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Toothache is an unwanted guest on the dinner table. This is commonly said so because while eating food sometimes you get a sudden pain in your tooth and you just cannot eat anymore. Tooth pain is always present with some underlying big issue which needs to be treated immediately to avoid further problems.

WHY IT HURTS SO BADLY??

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Pain is an unpleasant feeling with physical and emotional components & it is a very individual experience. At the tissue level there is stimulation of a pain receptors, now what are these pain receptors? Pain receptors are also called nociceptors, are a group of sensory neurons with specialized nerve endings widely distributed inside the body.These nociceptors respond to the damaging or potentially damaging stimuli by sending a “typical possible threat” signal to the brain. When the brain perceives the real threat, it creates a sensation of pain to inform the body part about the threat, so that it’s taken care of, this process is called nociception.A toothache may be dull or sharp shooting pain that you can feel with one or more number of teeth. Painful tooth may be sensitive to heat, cold, or sweets also can respond badly to pressure. Diagnosis Includes identifying the location of theaching tooth and reason for it. The dentist examines clinicallyandtakes X- rays if required to trace the problem. Inflammation of gums,pus formation (infection), redness- these signs can be seen along with the symptoms such as itching, soreness, tenderness other than the pain.Toothaches may result from number of causes such as;traumaticinjury, sensitive teeth, gum diseases like inflamed and swollen gums, impacted teeth, food lodgement between the teeth and in cavities, inflammation of tooth pulp, tooth decay, loose or broken teeth or fillings, grinding of teeth, sinusitis etc.

WHAT CAUSES TOOTHACHE ??

  1. Dental caries/ Tooth decay –Most common cause for toothache is dental decay it is also called Dental caries. Dental decay is a disease that softens the tooth enamel and makes cavities on tooth surface. When the bacteriaaccumulate in cavities or remain there for longer time demineralizethe tooth that means it softens the tooth enamel and also spreads to themore sensitive inner layers of tooth i.e. dentin and pulp. When the decay enters the inner sensitive layers of tooth, it damages the pulp ofthe tooth that requires removal of the pulp from within the roots ofthe tooth, this whole process is called root canal treatment. If you have a cavity on one of your teeth, you mightexperience atoothache whenever you eat or drink hot, cold, or sweet food.When the gums shrink away from the teeth, it exposes the sensitive parts of the tooth and causes pain.Recession of gums also loses the bone thus forms the gaps between the tooth and the gums called pockets, thus making it easy for disease-causing bacteria to accumulate. This, if left untreated, the supporting tissues and bone structure of the teeth can be severelydamaged, and may ultimately result in tooth loss.These are bacterial gum infections that destroy gum tissue and supporting bone that hold our teeth in place. Gum diseases start with gum inflammation & bleeding. The inflammation is a response to the foreign body, in mouth it starts with the plaque accumulation and when this plaque takes form of hard tartar, called calculus, it eats up the soft and hard tissues both. The more it extends the more it increases the disease from gingivitis i.e. inflammation of gums to periodontitis i.e. infection of structuresthat are holding tooth inside the bone. When the infection advances the tooth starts moving in its socket thereby needing an immediate removal.
  2. Dental abscess –Usuallyit occurs secondary to dental decay, trauma, deep fillings or failed root canal treatment. It’s a bacterial infection that can initiate swelling inside & outside the mouth, mostly the gums are swollen, spongy &tender.This oral health problem usually results either from severe tooth decay or due to the periodontal disease that infects the tooth thus spreads the infection from tooth to the underlying bone. Dental Abscess creates an outlet through the bone and oozes out in the form of pus. Besides causing excruciating pain, an abscessed tooth might make you have : Fever, Foul smelling breath, Sour taste in your mouth, Swollen neck glands, Swollen jaw, trismus i.e. inability to open mouth and sometimes even some changes in the voice such as hoarseness. Immediate treatment is required to be taken to avoid other extensive emergencies. This painful condition can also be caused by: A broken tooth, A chipped tooth, or forceful wedging of food or any foreign body in between the teeth or inside the gums.
  3. Impacted toothIt is a tooth that, for some reason, has been blocked from erupting through the gum.

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A few times a wisdom tooth that is also called a third molar erupts fully or sometimes it erupts halfway but mostly in abnormal position. Thus becomes troublesome and requires removal. An impactedtooth may cause:
• throbbing and sharp pain
• red, swollen, or bleeding gums
• bad breath
• a bad taste in your mouth
• difficulty opening your mouth
• pain when opening your mouth, or when chewing and biting
4. Teeth grinding – Grinding the teeth can harm the ligaments around the teeth. The extra forces on teeth can trigger inflammation in the tooth’s nerve, thereby causing toothache. Teeth Grinding on a regular basis can result in multiple oral health issues. Factors responsible for teeth grinding are – Stress, Anxiety, An abnormal bite, Missing teeth, Crooked teeth, Sleep apnoea etc.Also chronic teeth grinding may lead to jaw (temporomandibular joint) disfunction and also headaches. Tooth fracturesand tooth loosening. This destructive habit can even wear your teeth down to stumps that can expose the inside surface of tooth making it sensitive and painful.
5. Sinusitis -Tooth pain is a common symptom of sinusitis. It can be caused by sinus pressure and by drainage from sinus infections. The pain is usually felt in the upper rear teeth that are closest to the sinuses.Sinusitis is a common medical problem that can occasionally manifest as a dental pain.

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If the patient is experiencing dental pain in the upper backside teeth, then it can be arising from inflamed and infected sinus.Its better to visit your dentist for the correct diagnosis, your dentist might refer you to a physician who can give you treatment for sinusitis. If there is an obvious dental source of pain it should be resolved first.Mostly if the pain is arising from a sinus, toothache will intensify with certain types of movements such as jogging, jumping, or bending over may worsen it. This is because the sinus pressure shifts as you move and is felt more in your teeth. The pain may subside when you’re sitting or lying down. Tooth may crack / fracture due to some injury or general wear & tear, it can cause an erratic pain when the exposed tooth comes in contact with very hot or cold temperatures. It requires restoration using some dental filling materials.
6. Broken tooth or fillings-Dentists treat a cavity by removing the decayed portion of your tooth and replace it with a filling material. This filling may break in later years due to some reason which again can create painful situation.
Dental fillings break due to –
– Chewing and biting into hard foods, like nuts and hard candies
– Biting on hard objects, such as a pen cap or pencil
– Brittle tooth structure caused by root canal therapy
– Old restorations that have begun to separate from the tooth’s structure
– Clenching or grinding of the teeth (a night guard can help)
– Trauma to the face and mouth
Dental treatment will resolve your problems
Immediate dental treatment provides a positive outcome for toothache.
Infected teeth & gums are taken care by gum surgeries that are performed in the dental clinic. Dental decay can be removed and in case of pulp exposure the root canal treatment is performed, Wisdom teeth can be removed if abnormally positioned. When a toothache is left untreated, a severe infection may develop and spread to adjacent teeth& gums also to sinuses or jawbone.Maintaining proper oral hygiene is the key to prevent toothaches. The best way to prevent tooth decay is to brush at least twice a day, preferably after every meal. Maintaining proper oral hygiene is the key to prevent toothaches. Brushing twice a day is compulsory protocol for oral hygiene maintenance and Regular Dental Check up is must because if the problems are detected early and treated early the problem will be resolved with less discomfort, energy and money.

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