There's nothing more aggravating or borderline debilitating than tooth irritation. And along with the pesky pain comes the daunting reality that you could have a dentist appointment in your near future involving novocaine, a root canal, and a three-day recovery.
But before you call out of work, line up your Netflix cue, and beg a friend to come over for support, it’s important to consider the many reasons why your teeth hurt that might not be cavity-related at all. “Toothache or tooth pain can be the result of a myriad of causes other than a simple cavity,” says Gerry Curatola, DDS, dentist and founder of Rejuvenation Dentistry and RealSelf advisor. “That’s why it’s important to be discerning and attentive to what type of pain it is, where it’s coming from, and when it’s happening.”
To help you pinpoint the issue and avoid experiencing unnecessary anxiety, we got the lowdown on the other reasons you might be experiencing dental discomfort.
If you feel like your tooth pain always comes on while you're enjoying cold food or drinks, like when you drink ice water or bite into an ice cream bar, you might be dealing with tooth sensitivity, says Helen Martinez-Barron, DDS, a dentist at Pearland Family Dentistry in the Houston area. “This is most commonly caused by enamel that is worn very thin or completely worn through, which is due to wear from teeth grinding and acid erosion caused by acidic foods or GI issues such as acid reflux or frequent vomiting,” explains Dr. Martinez-Barron.
Sensitivity to heat, meanwhile, is generally due to issues with the tooth's pulp, or nerve, as it is one of the last symptoms felt before the nerve dies, she says. Deep decay, cracks or extensive dental work can cause eventual nerve death, usually indicating that you need a root canal.
How to treat it: Treatment for cold sensitivity can depend on the degree of pain, says Dr. Martinez-Barron. Dull or slight sensitivity is usually alleviated by using a toothpaste containing potassium nitrate or stannous fluoride, such as Sensodyne.
“If the sensitivity is a bit more pronounced, we have products that can be applied in-office, such as a higher concentration of fluoride applied in trays, or a desensitizing treatment called Gluma, which is similar to Sensodyne, or even steroids,” says Dr. Martinez-Barron. “Severe sensitivity will often require complete coverage of the remaining tooth structure with a crown, which is common for patients with acid erosion.”
2. You’re experiencing TMD (temporomandibular disorder).
Commonly referred to as TMJ, which actually refers to the affected temporomandibular joint, TMD can be pretty mysterious as the cause isn't always apparent, says Dr. Martinez-Barron. “TMD can be caused by injury to the jaw, such as a blow,” she explains. “Other causes can be clenching or grinding of the teeth (which puts a lot of pressure on the joint), dislocation of the disc between the skull and the mandible, or arthritis.”
How to treat it: Treatment for TMD depends on the cause, says Dr. Martinez-Barron. If you clench your teeth and experience joint pain, headaches, limited mouth opening and facial pain, Botox injections in your mastication muscles can help to lessen the force with which they contract. Other, more cost-effective remedies include custom-made or over-the-counter mouth guards, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, muscle relaxers, or even a heating pad.
3. You recently had your teeth whitened.
Teeth whitening can cause sensitivity, as the bleach can cause the teeth to become temporarily porous, says Dr. Martinez-Barron. This almost always resolves itself within a few days, or by using a toothpaste like Sensodyne.
How to treat it: “You can help to minimize sensitivity by brushing your teeth with Sensodyne a week or two before a bleaching treatment,” she says.
4. You brush too hard, and it's led to gum recession.
Of course you want to get those puppies as clean as a whistle, but applying too much pressure or brushing too aggressively can actually lead to more problems—and pain.
“Doing this wears away at the actual tooth structure, as well as the recession of the gums that normally covers the root of the tooth,” says Ira Handschuh, DDS, dentist at the Dental Design Center in White Plains, New York. You may notice extreme sensitivity to eating and drinking cold items, which is due to your root structure being more exposed.
How to treat it: While you can’t “undo” the damage caused by over-brushing, you can make an appointment with your dentist, who can place tooth-colored fillings on the areas where the tooth has worn away, says Dr. Handschuh. “Sometimes even placing a gum graft to build the gums back to the height they were originally is also possible,” he says. Your best bet to avoid this fate altogether: Invest in a high quality electronic toothbrush or a manual extra-soft bristled brush, and dial back the pressure.
5. You have a gum infection.
If you’ve been told that you have periodontal (gum) disease, you’re far from alone. In fact, nearly half of the U.S. adult population 30 and older has mild, moderate, or severe periodontitis, according to the Centers for Disease Control and Prevention (CDC).
But even if you’re lucky enough to not have it, you can still contract a gum infection. “This occurs when germs or bacteria enter the teeth or gum area and multiply to a point where the body cannot fight off the bad bacteria,” says Melissa Thompson, DDS, a Massachusetts-based dentist and owner of three Aspen Dental practices. “The infection may cause pain or swelling, a small pimple above the tooth or area, the release of pus, or even a bad taste in the mouth.”
How to treat it: As soon as you notice any of these signs, it’s best to get to your dentist’s office, stat. “Gum infection may lead to an abscess, which can cause even worse pain,” says Dr. Handschuh. “Your dentist will have to clean out the gum region around the infected tooth and prescribe antibiotics and oral rinses immediately.”
6. You've experienced tooth trauma.
Surprisingly, you might not be aware that you've had tooth trauma. It can be the result of an incident that happened many years ago. “This can entail anything from falling and hitting the teeth, being in a car accident where there’s a force to the mouth or jaw, or even chewing on some type of food that traumatizes the tooth,” says Dr. Handschuh.
Along with tooth trauma or a tooth fracture comes increased pain and sensitivity when chewing, which causes the tooth to flex and irritates the nerve endings within the tooth. “If a patient were to fall and hit or damage a tooth, their dentist would need to keep watch on that tooth with regular follow-ups and X-rays to make sure there’s no infection and also that the nerve inside the tooth is not dying,” says Dr. Thompson.
If the tooth has died as a result of trauma, signs would include discoloration on the outside of the tooth and temperature sensitivity.
How to treat it: “A root canal and crown is typically the treatment recommended for a dead tooth, and, if the tooth needed to be removed, implanting a bridge or removable appliance such as a partial denture would be the next step,” she says.
7. You have a nasty sinus infection.
Especially during allergy and flu season, a sinus infection may creep up in a way that doesn’t even feel like a normal one. “Since the roots of certain teeth actually sit right by the sinuses, the pressure from a sinus infection actually mirrors tooth pain,” says Dr. Handschuh.
How to treat it: You may have to wait out the sinus to get rid of the tooth achiness. “Instead of dental treatment, one would need medication like a decongestant and possible antibiotic prescribed by their family physician,” says Dr. Handschuh.
8. You grind or clench your teeth while you sleep.
Maybe a significant other has already clued you into the fact that you have this habit, but it can cause more than just annoyance to your bed partner. “In some cases, chronic teeth grinding can result in a fractured or loose tooth,” says Dr. Handschuh. “So it’s very important to have your teeth evaluated by your dentist so he or she can examine the way your teeth fit together, and consider whether or not any of them are hitting too hard or too early.”
An imbalance in where your teeth meet when they grind together is what can cause problems like tooth and muscle pain.
How to treat it: “There are many ways to treat this type of pain, one of which might be the use of a night guard, which assists in removing forces off of some teeth and placing the forces evenly throughout the oral cavity,” he says.
9. You recently got a filling or had drilling done to a tooth.
If this is the case, you may notice sharp sensitivity when biting down in the area that you had work done. “When teeth are drilled, you may experience sensitivity to cold for a couple of weeks, which is normal, but if there is sensitivity when you bite, especially on hard substances, an adjustment may be needed so that you are chewing more evenly,” says Dr. Thompson.
How to treat it: Since you’ll most likely notice this occurrence after you’ve already left your dentist’s office, you’ll have to schedule a follow-up visit so that your dentist can check on the bite and make minor adjustments to alleviate the pain. “Your dentist will adjust the bite if needed, and if it’s temperature-sensitive, they may place a topical fluoride or desensitizing paste on the area,” says Dr. Thompson.
10. You have a cracked tooth.
This can be caused by a number of things, including biting into something hard that causes the tooth to crack, an injury from something outside the mouth, like falling or an accident, or even tooth clenching and grinding. “If there is a crack, the tooth pain could be experienced when biting down, chewing, or even drinking something hot or cold,” says Dr. Thompson.
If the crack is to one of your front teeth, you may be able to actually see the damage, but if it is to the back teeth, visibility might be more difficult.
How to treat it:Visit your dentist’s office right away so he or she can examine or restore the area before the crack worsens—and immediately stop chewing on anything hard. “If it’s due to jaw clenching and teeth grinding, a custom-made night guard will be recommended to protect the teeth from future trauma,” says Dr. Thompson.
11. You have a cavity that's turned into more serious tooth decay.
Decay that is small to moderate in size typically doesn't hurt, says Dr. Martinez-Barron. “You’ll start to feel pain when the decay is approaching the nerve, which usually means it’s time for a root canal since a cavity has given the bacteria an entryway into the pulp,” she explains. “There’s no home remedy for this and antibiotics will only provide temporary relief, as they don’t remove the source of the infection which is inside the tooth and will have destroyed the blood vessels inside the tooth, which is how the antibiotic would remedy the infection."
How to treat it: “If left untreated, some tooth pain and infections can lead to life-threatening concerns and can spread throughout the body, causing an even greater infection,” says Dr. Handschuh, so follow up with your regular dental care appointments every six months (or more frequently if recommended by your dentist) to avoid these more serious scenarios.
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