Toothache

When a toothache begins, this is usually a sign that the nerve of the tooth is affected. This can be due to a transient, temporary nerve inflammation which manifests itself as sensitivity to hot or cold, lasts a short time and is only present when provoked. Toothache can also present as a throbbing, constant pain that may or may not respond to hot temperature and usually gets worse when pressure is applied to a particular tooth. This longer lasting discomfort is usually a sign of permanent nerve damage.

Temporary nerve inflammation can occur when inside of a tooth is exposed to the outside environment, through a fracture of tooth structure or a filling. Permanent nerve inflammation is most likely due to a serious tooth infection, either through a neglected tooth cavity or tooth decay that has set in under a filling.
If a toothache is of a serious, permanent nature, the only way to treat it is to either remove the infected nerve inside the tooth (i.e. complete root canal therapy of the affected tooth) or the infected tooth as a whole. There are advantages, disadvantages and risks and benefits associated with both of these treatment options. We will present you with clear explanations of both treatments, risks versus benefits and costs, before we commence treatment.

TOOTH SENSITIVITY

Tooth erosion and abfraction from clenching and grinding is the most common cause of tooth sensitivity. Teeth can become sensitive to cold, hot or sweet food and drinks. This usually occurs if the dentine (part of tooth underneath the hard enamel) is exposed to the outside environment. Sensitivity is not always related to toothbrush abrasion. Teeth can become sensitive when a medium or a hard toothbrush is used, in conjunction with extra abrasive toothpaste. Enamel is thinnest in this area of the tooth, so dentine is easily exposed. This creates yellowish defects on teeth surfaces and causes sensitivity. Whereas this damage cannot be reversed, it is easily preventable and easily arrested by switching to a soft toothbrush, using the appropriate cleaning technique, using gentler toothpaste and wearing an oral splint while sleeping.

FRACTURED TEETH OR FILLINGS

Heavily filled teeth and large fillings can break after extensive use. Sometimes, cracked teeth can cause an ambiguous, unlocalized toothache, months before they fracture. This is known as the cracked cusp syndrome. We can diagnose deteriorating, cracking restorations and teeth before they fracture, develop decay or cause pain. We may need to replace them or cover them with a crown.

 *Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.