There can be a number of causes for toothache, for example abscesses (inflammations with pus), tooth fracture, broken tooth filling, excess load on the tooth (like chewing on one side or grinding teeth), gum infections and many other diseases. Nevertheless, one of the most widespread causes is tooth decay (or dental caries). On early stage it may look like a white or yellow-brown spot on the tooth — at this stage the tooth enamel is affected. It is demineralized and a cavity is likely to appear. If this stage is timely noticed - a non-operative treatment is possible (i.e. without drilling is possible to reverse the tooth decay). In this case a special diet and fluoride gels are prescribed. If left without treatment and/or attention, a bit later the spot turns into a dark brown or a black hole — it means the enamel is destroyed and the cavity will go deeper into the dentine. It may take from several months to several years for tooth decay to progress — don’t forget, our teeth have it’s natural remineralizing potential, so the cavity may develop really slow.

Caries as the cause of toothache

In majority of cases, after reaching dentine, tooth decay goes deeper and affects the pulp — the inner part of the tooth with the nerve. Actually, people may start complaining about toothache even earlier, but when the nerve is affected — the toothache becomes really unbearable.

Toothache - photo 1
Photo 1. Toothache.

Basically, tooth decay is a damage caused by acid-producing bacteria in your mouth. Your enamel is weakened by these bacteria, it isn’t able to protect itself in case people consume way too much sweet and acid foods and drinks. At this point it is very important to understand that not all the bacteria is harmful, so there is no need to keep the mouth sterile, but to prevent serious cavities it’s time to think of proper mouth hygiene and regular visits to the dentist clinic.

Features of toothache

The toothache caused by dental caries can be sharp, throbbing or constant. Sometimes it starts without any apparent reason, and sometimes it starts under pressure on the tooth. Usually toothache is accompanied by gums swelling around the damaged tooth. Toothache is considered to be one of the strongest types of pain, because teeth (and their nerves) are located closer to the brain. Toothache often goes along with fever or headache (usually it is a sign of abscesses). Decayed tooth almost always has a bad smell.

Toothache - photo 2
Photo 2. Increased tooth sensitivity.

If it sounds familiar to you — we strongly recommend visiting your dentist as soon as possible, especially if:

Be careful, because infected tooth pulp may lead to serious infections and complications up to blood infection.


Going to the dentist is the only right decision if you can agree at least to one of the abovementioned points. Dentist will study the case and carry out the examination. During the examination you may have to undergo the X-ray or laser diagnosing procedure in order to analyze the case and understand the cause of the problem. Besides, you will be asked to answer the questions about the pain location, its severity and factors that increase the toothache. 

Toothache - photo 3
Photo 3. Practiced dentist can find the cause of toothache..

Toothache treatment

Toothache treatment basically depends on the situation. In case toothache is caused by tooth decay, the dentist will start its treatment. When the tooth has to be extracted as there are no ways to save it — the procedure is performed. After that your dentist will offer you several options that usually include dental implant crowns together or fixed bridges. Such a solution works great to enable the chewing function and make it look much better.

If decay is seriously cavitated, the pulp is affected, but the tooth still can be saved - the tooth drilling is obligatory. After cleaning off the decay and removing damaged parts of the tooth, the dentist performs root canal treatment and nerve removal. And then restores the damage with the filling.

Toothache - photo 4
Photo 4. Sometimes tooth decay leads to tooth extraction.

In may take time to do all that as first the damaged area needs to heal. The dentist may also prescribe antibiotics to prevent unwanted complications, swelling and infection. Pain and inflammation can be reduced by phototherapy procedures. The earlier you make an appointment in the dentist clinic — the less time and money you will spend on treatment.

As most of toothache cases are associated with tooth decay, proper dental hygiene: brushing with a good fluoride-containing toothpaste at least two times a day, flossing at least once a day, as well as regular visits to your dentist twice a year are required. Limit foods high in sugars and starch and support your immune system.

Video: Symptoms of Toothache

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