“Toothache” usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (temporo- mandibular joint), or spasms of the muscles used for chewing. The severity of a toothache can range from chronic and mild to sharp and excruciating. The pain may be aggravated by chewing or by cold or heat. A thorough oral examination, which includes dental X-rays, can help determine the cause, whether the toothache is coming from a tooth or jaw problem.

Sometimes, a toothache may be caused by a problem not originating from a tooth or the jaw. Pain around the teeth and the jaws can be symptoms of diseases of the heart (such as angina or heart attack), ears (such as inner or external ear infections), and sinuses (air passages of the cheek bones). For example, the pain of angina (inadequate supply of oxygenated blood to the heart muscle because of narrowing of the arteries to the heart) is usually located in the chest or the arm. However, in some patients with angina, a toothache or jaw pain are the only symptoms of their heart problem. Infections and diseases of the ears and sinuses can also cause pain around the teeth and jaws. Therefore, evaluations by both dentists and doctors are sometimes necessary to diagnose medical illnesses causing “toothache.”

Common Causes:

• Tooth decay
• Abscessed tooth
• Earache
• Injury to the jaw or mouth
• Acute MI (can include jaw pain, neck pain, or toothache)
• Sinusitis

The following are suggestions to help deal with toothaches:

• Aspirin, or other pain medicine when taken orally, can reduce pain until a dentist can examine the tooth. Do not give aspirin to children, and do not take prescription medications that were not given to you by your doctor for this purpose.
• Rinse the mouth with warm water to clean out unwanted food.
• Use dental floss and a water pick to remove trapped foods.
• Limit snacks and foods high in sugar.
• Do not place aspirin or acetaminophen on the aching tooth or gum tissue.
• No toothache will heal on its own. A toothache is a dental problem that needs to be treated as soon as possible.

For toothaches caused by a tooth abscess the dentist may recommend antibiotic therapy and other treatments, like root canal. To prevent tooth decay, use good oral hygiene. Sealants and fluoride applications by the dentist are important for preventing tooth decay.