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Potential Causes of Dental Pain

Dental pain refers to pain felt in the mouth area (e.g., gums, teeth, jaw). It usually indicates an oral health problem, such as gum disease, tooth decay or TMJ disorder, although the pain can also be caused by conditions that are not dental in nature, such as sinus or ear infections or heart problems.

In most cases, dental pain is due to tooth decay. When a cavity gets larger, it begins to irritate the pulp, which is the centre of the tooth that contains nerves and blood vessels. The pulp may also be irritated when the tooth is touched or comes into contact with cold, hot or very sweet food and beverages. In advanced cases of tooth decay, destruction of the enamel and dentin (the middle layer of the tooth) can allow bacteria to invade the pulp, which can lead to infection and result in tooth abscess. Whenever the pulp becomes irritated, its nerves send signals to the brain, causing pain. Although the pain may sometimes dissipate over time without any treatment, the condition will continue to worsen and the pain may return if the tissue and bone surrounding the affected tooth becomes infected.

Gingivitis may also be the cause of dental pain. The soft tissue of the gums may become inflamed because of the build-up of plaque along the gum line. As a result, gums loosen and detach from the teeth, forming deep pockets of space between the gums and teeth. Bacteria invade these pockets, causing swelling, bleeding and pain. In severe cases, when bacteria dissolve the bone surrounding tooth roots, tooth and bone loss may occur. When the roots of teeth become exposed due to receding gums or bone loss, tooth sensitivity can result. Nerve endings contained in the lower part of the tooth react to certain stimuli, such as cold air, food or drinks, causing dental pain.

Dental pain in the jaw area can be caused by muscle strain. The muscles controlling the temporomandibular joint (TMJ) can spasm and trigger pain. This often happens in patients with an unstable bite, missing or improperly aligned teeth.

Symptoms that May Be Associated with Dental Pain

The additional oral symptoms that may be related to dental pain depend on its cause and can include any of the following:

  • Sensitivity to certain stimuli (e.g., cold, heat, air, biting, chewing)
  • Loose teeth
  • Bad breath (halitosis)
  • Red, swollen gums
  • Bleeding gums
  • Receding gums
  • Difficulty opening or closing the mouth
  • Cracking sound when jaw opens
  • Foul-tasting discharge
  • Pus near the source of the pain

Furthermore, symptoms in other areas of the body may appear along with dental pain. These include fever, headaches and difficulty swallowing or breathing.

The Most Common Causes of Dental Pain

Dental pain may be due to a variety of medical conditions, but most commonly, the cause happens to be one of the following oral conditions:

Tooth decay. Tooth cavities cause a tooth to be sensitive and painful in response to certain stimuli. When untreated, tooth decay can lead to painful infection called tooth abscess. Dental pain caused by tooth decay is usually focused on a specific tooth.

Gum disease. Gingivitis and periodontitis often lead to infection of the gums. In severe cases, when the gums recede, pain may be felt as a result of exposed areas of the teeth. Excessive use of teeth whitening products can also irritate the gums, causing sensitivity.

Debris. Dental pain is often a result of certain types of food getting stuck in between the teeth and gum. Pain caused by debris is typically experienced only in the affected area and may gradually become more severe if the debris is not removed.

Temporomandibular joint (TMJ) disorder. Muscles surrounding the temporomandibular joint may spasm and cause jaw pain. Muscles may become strained due to clenching teeth, physical trauma to the area or arthritis, which can lead to jaw pain.

Teeth grinding (bruxism). Regularly grinding and clenching the teeth may cause dental pain, especially upon awakening.

Other common, but less frequent, causes of dental pain include:

  • Tooth eruption (in children) or tooth impaction
  • Fractured, cracked or broken teeth
  • Exposed tooth root
  • Dry socket (complication of tooth extraction)
  • Trauma to head or teeth
  • Abnormal bite
  • Recent dental work
  • Meth mouth (caused by use of methamphetamine)

Dental pain may also be the result of a condition elsewhere in the body, including:

  • Ear infection
  • Sinus infection
  • Migraines
  • Heart problems (the pain usually increases with exertion)
  • Neurological conditions (e.g., trigeminal neuralgia)
  • Burning mouth syndrome
  • Salivary gland dysfunction

It goes without saying that the treatment of dental pain will depend on its cause. In most cases, it will include dental treatment that can be provided by a dentist or dental specialist. If non-dental causes are behind the dental pain, a patient will be referred to another physician.