The five common causes of dental pain are as follows:
- A hole in the tooth
- An infection in the tooth
- An infection in the gum
- Dental trauma
Sensitivity occurs when the tooth structure below the enamel is exposed. The most common way this happens is from brushing away the gum next to the base of the tooth from using a hard or medium toothbrush, pushing too hard with an electric toothbrush, or brushing too vigorously. I commonly see this condition with people who have very good oral hygiene!
Sensitive teeth normally aren’t painful unless cold air or water touches the sensitive part of the tooth. It is usually a sharp pain that goes away very quickly when the cold or other stimulus is taken away.
This is not a serious condition and can be resolved by using a desensitizing toothpaste like sensodyne, switching to a soft toothbrush, and not brushing so hard. If this doesn’t help after a few days, you should see your dentist.
A hole in the tooth
If the hole is on the chewing surface of the tooth or on the front of the tooth you may be able to feel and see the hole. However, often the hole is between the teeth and you will have no idea you have a hole there until the hole is close enough to the nerve inside the tooth to cause pain.
If the pain is only when drinking cold drinks and sweets, then the hole is unlikely very deep and you will only need a filling. However, if the pain is severe, painful to hot and cold and lingers after the cold or hot is no longer there, or it hurts for no apparent reason, especially at night, then you will likely need a root canal or have the tooth taken out. A root canal is where the dentist takes the nerve out of the tooth allowing you to keep the tooth.
An infection in the tooth
When a hole in the tooth gets all the way to where the nerve is, the whole tooth becomes infected. It can also spread to the bone next to the tooth and sometimes even to other parts of the body. This is a potentially serious condition and you need to see a dentist. The dentist will need to either take the tooth out or you will need a root canal.
When an infection gets to the nerve it is often VERY painful and you will want to see a dentist without being told to. However, this is not always the case. I have seen many people who have had teeth get holes all the way to the nerve without ever being in pain and the only reason they are there is because they can taste the infection. It is also common to never feel the tooth hurt until it gets to the bone under the tooth and then it hurts when biting on the tooth. Even if there is no pain, you should stills visit your dentist as it is not wise to leave an infected tooth untreated in your mouth as you can potentially become very unwell if the infection spreads to other areas of your body.
An infection in the gum
A lot of people, particularly smokers and those who don’t clean their teeth very well, develop a long standing, low level infection in the gum that has no symptoms until the disease is quite advanced. Usually the person with this condition is blissfully unaware they even have the disease and they feel no pain. However, sometimes there can be a flare up of this infection and will require treatment with antibiotics to lessen the infection and relieve the pain. You need to see a dentist if you think you have an infection in your gum.
If you hit your tooth very hard the tooth will usually hurt for a few days just from the shock to the
nerve within the tooth. If there is no visible damage to the tooth and the tooth is still in the same position in your mouth, the tooth will not be painful in about 3-4 days. However, it is still wise to see a dentist and get it checked out to be sure. Obviously if the tooth is visibly damaged or in a different position or has darkened, you should see a dentist.