Gzfa – toothache: causes and treatment

Toothache: causes and treatment

What causes toothache? How are they treated??

How toothache arises?

If you can bite heartily without being impaired, your teeth and the entire chewing apparatus are healthy. Since the teeth are normally protected by the dentine and the hard enamel, the external influences such as B. keep heat or cold or acidic foods away from the sensitive interior of the tooth. It feels like the teeth are almost lifeless. However, this is a fallacy: the Teeth are traversed by the finest nerve fibers and blood vessels and are supplied from the inside. They are very sensitive there. When toothache develops, everyone is happy to be treated as quickly as possible. As a pain patient, you usually get a very short appointment in a toothache practice and receive preferential treatment.

Like any organ, too the entire tooth retention apparatus becomes ill, sometimes even without the patient’s knowledge. If the protective layer is already porous or if there is already a disease, the risk of toothache is increased because the sensitive areas of the tooth holder are unprotected and can be exposed to external influences.

How To Show A Toothache?

Like any other kind of severe pain, toothache affects a person a lot and is extremely stressful. They are one of the most unpleasant pains and can be very violent. They are considered by patients Intense, extreme, flashy, sharp, boring, throbbing, pounding, stabbing, pulsating or pulse-synchronous described. Toothache is excruciating and can last for months, only occur when chewing and disappear immediately. The range is diverse and individual.

When the cheek swells

Affected patients report permanent, lightning-like or nocturnal toothache or even wandering pain from one side of the mouth to the other and urgently seek help with toothache. The work of the dentist is made more difficult if the pain radiates and cannot initially be precisely located by the patient or has already disappeared when visiting the dentist. Sometimes the toothache occurs together with a hot, thick and swollen cheek, whereby the mouth can hardly be opened. Fever can also appear as a side effect. In the vernacular, one also speaks of the "thick cheek".

Various causes of toothache

The causes of toothache are very diverse and are not always directly in the oral cavity or in the throat. The pain can be very bad serious general illnesses draw attention and if necessary should also be clarified interdisciplinary with a family doctor or specialist. However, the first SOS measure should be an immediate appointment with a Experts in toothache treatment his. In the meantime, proven home remedies can also help relieve the pain. The dentist can then clarify whether the toothache comes from the teeth or possibly indicates other causes and thus does not come directly from the teeth.

Toothache can have a variety of causes and should be treated quickly.
Image source: © Doris Heinrichs | AdobeStock / Fotolia | # 29893190

The most common causes of toothache that come from the teeth

Caries: With inadequate oral hygiene or improper nutrition (mainly confectionery and sugary soft drinks) bacteria form one Biofilm on the tooth surfaces or between the teeth, where the toothbrush is difficult to get. One speaks of tooth decay or tooth decay when caries bacteria form aggressive acids through the conversion of sugar, which attack the tooth enamel and eat holes in it. Through these holes in the teeth, the bacteria, food residues or other irritants can penetrate unhindered into the dental pulp and trigger extreme toothache in some cases.

To treat tooth decay, first the Tooth thoroughly cleaned and opened to remove all areas already damaged. Depending on the extent of the damage, a tooth filling or a larger inlay or onlay to permanently close the tooth.

Thorough oral hygiene and the avoidance of sugary foods serve to prevent tooth decay and toothache.

Periodontitis and gingivitis: In the widespread disease periodontitis, overwhelming bacteria, also called plaque or biofilm, are the triggers of Disease of the tooth structure, the one Gingivitis (Gingivitis) begins. The inflammation is noticeable through swelling, redness and bleeding gums, but is usually not yet painful in the initial stage. That is why periodontal disease is often classified as harmless. However, if periodontitis is not treated, the gums decline, in the worst case, tooth loss. Toothache occurs because the sensitive tooth necks are exposed and react to external influences. When in contact with cold or hot food and when brushing teeth, the patient can experience sudden pain. Inflammation can also cause dull and difficult to localize pain.

In addition to thorough oral and tongue hygiene at home, regular hygiene is essential professional tooth cleaning at the dentist for the most important prophylaxis and therapy against periodontitis and the toothache caused by it. If the disease has already progressed, the treatment can drag on over a longer period of time, as bone in the jaw may have to be rebuilt.

Dental inflammation (pulpitis): Untreated caries, an injury to the jawbone (e.g. an accident or a sports injury) or after unsuccessful root canal treatment, bacteria can penetrate into the tooth. These attack the tooth nerve and damage it. The resulting swelling of the dental pulp increases the pressure inside what from permanent and pulsating toothache is accompanied. Even if the nerve dies, the pain can persist because the inflammation spreads through the root tip to the jawbone.

Because extreme toothache and massive damage to teeth and jaws can occur, quick action is urgently advisable. The specialists in a toothache practice will do anything to help you Save tooth. To prevent extraction, a Root canal treatment carried out. The root canals are exposed to completely remove all inflamed areas. The root canal is then thoroughly cleaned, prepared, filled and sealed.

Tooth fracture: Accidents in road traffic, at home, during sports and at work can result in tooth fractures, and children are also at risk when playing. Sometimes it is enough just to bite something hard – like the much-quoted cherry stone – so that a tooth breaks or parts of it break off.

The damaged tooth cannot always be saved by inlays, onlays or crowns. Sometimes the injury is so serious that it needs to be removed. A dental implant is a way to replace the tooth and restore the aesthetically natural look.

Tooth eruption: The baby teeth break in small children and the wisdom teeth in adults, which can be associated with toothache. If the jaw is too narrow for the additional teeth in adulthood, it can shift the well-positioned tooth base and cause painful tooth misalignments.

To prevent this from happening, it is important to consider in good time whether the wisdom teeth should be removed at the first sign of breakthrough or before. If the malocclusion already exists, the orthodontist is the specialist to take corrective action and permanently eliminate the pain.

Bruxism (gnashing of teeth): The clenching and grinding of teeth not only stresses the jaw joints, but also directly the tooth surfaces, which are ground down due to the high mechanical forces. One speaks of abrasion. If the upper protective layer is rubbed off, the chewing pressure is exerted directly on the dentine or the root membrane, which can cause severe toothache.

A splint therapy prevents further removal of the protective tooth structure or the overloading and incorrect loading of the chewing apparatus. A splint also prevents tension in the jaw and facial muscles. Because this muscle tension can be the cause of a variety of other pain and discomfort, such as one-sided head and face pain, tinnitus or neck, shoulder and back pain.

Foreign bodies such as braces or prostheses: Orthodontic braces or full and partial prostheses made of metal or plastic can loosen and shift and form painful pressure points. Cooperation with the master dental laboratory is necessary to restore the optimal and painless fit.

abscessed tooth: If inflammation of the tooth root spreads to the surrounding tissue and jawbone, an abscess, i.e. H. a pus, form. Persistent severe pain with pronounced warm to hot swelling are typical signs of a tooth abscess. In the case of dental treatment, the abscess – and thus the pus – is removed.

Leaking or lost fillings, crowns and temporary restorations: If dentures or fillings no longer seal properly, have become leaky or even fall out, the ground tooth is exposed. This is sensitive and can react to warmth or cold with toothache when brushing teeth and eating or drinking.

The dentist will repair the damage and replace fillings or close the tooth again.

Symptoms of typical CMD complaints: immediate help through DROS splint therapy.
Image source: © GZFA

What causes toothache that does NOT come from the teeth?

Toothaches that are not directly caused by sick or broken teeth are considered to be non-odontogenic toothache designated. It can be burning or tingling pain that moves from tooth to tooth or occurs on several healthy teeth at the same time. Persistent pain is not uncommon.

If there are other physical symptoms and there is no positive reaction to pain medication and dental treatment, the pain needs to be clarified interdisciplinary cooperation between the experts for toothache and other specialties such as B. Otolaryngologist, neurologist, orthodontist, orthopedist, cardiologist or psychologist.

The most common causes of toothache that do not come from the teeth

Inflammation of the sinuses: Dull, stinging or pounding pain in the area of ​​the molars of the upper jaw can be with a Inflammation of the maxillary sinuses (sinusitis) or the nasal mucous membranes (rhinitis) or a previous inflammation of the upper respiratory tract. Typical signs are pressure pain at the lower edge of the eye, pain in the throat at the level of the jaw and the increase in pressure when you bend down.

A visit to the ear, nose and throat doctor who recommends decongestant nasal sprays, expectorant medication and inhalation with essential oils is recommended. Sometimes antibiotics are also prescribed.

Cranio-mandibular dysfunction (functional disorders in the chewing apparatus): Hardening in the muscle structure, so-called trigger points, trigger a dull and stabbing muscle pain, which is known as myofascial pain designated. Trigger points can be caused by gnashing of teeth at night – i.e. by overloading or improperly loading the chewing muscles. The pain is usually exacerbated by chewing, jaw or head movements and not only radiates into the entire upper jaw, but can also Tension pains in the head, jaw and neck area cause. The general well-being is severely impaired, the risk of tinnitus is increased. One speaks here of CMD symptoms.

An occlusion splint can alleviate the symptoms because it causes one Relaxation of the muscles, reduces the pain-causing overload caused by clenching your teeth, grinding your teeth or rubbing at night and at the same time prevents further abrasion (abrasion) of the hard tooth substance.

trigeminal neuralgia: Short, electrifying and unilateral pain attacks, which are caused by lightning touching the face, brushing teeth or eating can indicate trigeminal neuralgia. There is usually complete freedom from pain between the attacks. Classic trigeminal neuralgia is triggered in the brain because a vascular loop presses on the nerve root and over-excites it.

For clarification, examinations by a neurologist and ear, nose and throat doctor with imaging methods are advisable. Special medication or neurosurgical intervention may be necessary.

Other causes of non-odontogenic toothache: There are other diverse causes – including very serious ones – for pain in the mouth and jaw that do not come directly from the teeth. These include e.g. B. shingles (Herpes zoster), Cysts, otitis media, migraines, Malfunction of the salivary glands, tumors or other diseases in the head, nerve malfunctions due to damaged nerves, heart disease such as angina pectoris or neurobiological changes that can even trigger phantom pain.

In addition, unclear and permanent complaints trigger pain insecurity in pain patients, which can lead to mental problems and even depression. In the case of toothache that is initially inexplicable, it is always highly advisable due to the complexity to consult an expert for toothache, general practitioners and specialists such as orthodontist, oral and maxillofacial surgeon, psychologist, neurologist, ear, nose and throat doctor or orthopedist. who can initiate further diagnostic and therapeutic measures in consultation with the patient.

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