A toothache—described as any pain, soreness, or ache in or around a tooth—can be a frustrating and unpleasant experience. In addition to sharp or dull pain, your tooth may be sensitive to temperature or pain when chewing or biting.
In order to get to the bottom of your tooth pain, your doctor will consider several potential diagnoses based on your medical history, dental exam, and sometimes an imaging test, generally an X-ray.
Here is a summary of the most general reason of a toothache, ranging from tooth sensitivity and decay to serious infections, like abscess formation.
Among all the things that might reason a toothache, the most common is tooth decay, inflammation of the tooth pulp, an abscess, a cracked or impacted tooth, gum disease, and sensitive teeth.
Let’s look at each of these potential causes individually.
Gum disease is characterized by infection of the gums. More specifically, with gingivitis, the gums become inflamed and become hot, red, and swollen. When an infection happens in the gums, periodontitis occurs. Eventually, if left untreated, the infection causes bone loss and deterioration of the gums.
Gums become detached from the teeth, forming pockets that fill with more bacteria. Tooth roots are then exposed to plaque and become susceptible to decay and sensitive to cold, touch, and chewing.
Tooth decay refers to erosion and cavity formation in the outer surface (enamel) of the tooth. When plaque—a sticky layer of bacteria—forms on the tooth enamel, it feeds on the sugars and starches from food particles in your mouth. This produces an acid that eats away at the enamel, causing weak areas and holes. Over time, the enamel breaks down and a cavity forms.
While cavities are usually painless, as the decay spreads inward toward the middle layer of the tooth (dentin), it can create symptoms such as sensitivity to temperature and touch.
Sometimes you may experience discomfort when your teeth or a specific tooth are exposed to cold air, liquids, and certain foods. This means your teeth may have developed a sensitivity linked to one or more stimuli, like cold temperatures.