Your guide to toothache

What is toothache?

Toothache is pain from a tooth or the surrounding face and jaw area. The most common cause of toothache is inflammation of the nerve of the tooth (the pulp), usually as a result of dental decay. Inflammation is the body's natural response to infection or injury.

Inflammation of the pulp is termed pulpitis. Initially, this produces a short sharp pain brought on by hot, cold, or sweet foods and drinks; at this stage it is reversible. However, if left untreated, the inflammation can progress and become irreversible and you may experience a throbbing pain of increasing severity. The pain usually lasts several minutes, and can also occur spontaneously, particularly at night.

As irreversible pulpitis progresses, the pulp may die and you may experience some temporary relief of pain. However, bacterial infection of the dead pulp can cause a continuous intense pain that affects your sleep. This can result in an abscess, which is a collection of pus, and you may notice a painful swelling on the gum next to the affected tooth or on the outside of the face. The tooth will be very painful to touch, and you may also feel unwell or have a fever.

Sometimes an untreated abscess can become chronic, which means that the infection has become long-lasting, and may recur. You will usually have a swelling on the gum from which pus drains. This is sometimes symptomless, but the infection can flare up from time-to-time, leading to more severe symptoms.

What can you do if you are experiencing toothache?

If you are experiencing any symptoms of toothache as described, you should make an appointment with your dentist as soon as possible.

Whilst waiting for your appointment, you can take over-the-counter painkillers for pain relief, such as paracetamol or ibuprofen. Always follow the instructions stated on the packet.

If you cannot get an appointment or do not have a dentist, you can attend an emergency dental clinic to treat the toothache; however you will need to find a dentist to carry out any permanent fillings or treatment.

What will the dentist do about toothache?

You will be asked questions about the toothache you are experiencing, and the dentist will carry out a general examination of your mouth and face to look for signs and causes of toothache, such as dental decay or swelling. X-rays and other special tests are usually carried out in order to diagnose the problem and allow the dentist to carry out the appropriate treatment.

If the tooth can be saved, the dentist will remove the decay and either place a simple filling or perform root canal treatment. Root canal treatment involves the dentist removing the infected pulp from the root of the tooth, and cleaning and filling the root to prevent further infection. The tooth will need to be removed by extraction if it cannot be restored.

If you have an abscess, the dentist will normally drain the pus and provide you with a temporary filling. The tooth will eventually need root canal treatment or extraction. Antibiotics may be prescribed if the infection is severe; it is important to follow the instructions and advice given by dentist.

What can you do to prevent toothache?

You should visit your dentist regularly for preventative advice and treatment.

A sugar-restricted diet and good oral hygiene is recommended and will help prevent future problems:

• Limit sugary foods and drinks to meal times
• Avoid sugary snacks and drinks between meal times
• Eating three healthy balanced meals a day will reduce the need for snacking
• Non-sugary snacks such as cheese and fruit is acceptable
• Brush your teeth twice a day (morning and night) for a minimum of 2 minutes with a fluoride toothpaste
• Dental flossing will help keep the areas between teeth clean
• Daily fluoride mouthwashes at a time different to toothbrushing will also help