An Overview of Toothaches
Toothache Symptoms continued...
A toothache needs to be differentiated from other sources of pain in the face. Sinusitis, ear or throat pain, or an injury to the temporomandibular joint (TMJ) that attaches the jaw to the skull may be confused with toothache. Pain from a deeper structure (called referred pain) may be passed along the nerve and be felt in the jaw or tooth. In order to pinpoint the source of the pain and get relief, call your dentist or doctor.
When to Seek Medical Care for a Toothache
You should call your doctor or dentist about a toothache when:
- Pain is not relieved by over-the-counter drugs
- You experience severe pain after a tooth is pulled; this may occur on the second or third day after tooth extraction. This is a result of the clot falling out and bone exposed until a new clot and cover the exposed bone. The condition is known as "dry socket syndrome." If you develop this condition, you should see a dentist within 24 hours.
- Pain is associated with swelling of the gums or face, or you have discharge around a tooth; fever is an important sign of infection in dental disease. Simple dental decay (caries) does not cause fever. These signs may signify an infection surrounding the tooth, the gum, or the jaw bone (mandible). Fever and swelling may indicate the presence of an abscess. Dental abscesses may require antibiotics and surgical opening (drainage) of the abscess. When this procedure is recommended to be done inside the tooth (endodontic drainage), a "root canal" is performed.
Broken or knocked-out teeth occur from an injury; unless associated with more severe injuries, your dentist should be contacted as soon as possible. Swallowed teeth and permanent tooth loss are considered dental emergencies. Tooth loss due to injury (traumatic loss) is treated differently in children who have lost their primary teeth than in older children and adults with injury to their secondary -- or permanent --teeth. If a child’s permanent (adult) tooth is fully knocked out, try to gently rinse it off and re-implant it as soon as possible and seek dental care. If you are not able to get it back in place it in a small amount of milk or even water and seek dental care.
- Pain is present at the angle of your jaw; if every time you open your mouth widely you have pain, it is likely that the temporomandibular (TMJ) joint has been injured or inflamed. This can occur from an injury or just by trying to eat something that is too big. Your dentist may be able to suggest solutions to this problem.
Wisdom teeth are causing pain; as wisdom teeth (third molars) are coming out, they cause inflammation of the gum around the erupted crown. The gum overlying the crown may become infected. The tooth most commonly involved is the lower third molar. The pain may extend to the jaw and ear. There may be swelling in the affected area so that the jaw cannot be closed properly. In severe cases, pain in the throat and the floor of the mouth may make it difficult to swallow.