As I’ve mentioned before, there are a lot of things that can cause a tooth to hurt.  Last week I discussed dental pain caused by decay or gum disease.  It seems like this would be enough, but unfortunately there are other causes to dental pain that we need to evaluate.

Cracked Tooth Syndrome

If too much force is exerted on a tooth or it has a large filling, there is a strong possibility of cracking the remaining tooth structure.  Every week I see several people who have chipped, cracked or split their tooth.  Often there are warning signs of a crack.  A “craze line” will often appear on the tooth that can be seen by your dentist.  It looks like a small crack line and can occur on any surface of the tooth.  If a tooth is actually cracked, it will typically hurt when you bite on something.  The pain is usually worse when you release the biting force and will last for a very short period of time.  If you notice this, don’t ignore it and go see your dentist!  If the crack extends to the nerve of the tooth, an abscess that creates a lingering, more intense pain may occur.  If this does happen the treatment of choice would be a root canal.  If the tooth actually splits, there is little to do but remove the tooth.  At any stage, you can have pain with the tooth.

Sinus Infections

Allergies, colds, the flu and sinus infections are just a few of the situations where the maxillary sinuses (right under your cheek bones) can become infected or inflamed.  The roots of the upper molars are very close to, and in some cases, actually in the sinuses.  The sinuses can transmit the inflammation to the nerves of the teeth and make it feel like you have a toothache.  Typically, it is a generalized discomfort that makes it difficult to designate a single specific tooth that hurts.  I often have people come in complaining of a toothache, only to find that their sinuses are actually the problem and their teeth are fine.  Allergy medications or antibiotics are typically all that is needed to alleviate the discomfort in the tooth.

Referred muscular pain

Believe it or not you can get a referred pain from muscles of the face to the teeth.  People who clench and grind their teeth not only cause damage to the teeth and supporting structures, they also “overwork” the muscles and can cause spasms.  Think of it as a “charlie horse” in your jaw.  For instance, a spasm in the masseter muscle (if you put your hands on the side of your face and squeeze your teeth together, the muscle that bulges on each side is the masseter) can refer pain to the lower first molars.  Other muscles will refer pain to different teeth in the mouth.  Moist heat and anti-inflammatory medication are the treatment required to alleviate the symptoms.

As you can see, there are several causes of pain in a tooth.  Don’t ignore pain in your mouth, it may be something simple, but then again – it may not!  Prevention is the key.  The vast majority of dental disease (and pain!) is preventable, yet only 50% of the population sees the dentist on an annual basis.  Don’t be part of the percentage that neglects your teeth, your smile will appreciate it!