What is a toothache?

Throbbing tooth pain is a sign that you might have tooth damage. Tooth decay or a cavity can give you a toothache. Throbbing tooth pain can also happen if there is an infection in the tooth or in the gums surrounding it.

Toothaches are typically caused by an infection or inflammation in the tooth. This is called pulpitis.

The soft pink pulp inside your tooth helps to keep it healthy and alive. Tooth pulp contains tissue, nerves, and blood vessels.

A cavity or crack in the tooth lets air and germs inside the tooth. This can irritate and infect the sensitive pulp nerves, leading to tooth pain.

Along with throbbing pain, other symptoms of a toothache can include:

  • constant dull ache
  • sharp pain when you bite
  • pain when you eat something sweet
  • sensitive or tingly teeth
  • pain or tenderness in the mouth
  • pain or aching in the jaw
  • mouth or gum swelling
  • redness
  • bad taste in the mouth
  • a bad smell in the mouth
  • pus or white fluid
  • fever

Both adults and children can get a toothache. See a dentist immediately if you have any signs or symptoms. You will likely need a dental exam and an X-ray to find out what’s causing the tooth pain.

Here are eight possible causes of throbbing tooth pain.

Tooth decay or a cavity is the most common reason for tooth pain. It can happen when bacteria “eat” through the hard enamel outer layer of a tooth.

Bacteria are part of normal mouth and body health. However, too much sugar and other foods on your teeth can cause too many bad bacteria.

Bacteria make a plaque that sticks to your teeth. Some kinds of bacteria give off acid that can lead to holes or cavities. Tooth decay might look like small white, brown, or black spots on your teeth.

Treatment

Your dentist can repair a hole or fix a weakened area in the tooth to help stop the throbbing pain. You may need:

  • teeth cleaning to get rid of plaque
  • filling to patch up the cavity
  • antibiotics to clear up infection

An abscessed tooth is when part or all of the pulp inside the tooth dies. The dead tissue makes a “pocket” of bacteria and pus called an abscess. Tooth infection or inflammation can cause an abscess.

A damaged tooth can lead to a tooth abscess if it is not treated quickly. This happens when a hole or crack lets in bacteria into the tooth.

Treatment

Treatment for a tooth abscess includes:

  • antibiotics to kill the bacteria causing the infection
  • draining and cleaning out the abscess
  • cleaning and treating the gums, if the abscess is caused by gum disease
  • root canal, if the abscess is caused by decay or a cracked tooth
  • implant, which involves replacing the tooth with a synthetic one

A tooth fracture is a crack or split in the tooth. This can happen by biting on something hard like ice. You may also get a tooth fracture in a fall or if you get hit in the jaw or face with something hard. In some cases, a tooth fracture can develop slowly over time.

A tooth fracture can lead to throbbing pain. The fracture allows things to get into the tooth and irritate or infect the pulp and nerves, triggering pain.

This may include:

  • bacteria
  • food particles
  • water
  • air

Treatment

Your dentist can repair a fractured tooth with dental glue, a veneer, or a filling. You may need a cap or crown on the tooth, or your dentist may recommend a root canal.

You can damage a filling with normal biting and chewing, by biting something hard, or by grinding or clenching your teeth. A filling may:

  • chip
  • crumble
  • crack
  • wear away
  • pop out

Treatment

Your dentist can repair or replace a damaged filling. You may need a crown on the tooth if it has become too damaged for a new filling.

gum infection is also called gingivitis. Infected gums can lead to gum disease or periodontitis. Gum disease is the main cause of tooth loss in adults.

A gum infection can be caused by:

  • not cleaning your teeth and mouth properly
  • a poor daily diet
  • smoking
  • hormonal changes
  • some kinds of medications
  • health conditions like diabetes
  • cancer and cancer treatments
  • genetics

Bacteria from infected gums can build up around the tooth roots. This can cause an infection in the gum tissue that results in a toothache.

Gum disease may shrink gums away from the tooth. It may also break down the bone that holds teeth in place. This can loosen teeth and cause cavities.

Treatment

A gum infection is normally treated with antibiotics. You may need regular cleanings by your dentist to remove plaque. A medicated mouth wash can help soothe gum and tooth pain.

If you have gum disease, you may need several treatments to help save your teeth. Treatment includes a “deep cleaning” called scaling and root planing to keep your teeth and gums healthy. In severe cases, dental surgery may be needed.

Grinding your teeth is also called bruxism. It usually happens during sleep. Clenching your teeth means biting down hard. Grinding and clenching can happen because of stress, genetics, and over-developed jaw muscles.

Grinding and clenching can cause tooth, gum, and jaw pain. They can lead to tooth erosion by wearing away the tooth. This increases the risk of cavities, tooth pain, and fractured teeth.

Signs of tooth erosion include:

  • small cracks or roughness on teeth edges
  • teeth thinning (biting edges look slightly transparent)
  • sensitive teeth (especially to hot, cold, and sweet drinks and foods)
  • rounded teeth
  • chipped or dented teeth and fillings
  • teeth yellowing

Treatment

Treating the cause of grinding and clenching teeth helps stop tooth pain. Wearing a mouth guard during sleep can help stop adults and children from grinding their teeth. It may also be helpful to practice stress relief techniques or seek counseling from mental health professional.

A crown or cap is a tooth-shaped cover. It usually covers the whole tooth down to the gumline. You might need a crown if a tooth is cracked or broken, or if a cavity is too big for a filling.

A crown holds the tooth together. It can be made of metals, ceramic, or porcelain. Dental cement holds a crown in place.

A crown can become loose through normal wear and tear. It can also chip or crack like a real tooth. The cement glue holding a crown in place may wash out. You may damage a crown by clenching or grinding your teeth or biting something hard.

A loose crown can trigger throbbing tooth pain. This happens because bacteria can get under the crown. The tooth may become infected or damaged, triggering nerve pain.

Treatment

Your dentist may remove the crown and treat the tooth if there is a cavity or tooth damage. A new crown is put on the repaired tooth. A loose or damaged crown can be repaired or replaced with a new one.

New growing (erupting) teeth can cause pain in the gums, jaw, and surrounding teeth. This includes teething babies, children getting new teeth, and adults growing wisdom teeth.

A tooth can become impacted if it’s blocked from growing through the gums. Or it may grow in the wrong direction, such as sideways instead of up. This can be caused by:

  • crowding (too many teeth)
  • a baby tooth that hasn’t fallen out
  • a cyst in the mouth
  • genetics

An impacted tooth may damage a neighboring tooth’s roots. A newly erupted tooth and an impacted tooth may also cause other teeth to move or loosen. This sets off pain in the gums and teeth.

Treatment

You can soothe pain or tenderness from an erupting tooth with an oral numbing gel or general pain medication. Treatment for an impacted tooth includes minor dental surgery to make room for the tooth. This may involve removing extra teeth or opening up blockages

Other causes of throbbing tooth pain include:

  • food or debris stuck between your teeth
  • abnormal bite
  • sinus infection (pain in the back teeth)
  • heart disease, such as angina (pain around the teeth and jaw)

A tooth infection can spread to the jaw bone and other areas of the face, throat, and head. Call your dentist immediately if you have other symptoms along with a toothache. These can include:

  • pain that lasts longer than a day
  • pain when biting or chewing
  • fever
  • swelling
  • red gums
  • bad taste or smell
  • difficulty swallowing

If your tooth has broken or come out, go to the dentist or emergency room immediately.

Try these tips to soothe throbbing tooth pain if you cannot see your dentist immediately:

  • Rinse your mouth with warm salt water.
  • Gently floss to remove food or plaque between teeth.
  • Apply a cold compress to your jaw or cheek.
  • Take over-the-counter pain medication like acetaminophen.
  • Try home remedies for toothaches like clove oil to numb the gums.

See your dentist or doctor if you have throbbing tooth pain. It may be due to an infection. Early treatment can help keep your teeth and body healthy.

Regular dentist visits help to prevent serious teeth problems before they cause pain. Check with your health insurance to find out if you’re covered for regular check-ups and teeth cleaning.

If you cannot afford a dentist, call some local dental schools. They often offer free or cheaper teeth cleaning and minor dental procedures, like fillings.

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