Count yourself lucky if you’ve never experienced a severe toothache. Toothache pain ranks high on the list of excruciating, intolerable pain because it originates in the soft center of your tooth (the pulp) where nerves reside.
Though you should schedule a checkup for a dull toothache or one that comes and goes, that type of pain can wait a day or two. A severe toothache, and especially a horrible toothache together with a fever, is a dental emergency.
At Dentistry With a Smile in Livingston, New Jersey, Maria Victoria Sebastian, DDS, specializes in emergency dentistry and understands the urgency of treating a severe toothache. If you need immediate dental care, call our office right away or walk in during regular business hours and our team will quickly screen your symptoms and take care of your tooth.
Toothaches occur when you have a deep cavity or the pulp inside your tooth develops an infection and becomes inflamed. Normally, your enamel protects the inner tooth, but cavities, a cracked or chipped tooth, gum disease, or dental trauma let bacteria get through the enamel and into the pulp.
The pulp is located in a tiny space in the center of your tooth and runs down a canal in the middle of each tooth root. From there, the nerves leave your tooth and travel to your brain, where they deliver pain messages.
These nerves are incredibly sensitive and exist to sense pain. Because they’re tucked inside a small space restricted by hard tissues, nerve inflammation can’t expand into the surrounding spaces, so the increasing inflammation causes pressure. This pressure pushes the nerves against the hard tissues, causing more pain than you would have from inflammation alone.
Another complication arises because dentin — the layer of hard tissue between your enamel and pulp — contains microscopic tubules running from the outer enamel to the inner pulp. These tiny tubes can accelerate decay and amplify pain from a pulp infection.
There are three reasons you should consider a severe toothache to be an emergency:
You will quickly discover that an infected (or damaged) tooth is exquisitely sensitive to touch and temperature. You’ll have a hard time biting, chewing, drinking, or brushing because it hurts too much to touch your tooth.
You should never wait for the pain to get better. An over-the-counter pain reliever may take the edge off your pain, but it won’t go away. Once an infection develops in your tooth, it doesn’t heal on its own. The only way to get relief is to seek immediate dental care.
By the time you have a severe toothache, you either have extensive tooth decay and/or a serious pulp infection. The longer they go untreated, the higher your risk of losing your tooth.
Tooth decay weakens the enamel, potentially causing your tooth to crack or break apart. A pulp infection causes a different problem. Inflammation from the pulp spreads into your gums and jawbone, where it quickly erodes the tissues. Without prompt treatment, you can have such extensive bone damage that your tooth loosens and falls out.
A pulp infection can also get into your bloodstream, carrying bacteria throughout your body. Dental bacteria are closely associated with chronic health conditions like heart disease, high blood pressure, type 2 diabetes, bronchitis, and liver disease.
You may be able to soothe your pain a little by rinsing with warm water and applying a cold compress to your cheek over the aching tooth. You can also take ibuprofen (or ibuprofen and acetaminophen) to ease your pain and reduce inflammation.
However, don’t put aspirin or pain relievers against your tooth. They may contain ingredients that damage your gums.
You should also be careful to follow the dosing directions on the package. Exceeding the dose for too long can lead to complications. For example, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) capable of causing peptic ulcers, liver disease, and heart problems when used excessively.