Toothache

Toothache
Classification and external resources
ICD-10	K08.8
ICD-9	525.9
DiseasesDB	27698
MeSH	D014098

A man with an aching tooth; a sculpture in the window of a dentist's office.

A toothache, also known as odontalgia or, less frequently, as odontalgy, is an aching pain in or around a tooth.

Causes

• Dental etiology, In most cases toothaches are caused by problems in the tooth or jaw, such as
  • Dental caries
  • Pulpitis, an inflammation of the dental pulp. This can be either reversible or irreversible. Irreversible pulpitis can be identified by sensitivity and pain lasting longer than fifteen seconds, although an exception to this may exist if the tooth has been recently operated on. Teeth affected by irreversible pulpitis will need either root canal treatment or extraction of the tooth.^[1]
  • A special condition is barodontalgia, a dental pain evoked upon changes in barometric pressure, in otherwise asymptomatic but diseased teeth.^[2][3]
  • Periodontitis
  • Wisdom teeth
  • Cracked tooth
  • Dry socket, which is a condition arising after having one or more teeth extracted (especially mandibular wisdom teeth).
  • Some causes of toothache are the more obvious culprits such as a cracked tooth, filling or veneer, dental caries from eating acidic, sweet foods that corrode the fillings and the tooth’s protective enamel layer. This corrosion is caused from the bacteria that are present on the teeth which break down the sugars in refined foods and then excrete them in the form of acids, which then eat away at the protective enamel of the tooth, causing a cavity, infection and eventually toothache.

• Non-dental etiology
  • Trigeminal neuralgia
  • Cytotoxic chemotherapy-induced neuropathy^[4]
  • Atypical odontalgia is a form of toothache present in apparently normal teeth. This is the intra-oral equivalent of atypical facial pain. The pain, generally dull, often moves from one tooth to another for a period of 4 months to several years. The cause of atypical odontalgia is not yet clear, although some form of nerve deafferentation is plausible.
  • Referred pain of angina pectoris or a myocardial infarction.

Severity

The severity of a toothache can range from a mild discomfort to excruciating pain, which can be experienced either chronically or sporadically. This pain can often be aggravated somewhat by chewing or by hot or cold temperature. An oral examination complete with X-rays can help discover the cause. Severe pain may be considered a dental emergency.

See also

Barodontalgia Dental caries Gum disease Tooth abscess

Temporomandibular disease Wisdom teeth Endodontic therapy Tooth extraction

References

1. ^ Merck. Toothache and Infection. The Merck Manuals Online Medical Library.
2. ^ Zadik Y, Chapnik L, Goldstein L (June 2007). "In-flight barodontalgia: analysis of 29 cases in military aircrew". Aviat Space Environ Med 78 (6): 593–6. PMID 17571660. http://www.ingentaconnect.com/content/asma/asem/2007/00000078/00000006/art00009. Retrieved 2008-07-16. 
3. ^ Zadik Y (August 2006). "Barodontalgia due to odontogenic inflammation in the jawbone". Aviat Space Environ Med 77 (8): 864–6. PMID 16909883. http://www.ingentaconnect.com/content/asma/asem/2006/00000077/00000008/art00013. Retrieved 2008-07-16. 
4. ^ Zadik Y, Vainstein V, Heling I, et al. (September 2010). "Cytotoxic chemotherapy-induced odontalgia: a differential diagnosis for dental pain". J Endod 36 (9): 1588–92. doi:10.1016/j.joen.2010.05.004. PMID 20728733. http://www.jendodon.com/article/S0099-2399(10)00458-9/abstract.