Toothaches are certainly not fun and can even be scary if you don’t know the cause. There are many levels of pain and discomfort − sharp pain, dull pain, aching pain, sweet sensitivity, hot/cold sensitivity, or even what patients describe as a “heartbeat” throbbing pain. Depending on a patient’s description, a dentist can be clued in as to what the culprit might be.

Tooth decay. Initially, most people do not feel a cavity. As it gets deeper and approaches the nerve, the body recognizes the bacteria as harmful and the pain begins. Pain alerts us that something is wrong. However, a patient sometimes will not experience any pain, yet will have a tooth that is entirely rotted away. So you could say that patients with tooth pain are actually luckier. It gets them to the dentist sooner, averting many problems that might otherwise occur.

Inflammation of the nerve. Any stimulus, which is harmful to the tooth, can elicit a response of producing swelling of the inside of the tooth. Since pressure builds up with no place to expand, pain can often be severe in these situations.

Abscess. When a tooth abscesses, the nerve is essentially already dead. Periodontal ligament surrounds the tooth, which is loaded with fibers. The infection then leaks out of the tooth and into the bone and pus builds up. These bacteria can easily enter the bloodstream and create problems elsewhere. As the pressure builds up in the bone, the periodontal ligament senses it and responds with pain. When you tap on the tooth, it can be very painful since you are putting pressure on the abscess within the bone.

Cracked tooth. When a tooth cracks or splits, the nerve itself is greatly stimulated. It is like a live electrical wire. Usually a patient experiences pain upon biting into food. Dentists attempt to aggressively treat these problems because failure to do so could lead to extended treatment and poorer prognosis.

Gum disease. Often this is a dull ache and slowly progresses. It is critical to eliminate the plaque and tartar both above and below the gum line in order to heal. Think of it like removing a splinter. Once the tartar is gone, the body can try and heal itself although the bone is generally lost for good.

Root sensitivity. Teeth sensitive to hot and cold can often mean root sensitivity. Gentle brushing can relieve these problems as do toothpastes with ingredients designed to plug the tiny nerve fibers in the exposed roots. Dentists can also desensitize the tooth by coating the root with a polymer like substance.

Non-dental causes. Sometime tooth grinding or a sinus infection will cause tooth pain. If you correlate the time of the tooth pain with either a sinus infection or increased life stresses, it can often help the dentist make the diagnosis. In these situations, the teeth generally look healthy despite the patient experiencing pain. Taking sinus medication and reducing life stressors will help.

Your dentist can often be helpful in keeping you from having tooth pain in the first place. Regular checkups will catch problems when they are small and before significant pain begins. There is no substitute for good x-rays, magnification, and a good set of eyes at the dentist.