William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Toothache facts
- What is a toothache?
- What are dental causes of toothaches and how are they treated?
- Dental cavities and dental abscesses
- Gum disease
- Tooth root sensitivities
- Cracked tooth syndrome
- Temporalmandibular joint (TMJ) disorders
- Impaction and eruption
- What are non-dental causes of toothaches?
- How is toothache during pregnancy managed?
- Are home remedies effective for toothaches?
- Can toothaches be prevented?
- Find a local Doctor in your town
Tooth root sensitivities
Toothache can also be caused by exposed tooth roots. Typically, the roots are the lower two-thirds of the teeth that are normally buried in bone. Roots can be exposed by aggressive tooth brushing, irregular tooth positioning, or gum disease. During gum disease, bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The condition of exposed roots is called "recession." The exposed roots can become extremely sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone. Acidic drinks can also further aggravate the tooth and contribute to further breakdown of the exposed roots. This is referred to as "acid erosion."
Early stages of root exposure can be treated with topical fluoride gels applied by the dentist or with over-the-counter special toothpastes (such as Sensodyne) which contain fluorides and other minerals. These minerals are absorbed by the surface layer of the roots to make the roots resistant and less sensitive to the oral environment. Dentists may also apply "bonding agents" or bond a filling to the exposed roots to seal the sensitive areas and provide relief. Additionally, soft toothbrushes are always recommended for teeth to avoid unnecessary wear on enamel and root surfaces.
Cracked tooth syndrome
"Cracked tooth syndrome" refers to a toothache caused by a broken tooth (tooth fracture) without an associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc. Your dentist can usually detect the fracture by painting a special dye on the cracked tooth or shining a special light on the tooth. Treatment usually involves protecting the tooth with a full-coverage crown made of gold and/or porcelain. However, if placing a crown does not relieve pain symptoms, a root canal procedure may be needed. In some cases, the crack is too deep and the tooth cannot be saved. In this case, the tooth is extracted.
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