Toothache
What causes toothache?
Acid-producing bacteria in the mouth cause dental decay by breaking down fermentable sugars such as glucose, fructose and lactose. The resultant acids then corrode the tooth enamel. The pain of toothache is caused by the exposure of tooth nerve endings.
Toothache caused by a cavity requires a visit to the dentist. The tooth will not mend itself. If pain does eventually lessen, the nerve ending may have ‘died’. However the tooth decay will still be present and the tooth will continue decaying unless a dentist treats the tooth. Pain intensifies when there is infection in the surrounding tissues.
How can you prevent toothache?
You can help prevent toothache by regular brushing and flossing. Fluoride can help prevent tooth decay. In Australia sufficient fluoride is obtained from fluoride-containing toothpaste and fluoride in the water supply.
Dental floss will help reduce tooth decay by removing food and plaque from the spaces between teeth. Mouthwashes (antiseptics) temporarily lower the number of bacteria in the saliva, but offer only short-term protection.
The role of saliva in tooth decay
Although good oral hygiene is important, other reasons such as hereditary factors and lack of saliva can also cause tooth decay. Saliva helps prevent tooth decay because it neutralises the acids produced by carbohydrate food breakdown, and its enzymes help clear carbohydrates and bacteria from the mouth. Sugar-free gum stimulates saliva production.
Sensitive teeth
‘Sensitive teeth’ tends to be a term used for teeth that are painful when exposed to extremes of temperature. The reason is unknown. People with sensitive teeth often have different responses to special toothpastes for sensitive teeth and may have to try a variety of products before they find one that suits them.
How can you relieve toothache?
Temporary pain relief, such as paracetamol or paracetamol plus codeine, may be used until you can see a dentist. However, codeine-containing products may cause constipation and should be used cautiously in people prone to constipation, especially the elderly.
It is preferable not to use aspirin because of the risk of bleeding during dental treatment. However, an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen may be suitable as it has less risk of bleeding than aspirin. NSAIDs should be avoided if you have asthma or a history of stomach problems because they may worsen these problems.
Topical analgesics
Topical analgesics containing benzocaine can be applied to the affected cavity with a cotton wool swab. However, they should not be applied to large areas of damaged gum tissue.
When should you seek immediate dental advice?
You should seek an immediate dental appointment if you have:
- obvious inflammation, abscess or fever;
- general unwellness;
- a swollen jaw or face; or
- injury caused by trauma, such as a blow to the mouth.
Last Reviewed: 31 March 2009
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