88: Excruciating Tooth Pain: What To Do Next

Tooth pain occurs when the nerve in the roots of your tooth is irritated (1). A throbbing toothache is one of the most excruciating pains you can endure. When you experience it, the first thing you need to do is to visit a dentist.

Although most people know about this, what would happen if you can’t see a dentist immediately? How can you dial down the pain? How can you manage it until your next appointment? This article shall answer these questions. You shall also learn what you should avoid while you wait to see the dentist.

Determine The Cause First

There is a myriad of things that cause toothaches, with the most common ones being;

Tooth decay

Tooth decay refers to the erosion of the enamel (the hard layer that protects the insides of the tooth). When plaque builds up on the tooth’s surface, it breaks down starch and sugars from food particles in the mouth. This process produces a mild acid, which erodes the enamel. Over time, the enamel weakens and develops holes. As the erosion progresses and gets deeper into the dentin (the middle layer of the tooth), you begin to experience tooth sensitivity to touch and sudden temperature changes.

Damaged filling

You can damage a tooth filling through normal chewing and biting by clenching and grinding your teeth, or by biting hard objects. When you do any of these, the filling may:

  • Pop out
  • Wear away
  • Crack
  • Chip
  • Crumble

Tooth fracture

A tooth fracture is a split or a crack in the tooth. It can occur when you bite a hard object like ice or a piece of hard substance in your food, such as an olive stone. You can also get a tooth fracture when you fall and hit a hard surface with your face or jaw. In some other instances, tooth fractures develop slowly and over a long period.

Tooth fractures cause throbbing pain and allow debris and bacteria to gain access to the pulp. These infect and irritate the nerves and pulp, which causes pain.

Infected gums

A gum infection (gingivitis) can cause periodontitis. This, in turn, can cause tooth loss, especially in adults. Gum infections are often caused by;

  • Poor diet
  • Hormonal changes
  • Poor oral health
  • Health conditions, including diabetes (2)
  • Smoking
  • Cancer and its treatments
  • Genetics

The bacteria from the infected gums builds up around the roots of your tooth. This build-up eventually causes gum tissue infection which in turn causes toothache.

Abscessed tooth

This occurs when part or all of the tooth pulp dies. The dead tissue creates a home for pus and bacteria. Tooth infection often causes an abscess. (3)

Warning signs of an inflamed/infected tooth

  • Sensitivity to cold and hot temperatures
  • Persistent throbbing toothache radiating to the jawbone, ear, and neck or head
  • Sensitivity to pressure when biting or chewing
  • Fever
  • Difficulty swallowing or breathing
  • Swollen and tender lymph nodes under the jaw

tooth pain

Top Three Ways To Treat Excruciating Toothache

As you prepare to see your dentist, you can use these simple home remedies to provide short term relief from the pain.

Ice pack

An ice pack can help ease tooth pain. This home remedy is especially useful if the toothache is caused by swollen gums or an injury. Try holding the ice pack against your cheek (right above the painful tooth) for several minutes during each round. The cold from the ice pack will constrict blood vessels and slow down blood flow to the affected region. This aids in numbing the tissue to the pain and reducing inflammation. It also aids in reducing swelling, if present.

Over the counter anti-inflammatories

Anti-inflammatories such as naproxen and ibuprofen work great against toothaches. They work to reduce inflammation of the affected tooth and the surrounding gum tissue. When using these OTC drugs, be sure to adhere to the specified dosage.

Over the counter anesthetic agents

You can apply the pain-relieving liquids or gels directly to the sore tooth and the surrounding gums. They contain benzocaine, which numbs the mouth for some time. Bear in mind that these anaesthetics are designed to provide short term relief only.

Other Possible Home Remedies

Salt water rinse

You can rinse your mouth with some warm, salt water. The solution helps dislodge debris stuck between your teeth and in cavities. It also helps to reduce swelling, relieve your sore throat and encourage healing.

You can prepare your saltwater rinse by dissolving a teaspoon of salt in a glass of warm water. You need to swish around the solution in your mouth for 30 seconds and then spit it out. Repeat this process as often as you find it necessary.

Clove oil

Clove oil naturally numbs the pain. To use it, rub it directly on the affected tooth and surrounding gums.

Things to avoid if you cannot see your dentist immediately

Hot or cold food and beverages

The dentine is sensitive to hot and cold temperatures. Imagine what these would do to your pulp? Hot and cold beverages and foods will only make things worse. If you are going to drink or eat, wait for your food to get to room temperature.

High sugar or acidic foods and beverages

High sugar and acidic beverages and foods act as fuel to bacteria, causing you further tooth pain. Until your toothache is sorted, avoid sugary foods and drinks.

Sleeping With A Toothache

If you have to go to sleep with a toothache, here are some things you can do to make the night bearable:

If the toothache is caused by swelling, you should rest with your head above your heart. This position will prevent blood from pooling in your neck and head and increasing pressure and pain.

If it is caused by an infection, rinse your mouth with salt water or use clove oil. These solutions will help kill bacteria.

Overall, you should watch what you eat before you sleep. Stay away from sugary foods and hot/cold foods and beverages.

What To Expect At The Dentist (Treatment Options)

The dentist will first inject the tissue around the tooth with an anaesthetic to try and relieve the pain. If there is some swelling or fever, they will prescribe some antibiotics.

Once the infection, swelling, and fever are gone, the dentist will pull out the tooth, conduct a root canal treatment or perform a filling. The procedure chosen depends on the cause of the pain and the extent of tooth damage.

Ways to prevent tooth pain

The best way to avoid a toothache is by keeping your gums and teeth healthy. You can achieve this by;

  • Reducing your intake of sugary and acidic foods
  • Not smoking
  • Brushing and flossing regularly
  • Having regular dental checkups
  • Brushing your teeth using fluoride toothpaste twice daily

It’s unfortunate to experience toothache when you can’t see a dentist immediately. But when it happens, now you know what to do to manage the pain. But generally, the best way to avoid finding yourself in such a position is to maintain excellent oral hygiene and regular check-ups at your dentist.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb
Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.