8 Causes of Aching Teeth


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Evidence Based - Facts Checked

This content is medically reviewed by Dr. Navneet Singh and written by Puneet Utreja

Last Update Date - 2nd September 2020



Aching teeth is caused due to some obvious reasons like tooth decay or cavity; however, there are specific surprising reasons like exercise or sinusitis. In this article, we will focus on various possible known reasons for aching teeth and how and when to decide to meet a dentist.

Before we begin, on a positive note, it is said that there is a positive side of a pain, which is, that it lets you know that you are alive.

Aching Teeth

Following are the various reasons for aching teeth:-

8 Causes of Aching Teeth


1 - Tooth Abscess

Tooth Abscess

A tooth abscess is characterized by an inflammation in the root of the teeth, which is caused due to the death or decaying of the soft tissue in the root canal.

The death of the soft tissue is caused due to an infection in and around the tooth's soft tissue root.

Decayed Tooth

The tooth enamel protects the root canal from microorganism; however, when the tooth starts decaying, the bacteria gets passage inside the root canal, and hence, it causes infection. Your body identifies the bacteria as a foreign object and therefore sends its army of cells (White Blood Cells) to fight, and as a result, pus formation occurs1Sanders, J. L. (2019, November 27) Source - Pubmed

  • Aching Teeth
    The pain may radiate from teeth to the jaw, ear, and in some cases, head too. In most of the cases, patients find it difficult to point out the exact teeth in which they are feeling the pain as the pain radiates. Further, it sometimes gets missed out in the X-Ray too
  • Fever
  • Redness in the gums due to inflammation
  • Swollen Gums
  • Teeth become sensitive to temperature, and the pressure created while chewing food causes toothache
  • In extreme cases, the patient might experience swelling on the cheek and face

Even though you might get temporary relief from your aching teeth; however, it is strongly advised to go and see your dentist as there are high chances of the spread of infection in the neighboring teeth.

Your dentist would empty the tooth canal followed by cleaning the pus, shaping, sealing back of the root canal, and finally would cover it with a cap.

Tooth canal clean

After that, an antibiotic shall be prescribed if your dentist feels that there are still some chances of infection. 

Read More: 10 Secret Remedies for Tooth Pain if Dentist is Away  

2 - Tooth Decay

Decayed Tooth

Because of poor oral hygiene, a sticky layer of bacteria called plaque gets deposited on the tooth enamel. These bacteria consume sugar and starch from the food that we eat and, after that, produce lactic acid, which acts upon your tooth enamel and erodes it gradually, leading to the formation of the cavity (as shown in the image).

Dental Plaque

Cavity formation, itself is not painful however when it gradually deepens, it leads to tooth sensitivity to touch and temperature and thereby cause toothache

  • Aching Teeth
    The pain can be continuous and can become sharper with time
  • Foul breath
  • Sensitivity in the teeth
  • Spots (black or grey) on the teeth
  • Bad taste in the mouth

Tooth decay can be treated easily if diagnosed during the early stages. Your dentist may first start with an X-Ray to check the extent of damage and after that, depending upon the condition, do: -

 - Root canal treatment followed by a filling or a crown

- Extract the teeth if the extent of damage is enormous. It helps in preventing the spread of bacterial infection to the neighboring teeth.

3 - Tooth Fracture

Fractured Tooth

What is a fractured tooth?

A fractured tooth is generally caused due to trauma in the mouth wherein, while doing an activity, your tooth comes in immediate contact with a hard surface and hence results in a tooth fracture2Mamoun, J. S., & Napoletano, D. (2015) Source - Pubmed

In aged individuals, sometimes, biting a crunchy fruit may also cause a tooth fracture.

  • Tooth Sensitivity
    With a fractured tooth, you may start feeling sensitivity in and around the affected tooth, as the inner pulp of the tooth, which consists of blood vessels and nerves, gets exposed to the food and drinks.
  • Tooth Ache
    Since the inner pulp is exposed, while biting, you may feel a toothache. The inner pulp comes in contact with the food, becomes irritated, and sometimes results in inflammation and therefore causes toothache.
  • Crack in the tooth

The sooner you visit your dentist after having a fractured tooth, the lesser would be the agony you would suffer from. Following are the various questions that you might have while getting a treatment for fractured tooth:-

Can a fractured tooth be saved?

Yes, in the majority of the cases, the fractured tooth can be saved. If the extent of damage is till the pulp region only, then there is no need to extract your tooth. The most preferred treatment in such cases is endodontic treatment or a root canal treatment. The intent of your dentist in such cases is to prevent the stimuli from the outside forces (food, drink, contact with the hard object) reaching the pulp.

Should I keep my Broken Tooth with me?

It is always better to keep the broken part of the tooth with you and share it with your dentist as it will help him check the extent of the damage. No, he may not be able to seal back the broken tooth part with your tooth, but there are dental sealants and tooth caps that are used to give your tooth a natural look and shape.

Does a fractured tooth have to be pulled/Extracted?

If the extent of damage is quite deep and extends beyond the pulp and reaches till the gums, your dentist will then have to extract the whole tooth. The final decision, whether to extract a tooth or treat it with a root canal treatment, is done after examining the extent of damage with the help of an X-Ray.

What happens if a fractured tooth goes untreated?

Well, if the fractured tooth is kept clean by adhering to proper oral hygiene, you can live with it for quite a long time without treating it; however, practically, it is quite hard to be compliant with oral hygiene practices. No, matter how careful you might be, there is always a chance for the bacteria to ooze in through the fractured space and cause infection followed by inflammation and aching teeth.

Can a fractured tooth repair itself?

Yes, a fractured tooth can repair itself only if the damage is minimal. If the tooth has a slight crack on the outer layer of the teeth and you do not feel any pain or sensitivity, then it can repair itself. This process is known as mineralization.

However, to be very sure about the extent of damage, it is always advised to check with your dentist.

4 - Disease in the Gums

Gum Disease

What happens if you have gum disease?

Gum disease is caused due to inflammation of the soft tissues and the bone, supporting the tooth. A bacterial infection is responsible for the inflammation. The bacteria stick around the teeth and inside the cavities present around the teeth. In response, our immune system reacts against the bacteria and cause inflammation.

There are two types of gum diseases:-

1. Gingivitis

It is an early stage of the gum infection and typically goes unnoticed; however, if treated well on time, it can be treated easily. Therefore it is recommended to meet your dentist at least twice a year for a dental health checkup.3Gingivitis and periodontitis: Overview. (2020, February 27) Source - Pubmed

2. Periodontal Gum Disease

If gingivitis is not treated well on time, it results in Periodontal gum disease4Brazier, Y. (2018, January 18) Source - Medical News Today. It is the chronic inflammation of the soft tissues and bone supporting the teeth leading to a loss of the supporting bone and teeth.

  • Swelling in the gums
  • Bleeding in the gums while brushing/flossing your teeth
  • Loss of tooth
  • Sensitivity to food and drink
  • Foul breath
  • Loose tooth

Causes of Gum Disease 5Becker, D. E. (2007) Source - Pubmed 6Bharti, V., & Bansal, C. (2013, March)                       Source - Pubmed 7Patil, S. N., Kalburgi, N. B., Koregol, A. C., Warad, S. B., Patil, S., & Ugale, M. S. (2012, April) Source - Pubmed 8Da Silva, M. K., De Carvalho, A. C., Alves, E. H., Da Silva, F. R., Pessoa, L. D., & Vasconcelos, D. F. (2017) Source - Pubmed9Llambés, F., Arias-Herrera, S., & Caffesse, R. (2015, July 10) Source - Pubmed

  • Smoking
  • Vitamin C deficiency
  • Antianginal and Anticonvulsant drugs
  • Changes in the hormones during the menstrual cycle, puberty, and pregnancy
  • Genetic factors
  • Diabetes

Can gum disease be cured?

Well, the answer is a conditional yes. Early diagnosis of gum disease (gingivitis and periodontists with minor surgeries), can be cured

Following are the techniques that your dentist will use for the treatment10InformedHealth.org Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006                         Source - Pubmed:-

  • Scaling
    Scaling is a technique in which the dentist removes calculus and plaque from the teeth. If the gum disease is caused due to calculus or plaque, your dentist might decide to treat it, using scaling technique.
  • Surgery
    If gum disease has progressed from gingivitis to periodontal gum disease, surgery may be required to stop the further spread of infection and also replace the lost tooth.
  • Mouth Rinse
    A mouth rinse shall be prescribed to disinfect your teeth from time to time.

5 - Temperature Sensitivity

Temperature Sensitivity

Episodes of discomfort, when your tooth or teeth comes in contact with food, drinks, cold or warm air, is characterized as temperature sensitivity11Miglani, S., Aggarwal, V., & Ahuja, B. (2010, October)                         Source - Pubmed. It is also known as Dentin Hypersensitivity. It causes extreme pain in the tooth and may lead to headaches12Renton, T., & Wilson, N. H. (2016, May)                         Source - Pubmed. It is caused due to the erosion of the enamel leading to the exposure of dential tubules to  food, drinks, cold or warm air13Davari, A., Ataei, E., & Assarzadeh, H. (2013, September)                         Source - Pubmed

  • Toothache
    Continuous exposure of the tooth or teeth to change in temperature causes neurogenic inflammation14Le Fur-Bonnabesse, A., Bodéré, C., Hélou, C., Chevalier, V., & Goulet, J. (2017, December 15)        Source - Pubmed and hence results in toothache
  • Mild Headache
  • Sensitivity to following triggers15Davari, A., Ataei, E., & Assarzadeh, H. (2013, September)                        Source - Pubmed

  1. 1
    Warm/Cold air
  2. 2
    Mouthwash containing alcohol
  3. 3
    Hot/cold food
  4. 4
    Hot/cold drinks
  5. 5
    Sweet/acidic foods
  6. 6
    Toothpaste
  • The wrong technique of tooth brushing
  • Use of extremely hard toothbrush bristles
  • Teeth grinding
  • Excessive consumption of acidic food like sugar, processed food, dairy products, soda, and artificial sweeteners, fish16D;, O. S. (2017)        Source - Pubmed
  • Dental Treatment like excessive scaling, sometimes before final crown placement and bleaching
  • Decayed tooth
  • Tooth Fracture
  • Gum disease (Gingivitis and Periodontal gum disease)
  • Esophageal acid re-flux
Can I follow Home Remedies to Treat Temperature Sensitivity?

The answer is conditional yes. Home remedies for dental pain can help you temporarily however for a permanent relief/treatment it is strongly advised to visit your dentist.

Does tooth sensitivity to cold mean root canal always?

Tooth sensitivity always does not mean that the treatment shall involve root canal treatment. If the tooth sensitivity is mild, your dentist can recommend: -

  • to use a toothpaste made for sensitive teeth
  • to use alcohol-free mouthwash
  • to use a toothbrush with soft bristles
  • teach proper brushing technique
  • prescribe desensitizing agents
  • to use teeth guard if the tooth sensitivity is due to teeth grinding
Dental Treatment if Tooth Sensitivity is Chronic

If the tooth sensitivity is not mild, your dentist, depending upon the reason of the teeth sensitivity may use:-

  • Laser Treatment17Lan, W., And, Liu, H., & LIU., W. L. (2009, April 29)        Source - Libertpub
  • Root Canal treatment
  • Use of grafts and sealants

6 - Teeth Grinding (Bruxism)

Teeth Grinding (Bruxism)

Teeth grinding or bruxism is defined as the attrition and flattening of the teeth. It is caused due to clutching of the teeth and tightening of the jaw together. In the majority of cases, the patients happen to grip their teeth while they are asleep.18Sutin, A. R., Terracciano, A., Ferrucci, L., & Costa, P. T. (2010, June)                        Source - Pubmed

What is grinding your teeth a sign of?

Teeth grinding or bruxism is a sign of stress, anxiety, anger, and concentration. Whenever either of these emotions is expressed, patients tend to clench their teeth and jaw.

Symptoms of Teeth Grinding (Bruxism)19Murali, R. V., Rangarajan, P., & Mounissamy, A. (2015, April)                       Source - Pubmed

  • Tooth sensitivity
  • Toothache
  • Pain in facial muscles
  • Stiffed and painful jaw
  • Pain in the ear
  • Attrition in the teeth
  • Recession of gums
  • Chipped teeth
  • Inadequate sleep
  • Mobility in teeth
  • Stress, anxiety, and anger
  • Subconscious involuntary teeth and jaw clenching activity
  • Genetically inherited from parents
  • Alcohol and caffeine
  • Medications
    - Dopamine antagonist
    - Dopamine agonist
    - Amphetamines
    - Antidepressants
  • Trauma
  • Down syndrome
  • Parkinson disease

Can bruxism be cured?

There is no direct cure for teeth grinding, dentist, however, recommend the use of teeth guard, also called as occlusal splints. Its use will avoid the contact of the upper teeth with the lower and thereby prevent the attrition of teeth

How do I stop20Yap, A. U., & Chua, A. P. (2016)  Source - Pubmed grinding my teeth in my sleep?

  • Avoid alcohol/caffeine in the night
  • Try to holiday as it will reduce stress and anxiety and thereby reduce the chances of teeth grinding
  • Bath before sleep will help you manage your stress and anxiety
  • Use teeth guards

7 - Damage in Dental Filling

Damaged Dental Filling

Dental fillings are used by the dentists to seal the exposed inner cavity/pulp. With time, the dental filling may get damaged, leading to the exposure of the internal cavity to bacteria, food, and temperature, and as a result of which you may experience aching teeth.

Can you damage a filling?

Yes, dental filings can get damaged due to a sudden force. Biting a hard/crunchy food item, teeth grinding, or trauma can cause your dental filling to wear and tear.

How can you tell if a filling is bad?

If your dental filling is in the initial stage of wear and tear, typically, it might be difficult for you to judge; however, your dentist can quickly find it out. This is the reason it is advised to visit your dentist at least twice a year for a dental health checkup.

On the contrary, If the dental filling has progressed to stage two of wear and tear, you will start feeling shooting pain in the tooth. Further, you shall notice a change in the surface of the tooth.

  • On and Off episodes of a throbbing toothache
  • Tooth sensitivity
  • Feeling of void in the tooth when touched with tongue
  • Mobility in tooth
  • Acute pain resulting in headache
  • Difficulty in brushing your teeth
  • Trauma
  • Excessive consumption of acidic food
  • Alcohol
  • Applying excessive pressure on the tooth (that has dental filling) while chewing
  • Poor oral hygiene
  • Improper brushing technique
  • Amalgam Allergy (Allergy to metal) 21Sjursen, T. T., Lygre, G. B., Dalen, K., Helland, V., Laegreid, T., Svahn, J., . . . Björkman, L. (2011, November) Source-Pubmed

In case if you experience the symptoms, as discussed, please schedule a visit with your dentist as soon as possible as an open cavity is vulnerable to bacterial infection and tooth decay.

Your dentist will, first of all, take an X-Ray to check the extent of the damage. After that, the procedure to seal the open cavity would start.

However, if the dentist feels that the cavity might have got exposed to bacteria, then he might consider cleaning up the hole and then seal it back. Further, a 5-day antibiotic course shall be prescribed to subside the bacterial infection.

8 - Wisdom Tooth Pain

Wisdom tooth is the last permanent tooth to erupt after the age of 17. These are four in number. Since wisdom teeth are located in the farthest back; therefore, it becomes quite challenging to brush or floss, and thus it becomes a vulnerable place for bacteria to grow.

Can wisdom teeth cause tooth pain?

Wisdom Tooth Pain

If a wisdom tooth tries to come to light in an oblique angle or tries to emerge in through a very tight space, it causes a severe toothache. As highlighted in the image above, the pain is felt on the backside (to be very specific – 3rd molar region)22Renton, T., & Wilson, N. H. (2016, August)                                Source-Pubmed

If by any chance, the wisdom tooth comes out, having the condition as specified, it will cause inflammation and colossal discomfort.

  • Pain in the Jaw
  • Inflammation in the gums
  • Difficulty in opening the mouth
  • Difficulty in chewing food
  • Bleeding in the gums
  • Foul breath
  • Pericoronitis

When the gums and the tissues around the emerging wisdom tooth become inflamed and infected, the condition is called pericoronitis. If the infection is not stopped, it can lead to the death of the patient.

  • Angular growth of the wisdom tooth
Wisdom Tooth Pain
  • Lack of space for the growth of wisdom tooth
  • Trapping of the growing wisdom tooth inside supporting bone

If your pain is severe and is accompanied by the following clinical conditions, your dentist might decide to extract the developing wisdom tooth:-

  • Damage to the neighboring teeth
  • The decay of wisdom tooth present above the gums
  • Tumor or cyst in the developing wisdom tooth
  • Pericoronitis

An X-Ray is taken before starting the procedure followed by anesthesia.

Post-procedure, a pain killer and antibiotic, is prescribed to subside post-surgery pain and infection. For pericoronitis, metronidazole, 200gms thrice a day for three days is recommended.

 How long does wisdom teeth pain last?

The wisdom tooth pain, post-extraction lasts for 5 – 15 days, depending upon age and gender23Park, W., Park, I. K., Shin, K. S., & Choi, E. J. (2019, August) Source-Pubmed.


References

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    Sanders, J. L. (2019, November 27).
    Dental Abscess
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    Cracked tooth diagnosis and treatment: An alternative paradigm.
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    Periodontitis: Treatment, home remedies, and symptoms.
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    Drug-induced gingival overgrowth: The nemesis of gingiva unravelled.
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    Patil, S. N., Kalburgi, N. B., Koregol, A. C., Warad, S. B., Patil, S., & Ugale, M. S. (2012, April).
    Female sex hormones and periodontal health-awareness among gynecologists - A questionnaire survey. 
    Retrieved August 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723266/)
  8. 8
    Da Silva, M. K., De Carvalho, A. C., Alves, E. H., Da Silva, F. R., Pessoa, L. D., & Vasconcelos, D. F. (2017). Genetic Factors and the Risk of Periodontitis Development: Findings from a Systematic Review Composed of 13 Studies of Meta-Analysis with 71,531 Participants. 
    Retrieved August 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424192/
  9. 9
    Llambés, F., Arias-Herrera, S., & Caffesse, R. (2015, July 10).
    Relationship between diabetes and periodontal infection.
    Retrieved August 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499526/
  10. 10
    InformedHealth.org Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Gingivitis and periodontitis: Overview. [Updated 2020 Feb 27].
    Retrieved August 28, 2020 Available from: https://www.ncbi.nlm.nih.gov/books/NBK279593/
  11. 11
    Miglani, S., Aggarwal, V., & Ahuja, B. (2010, October).
    Dentin hypersensitivity: Recent trends in management.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010026/
  12. 12
    Renton, T., & Wilson, N. H. (2016, May).
    Understanding and managing dental and orofacial pain in general practice.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838424/
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    Davari, A., Ataei, E., & Assarzadeh, H. (2013, September).
    Dentin hypersensitivity: Etiology, diagnosis and treatment; a literature review.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927677
  14. 14
    Le Fur-Bonnabesse, A., Bodéré, C., Hélou, C., Chevalier, V., & Goulet, J. (2017, December 15).
    Dental pain induced by an ambient thermal differential: Pathophysiological hypothesis.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736355/
  15. 15
    D;, O. S. (2017).
    The relationship between dentine hypersensitivity, dietary acid intake and erosive tooth wear.
    Retrieved August 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/29017845/
  16. 16
    Lan, W., And, Liu, H., & LIU., W. L. (2009, April 29).
    Treatment of Dentin Hypersensitivity by Nd:YAG Laser.
    Retrieved August 29, 2020, from https://www.liebertpub.com/doi/abs/10.1089/clm.1996.14.89
  17. 17
    Sutin, A. R., Terracciano, A., Ferrucci, L., & Costa, P. T. (2010, June).
    Teeth Grinding: Is Emotional Stability related to Bruxism?
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2934876/
  18. 18
    Murali, R. V., Rangarajan, P., & Mounissamy, A. (2015, April).
    Bruxism: Conceptual discussion and review.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439689/
  19. 19
    Yap, A. U., & Chua, A. P. (2016).
    Sleep bruxism: Current knowledge and contemporary management.
     Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5026093/
  20. 20
    Sjursen, T. T., Lygre, G. B., Dalen, K., Helland, V., Laegreid, T., Svahn, J., . . . Björkman, L. (2011, November).
    Changes in health complaints after removal of amalgam fillings.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229679/
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    Renton, T., & Wilson, N. H. (2016, August).
    Problems with erupting wisdom teeth: Signs, symptoms, and management.
    Retrieved August 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979926/
  22. 22
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    Post-extraction pain in the adjacent tooth after surgical extraction of the mandibular third molar.
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This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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