What is a toothache?

A toothache is pain in or around a tooth. The pain can be caused by an infected tooth, an infected gum, an irritated tooth nerve, or a problem with your sinuses or jaw.

How does it occur?

A tooth is covered with calcified enamel, which protects the soft living center of the tooth. The center contains the blood supply, the nerve, and the pulp, which is the tissue surrounding the blood vessels and nerve.

Pain may occur if you have tooth decay. Decay may irritate the nerve or it may lead to bacterial infection of the pulp, which can be very painful.

A tooth's nerve can also be irritated by a fracture or crack. You may get a toothache if a filling in your tooth is damaged. Repetitive motions such as chewing gum more than usual or grinding your teeth during sleep can also cause damage and pain.

What are the symptoms?

Tooth pain may be sharp, throbbing, or constant. Or it may hurt only when you put pressure on the tooth. Most often you will feel pain in the area of the problem tooth, but sometimes you may feel the pain in another area.

In some cases, you may have swelling around the tooth or get a fever or headache. Sometimes there is foul-tasting drainage from an infected tooth.

How is it diagnosed?

Tooth pain is usually diagnosed by careful examination of your teeth, the surrounding gums, and other areas around your mouth. If your teeth are in good condition, your health care provider will check your ear, throat, jaw, or sinuses to see if they may be causing the pain.

How is it treated?

Because a toothache can have a variety of causes, the best way to treat your toothache is to see your dentist and follow his or her instructions. In most cases, you can wait to go to the dentist until the next available appointment. Until then your health care provider or dentist may prescribe antibiotics or pain medication. Pain medications commonly used for a toothache are acetaminophen (Tylenol) and anti-inflammatories, such as ibuprofen. Narcotics are not often prescribed for a toothache.

If you have significant swelling or fever, your health care provider may consult with your dentist or you may need to have an emergency dental visit. In severe cases of toothache, blood tests or x-rays may be done.

Proper treatment of dental infections is important to prevent spread of the infection to other parts of the face and skull and possibly even to the bloodstream.

How can I prevent toothache?

The best way to prevent a toothache is to prevent damage to your teeth by:

• brushing with fluoride

• flossing to remove food particles between the teeth and to stimulate healthy gums

• getting dental care as often as your dentist recommends.

The most important times for regular dental checks are during childhood and in middle age. (During middle age, gum disease may begin to cause dental problems.)

A healthy diet is the cornerstone of dental health. A diet rich in fresh fruits and vegetables and whole grains is healthy for teeth and gums. Avoid foods made with refined sugars, such as sweets and white bread, and sweet, sticky foods, such as dried fruits, which stick on the teeth and can cause decay. Foods such as raw apples and popcorn help clean the teeth and make good snacks.