Why the tooth hurts? Usually the reason for toothache is one of the four causes: dental caries or cavity, dental nerve inflammation, tooth root tip inflammation or gum inflammation.
Dental caries i.e. cavity
Dental caries is an infectious disease caused by microbes that live in the oral cavity. Microbes produce acids from food sugars that damage the teeth.
These microbes can colonize the teeth at an early age, when the first teeth come and a suitable surface for adhesion appears. Origins of the infection are mostly parents who clean pacifiers in their mouth, feed the baby with their spoon or kiss the children on the mouth.
Four concomitant factors are needed for a cavity to develop:
- a tooth, that the microbes can adhere to,
- microbes that cause dental caries, without which no cavities develop,
- carbohydrates (food), out of which microbes produce acids,
- time, so that the acids produced by the microbes could affect the enamel. This means that the more frequently a person eats, and the less he cleans the teeth of the food residues, the faster the cavities occur.
Dental nerve inflammation
Dental nerve inflammation develops usually when the dental caries is left untreated. Small cavity becomes a deep hole through which microbes causing the inflammation reach the dental nerve. This inflammation can be acute (with strong pain) or chronic (with mild symptoms).
Tooth root tip inflammation
If the dental nerve inflammation is not treated at the time of symptoms, the nerve shrivels and the microbes reach the bone tissue surrounding the tooth root through the tip aperture. An inflammation of the surrounding tissues of the root tip develops. This inflammation can also be acute with pain or chronic.
If the tooth hurts and is sensitive under chewing pressure, it could be the result of acute tooth root tip inflammation. At the beginning the pain is constant and throbbing and it is evident which tooth causes the pain. As the inflammation progresses, the pain goes stronger and may radiate to the adjacent teeth. The gums in the root tip area are flushed and swollen. An abscess can form in the gum. Malaise and fever may accompany.
The course of chronic tooth root tip inflammation can be without recognizable symptoms. This kind of inflammation usually does not cause pain. In some cases, a fistula can occasionally form in the gingival root tip area, from which a small amount of pus is secreted. The existence of such inflammation can be determined with X-ray and it needs treatment, regardless of whether the tooth hurts or not. The existence of a constant inflammation is especially dangerous to people suffering from cardiovascular diseases or who are with artificial joints. Therefore the teeth need to be checked and treated on a regular basis by a dentist.
Sometimes gingivitis can be the cause of pain. Development of gingivitis is directly connected to oral hygiene. The microbes in the plaque irritate the gums and cause inflammation, redness, bleeding, itchiness and pain.