Toothache
Toothache is a common dental issue primarily resulting from cavities, which are caused by decay leading to holes in teeth, or from inflammation of the gums surrounding the teeth. Both conditions arise due to bacterial plaque buildup, which can cause pain when it affects deeper layers of the tooth, such as the dentin or pulp. Symptoms may intensify with exposure to temperature changes or during chewing. Other factors contributing to toothache include tooth fractures, teeth grinding, or issues not directly related to dental health, such as sinus congestion or heart disease. Treatment typically involves a dentist cleaning the affected area, filling cavities, or providing more extensive care like root canals or extractions, depending on the severity of the condition. Historical records show that toothaches have been acknowledged in ancient civilizations, and advancements in dental research continue to evolve, aiming to reduce their prevalence. Overall, understanding the causes and treatment options for toothaches can help manage this discomfort effectively.
Toothache
Anatomy or system affected: Gums, mouth, teeth
Definition: Pain around a tooth or in the jaw
Causes and Symptoms
Toothache is most commonly due to a cavity, which is decay that produces a hole in a tooth. Another frequent cause is inflammation of the gums, the soft tissue around the teeth. Cavities and gum disease are both caused by bacteria that accumulate, along with saliva and food particles, in deposits called plaque on the teeth. Cold, heat, or chewing may intensify toothache.
Initially, a decaying tooth is not painful. Pain may arise after the bacterial assault progresses through the tooth’s hard, outermost layer of enamel and reaches the dentin. When the disease advances to the pulp, the blood vessels and nerves of this soft, innermost tooth tissue may die. At this stage, known as endodontic disease, severe pain and swelling may arise, especially if an abscess develops.
The early stages of gum inflammation—called gingivitis—also are not painful. Pain develops during the next stage, known as periodontal disease, as bacterial toxins erode the jawbone and weaken the attachments of the teeth to it. An abscess may form.
Other causes of toothache include exposure of the tooth roots, fracture of a tooth, and clenching or grinding of teeth. Toothache occasionally results from a problem not originating in the teeth or jaw, such as sinus congestion, heart disease, or ear infection.
Treatment and Therapy
A dentist will most commonly treat a cavity by placing a filling in the tooth. An advanced cavity, however, may require a crown or cap for the tooth. For decay that has reached the pulp, the dentist may refer the patient to an endodontist for a root canal procedure, in which the dying pulp tissue is removed. In extreme cases, the tooth may be extracted.
If a toothache is caused by gum disease, then the dentist will clean the teeth to remove plaque or, in severe cases, refer the patient to a periodontist for more elaborate treatment. Antibiotics may be administered.
A toothache caused by the exposed root of a tooth is often treated with a topical fluoride gel, special toothpaste, or protective filling. If a dentist cannot determine the cause of a toothache, then the patient may need to consult with a physician to determine whether there is another underlying illness.
Perspective and Prospects
Toothaches are mentioned in the writings of ancient civilizations of the Middle East and Asia. Remedies included filling or extracting decayed teeth and splinting loose ones.
Since the mid-twentieth century, dental research has increased greatly, resulting in a decreased prevalence of toothaches. Research areas that may one day reduce the incidence even further include genetically engineered bacteria. Dental research is conducted both at dental schools and at such institutions as the National Institute of Dental and Cranio-Facial Research.
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