up at night?

• Ever had a dull ache/throb?

• Does the pain feel like it is going towards you ear or eye?

• How long does the pain last? Seconds, minutes or hours?

• Are your gums bleeding or swollen?

 

If you have any or all of these symptoms, it could mean that you have something wrong with a tooth or teeth. The sooner you can get to a dentist the simpler the solution may be.

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Write up and Clinical treatment done by Dr Funmi Sijuwade BDS, (Lagos), MSc (Manchester).

Dr Funmi Sijuwade is one of the Dental surgeons with special interest in aesthetic dentistry especially with the use of composite filling to achieve good aesthetic outcomes. She has a masters’ degree in restorative and aesthetic dentistry from the University of Manchester, United Kingdom.