![]() ![]() This may lead to ischemia (lack of oxygen) and necrosis (tissue death). Inflammation therefore increases pressure in the pulp system, potentially compressing the blood vessels which supply the pulp. Common causes include tooth decay, dental trauma (such as a crack or fracture), or a filling with an imperfect seal.īecause the pulp is encased in a rigid outer shell, there is no space to accommodate swelling caused by inflammation. Pulpitis (inflammation of the pulp) can be triggered by various stimuli (insults), including mechanical, thermal, chemical, and bacterial irritants, or rarely barometric changes and ionizing radiation. The majority of pulpal toothache falls into one of the following types however, other rare causes (which do not always fit neatly into these categories) include galvanic pain and barodontalgia. Natural history of dental caries and resultant toothache and odontogenic infection. : 31 Another typical difference between pulpal and periodontal pain is that the latter is not usually made worse by thermal stimuli. : 48 When a tooth is intentionally stimulated, about 33% of people can correctly identify the tooth, and about 20% cannot narrow the stimulus location down to a group of three teeth. : 125–135įor instance, the periodontal ligament can detect the pressure exerted when biting on something smaller than a grain of sand (10–30 µm). : 125–135 Consequently, pain originating from the dentin-pulp complex tends to be poorly localized, whereas pain from the periodontal ligament will typically be well localized, : 55 although not always. īoth the pulp and periodontal ligament have nociceptors (pain receptors), but the pulp lacks proprioceptors (motion or position receptors) and mechanoreceptors (mechanical pressure receptors). There are many possible non-dental causes, but the vast majority of toothache is dental in origin. Toothache may be caused by dental ( odontogenic) conditions (such as those involving the dentin-pulp complex or periodontium), or by non-dental ( non-odontogenic) conditions (such as maxillary sinusitis or angina pectoris). Historically, the demand for treatment of toothache is thought to have led to the emergence of dental surgery as the first specialty of medicine. ![]() In 2013, 223 million cases of tooth pain occurred as a result of dental caries in permanent teeth and 53 million cases occurred in baby teeth. : 125–135 It is one of the most common reasons for emergency dental appointments. Toothache is the most common type of pain in the mouth or face. The relief of toothache is considered one of the main responsibilities of dentists. The treatment of a toothache depends upon the exact cause, and may involve a filling, root canal treatment, extraction, drainage of pus, or other remedial action. Proper oral hygiene helps to prevent toothache by preventing dental disease. Correct diagnosis can sometimes be challenging. Less commonly, non-dental conditions can cause toothache, such as maxillary sinusitis, which can cause pain in the upper back teeth, or angina pectoris, which can cause pain in the lower teeth. The apical abscess usually occurs after pulp necrosis, the pericoronal abscess is usually associated with acute pericoronitis of a lower wisdom tooth, and periodontal abscesses usually represent a complication of chronic periodontitis (gum disease). Left untreated, pulpitis may become irreversible, then progress to pulp necrosis (death of the pulp) and apical periodontitis. Pulpitis is reversible when the pain is mild to moderate and lasts for a short time after a stimulus (for instance cold) or irreversible when the pain is severe, spontaneous, and lasts a long time after a stimulus. ![]() When severe it may impact sleep, eating, and other daily activities.Ĭommon causes include inflammation of the pulp, (usually in response to tooth decay, dental trauma, or other factors), dentin hypersensitivity, apical periodontitis (inflammation of the periodontal ligament and alveolar bone around the root apex), dental abscesses (localized collections of pus), alveolar osteitis ("dry socket", a possible complication of tooth extraction), acute necrotizing ulcerative gingivitis (a gum infection), and temporomandibular disorder. Toothache, also known as dental pain, is pain in the teeth or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases. "Thou hell o' a' diseases" – William Hole's illustration for Robert Burns' poem "Address to the Toothache" (1897, poem c. ![]() Odontalgia, dentalgia, odontodynia, odontogenic pain : 396 ![]()
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